Author

Brook Raflo

  • Legislation & Regulation

    House Passes $93 Billion in Medicaid Cuts, Final Budget in Conference

    Washington By a vote of 215 to 212, the U.S. House of Representatives March 20 passed a 2004 budget resolution that contains approximately $93 billion in Medicaid cuts. Although the final resolution was less severe than its predecessor — which recommended $215 billion in cuts to both Medicaid and Medi-care — it still could hurt the home care industry, according to Seth Johnson, director of public policy at the American Association for Homecare. “These cuts would make it very difficult for our legislative proposals that cost any amount of money,” Johnson explained. Additionally, “programs like competitive bidding could be an alternative they would look at more closely.” AAHomecare’s hopes of defeating such cuts now rest in the Senate, where lawmakers passed a 2004 budget resolution...

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  • OIG Warns: No Telemarketing

    Washington For the second time this year, the U.S. Office of Inspector General has posted a special fraud alert concerning telemarketing and durable medical

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  • HME Products

    Sweet Success

    The good news for America’s 17 million diabetes sufferers is that the disease is no longer an early death sentence. Careful monitoring of blood glucose — and careful attention to the early warning signs of complications — can ensure a long, healthy life for people with diabetes. The bad news for diabetes-management advocates is that nearly 6 million Americans with diabetes do not even know they have the disease, according to the American Diabetes Association. Fortunately, clinicians and the federal government are beginning to understand the benefits of early diagnosis and disease management, and this growing awareness means huge opportunities for the manufacturers and providers of diabetes-management products. “Ten or 15 years ago, doctors were much more likely to tell someone, ‘You have only a...

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  • CMS/Medicare

    Medicare Funds Are Shrinking Quickly

    Washington By 2026, Medicare Part A will be insolvent, and the government’s expenditures for Medicare Part B will outweigh premiums by a ratio of four to one, according to a sobering report from Medicare’s Boards of Trustees. Each year, the trustees for Medicare’s Hospital Insurance and Supplementary Medical Insurance Trust Funds report to the U.S. Congress on the financial status of the funds. The HI fund lost ground this year, as hospital admissions increased and the Bureau of Economic Analysis predicted lower taxable wages, the trustees said. Similarly, the outlook for the SMI fund worsened, due to the rapid growth of Medicare Part B spending and the passage of reimbursement increases for physicians. “Over the next 10 years, the average annual increase in [SMI] benefit...

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  • Providers

    The MED Group Parts Ways With Invacare

    Lubbock, Texas After more than two decades of business dealings, The MED Group and Invacare have parted ways, for now, according to David Miller, MED’s chief executive officer. Miller insisted the decision not to sign a contract with Invacare “had nothing to do with a failure or breakdown,” despite unsubstantiated reports to the contrary that appeared last week in the trade press. Instead, MED based the decision solely on the results of a new “request for proposals” process, Miller explained. For the first time in MED’s history, the organization late last year asked vendors to submit contract proposals in 15 product categories. During the months of January and February, MED evaluated the proposals and negotiated with each of the potential vendors, attempting to find the...

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  • Providers

    Connaughton Explains Decision to Resign as AAHomecare President

    Alexandria, Va. After serving three years as the public face of the Ameri-can Association for Homecare, Tom Connaughton March 21 announced he will resign as president of the association, effective mid June, 2003. “This decision is indeed a bitter sweet one,” Connaughton told HomeCare. “I have loved working with this industry and with my staff, and I believe very strongly in the importance of this industry. However, an opportunity has arisen in a company that I have represented in the past, and, at this time in my career, it’s something that I want to do.” In his new position — at the helm of a medical manufacturer’s Washington office — Connaughton likely will not address home care issues, he said. Cook Group, based in Bloomingon,...

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  • CMS/Medicare

    GAO Paints Grim Medicare Picture

    Washington The nation’s two largest health insurers — Medicare and Medicaid — are in dire straits, in part because the government pays too much for Part B equipment and services, according to a Jan. 30 report from the U.S. General Accounting Office. Pointing to disparities between what Medicare pays for medical equipment and what other government agencies and private insurers pay, the report argues the need for a more-flexible reimbursement structure. “To lower unreasonably high payment rates, [the Centers for Medicare and Medicaid Services today] must follow a lengthy and complicated regulatory process for making payment adjustments,” the GAO said. But that process will change as of Feb. 11, 2003, when a rule outlining CMS’ expedited payment-adjustment authority — the “inherent reasonableness” rule — becomes...

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  • Legislation & Regulation

    Bush Proposes Medicaid Overhaul

    Washington One day after the U.S. General Accounting Office added Medicaid to its 2003 list of “high-risk” programs, the Health and Human Services Department Jan. 31 unveiled a plan for sweeping Medicaid reform. As many state governments are facing the worst budget shortfalls since World War II, the Bush administration is proposing a cash infusion for states that choose a new, more-flexible Medicaid option. Instead of matching state Medicaid expenditures, this option would provide for two annual federal allotments: one for acute-care health insurance and one for long-term care and community services. It also would give state officials the flexibility to adjust and/or cut benefits to “non-mandatory” Medicaid populations, such as elderly Americans receiving institutional care. In exchange for choosing this flexible option, states would...

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  • CMS/Medicare

    Scully: Spending Report Signals Need for Medicare Reform

    Baltimore Not only is health care spending growing, but it is growing at an accelerated rate, according to a Jan. 8 report from the Centers for Medicare and Medicaid Services. Americans and the federal government spent $1.4 trillion on health care during 2001, an 8.7 percent increase, compared to spending during 2000. Public health care spending — which accounted for nearly half of the total — jumped 9.4 percent, as Medicare reimbursements increased and Medicaid rosters grew. “Legislation [including the Benefits Improvement Protection Act of 2000] added $7.5 billion to total Medicare spending in 2001,” the report said. Increasing at its fastest rate since 1993 — 10.8 percent — Medicaid spending soared to $224.3 billion during 2001. The report attributed this growth to an 8.5...

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  • Legislation & Regulation

    Bush’s Budget to Fund Shift to Home Care

    Washington As the nation waited anxiously to hear the President’s Jan. 28 State of the Union Address, administration officials provided a sneak preview of Bush’s 2004 budget proposals. Health care highlights included a $1.75 billion program to help disabled elderly people make the transition home from an institution, a plan to restructure Medicare, and a boost in funding to address chronic diseases such as asthma and obesity. Early in 2001, Bush announced a New Freedom Initiative, designed to help disabled Americans integrate more fully into society. To further this initiative, the 2004 budget will include a five-year, $1.75 billion program that will encourage states to revamp long-term care systems to provide more cost-effective choices between institutional and community-based care options. “The President and I are...

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