Court Approves Settlement with HHS Requiring Coverage For Maintenance Therapy Services [02-07-13]

Filed under: Industry Updates — Editor @ 9:58 am

Glenda JimmoA previous Marden Industry Update Post on November 12, 2012 reported on a proposed settlement with the U.S. Department of Health and Human Services (“HHS”) in a class-action lawsuit concerning Medicare coverage for medical rehabilitation services. The proposed settlement of the case, Jimmo et. al. v. Health and Human Services Secretary, was given final approval by Chief Judge Christina C. Reiss in the U.S. District Court in Vermont on January 24, 2013. Under the settlement HHS will be required to apply a revised standard when determining coverage for rehabilitation services.  This impacts all services settings including SNFs, outpatient clinics and home health. (more…)

Early Signs of Progress on A Permanent Fix for Physician Fee Schedule [02-06-13]

Filed under: Industry Updates — Editor @ 1:52 pm

House Speaker Boehner Presides Over Opening Session Of CongressThe very early days of the 113th Congress have witnessed several developments which may augur that Congress will finally make a concerted effort to enact a permanent solution to the nearly decade-long problems created by the Sustainable Growth Rate (“SGR”) formula for the physician fee schedule. Under current law, providers reimbursed under the fee schedule face a nearly 30 percent reduction in payments on January 1, 2014 unless Congress takes action to prevent it. The recent developments of significance are described below. (more…)

The Cost of Long Term Care [02-06-13]

Filed under: Industry Updates — Editor @ 12:34 pm

mapSquared Away used data from Genworth, one of the nation’s largest insurers in the long term care insurance market, to generate a U.S. map with the median cost in each state of a semi-private room in a nursing care facility in October of 2012.  Click on the map for a larger view.

Knee Surgery Looks No Better Than Therapy For Torn ACL [01-31-13]

Filed under: Industry Updates — Editor @ 2:45 pm

griffinkneeOne week after quarterback Robert Griffin III blew out his right knee in an NFL playoff game, fans’ questions  morphed from “How could this have happened?” to “When do we get him back?” But figuring out when an athlete with damaged knee ligaments can get back in action is an inexact art at best, because medicine has yet to come up with a solid way to fix a knee. What do you do? (more…)

HHS Reports Medicare Per Capita Spending Stagnant in 2012 [01-15-13]

Filed under: Industry Updates — Editor @ 2:54 pm

department_of_health_and_human_servicesOn January 10, HHS released a report showing per capita spending in the Medicare program increased by just 0.4% in FY 2012. The increase comes after a considerably larger per capita growth of 3.6% in FY 2011 and 1.8% in FY 2010. (more…)

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