CMS Names a Permanent Administrator

Marilyn Tavenner was named the first permanent CMS administrator since 2006 on Wednesday. Tavenner served as an acting administrator since late 2011 and received a 91-7 vote, according to Modern Healthcare. The former Virginia secretary of health and human services employee’s election follows a February nomination by President Barack Obama.

Cooper Institute’s FitnessGram Fights to Maintain Foothold

FitnessGram is under assault, as it seems to be every legislative session. FitnessGram measures a child’s fitness in several ways. It assesses students’ aerobic capacity and body composition as well as muscular strength, endurance, and flexibility. The tool—developed by the Dallas-based Cooper Institute and championed by Sen. Jane Nelson, R-Flower Mound—was implemented in the 2007-2008 school year. Originally, all students were required to be assessed in grades 3-12. The 2011 legislature limited FitnessGram only to students who were enrolled in physical education. Texas requires 30 minutes a day or 135 minutes a week of physical activity in elementary school and… Full Story

Changes to Program Integrity Manual May Benefit Medicare Providers

These days, if you are a Medicare provider, the phrase “lack of medical necessity,” most likely, makes you twitch with anxiety. That is because, for the past five years, Medicare auditing contractors (i.e., ZPIC, MAC, and RAC) have denied more Medicare Parts A and B claims for “lack of medical necessity” than for any other reason, thus costing providers hundreds of millions of dollars in free services and products. Importantly, claims denied for “lack of medical necessity” are rarely deemed fraudulent, but instead considered “technical violations.” The reason more claims are denied for “lack of medical necessity” than anything else… Full Story

Let’s Roll “Rolling Blackouts” out of Committee

The hospitals of North Texas thank State Senator John Carona (R – Dallas) for introducing Senate Bill 1139 this legislative session. This bill would exempt hospitals from rolling blackouts. In February 2011, North Texas hospitals were subjected to rolling blackouts without prior warning. Our community was lucky no one died, although hospitals had several close calls. The same laws and regulations exist today as in 2011, with no modifications to address what happened to area hospitals while performing surgery and treating trauma patients. Simply put, we need Senate Bill 1139 enacted into law to protect patients. The problem is the… Full Story

CMS Proposes DSH Cuts to Expand Medicaid

The Obama administration proposed a rule Monday that will cut Medicaid spending by reducing disproportionate share hospital (DSH) payments from fiscal year 2014 through fiscal year 2020. The DSH payments offer extra funding to hospitals that serve larger-than-average shares of low-income patients and uncompensated-care cases, according to Modern Healthcare. The Affordable Care Act (ACA) requires $18.1 billion in reductions to Medicaid DSH payments from 2014 to 2020. The cuts seek to offset the cost of increased Medicaid eligibility for legal residents with incomes of as much as 138 percent of the federal poverty level. Currently, federal poverty guidelines list $19,530 as the… Full Story

Texas End-of-Life Bill Pending in Senate

Controversy surrounds a Texas bill that would give doctors more leverage in making end of life decisions for patients. Senate Bill 303, which has been approved by Texas Senate and is currently pending in the House, allows doctors to withdraw life-sustaining treatments they deem medically futile. “Pro-life” advocacy groups vehemently oppose the legislation, which they fear has the potential to be abused by doctors, although the Texas Medical Association, the Texas Hospital Association and the Texas Alliance for Life support the bill. “Patients, not hospitals, are the ones who should be protected by legislation,” the Association of American Physicians and Surgeons said in an alert to… Full Story