CMS Seeking Comment on Durable Medical Equipment Interim Final Rule

CMS is seeking comments on an interim final rule that increases payments to suppliers for some DME and enteral nutrition in areas of the country that are not subject to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DEMPOS) Competitive Bidding Process (CBP). These include rural areas, and Alaska, Hawaii and the territories. From June 1 through December 31, 2018, payments will return to the blended rates that were in effect in 2016.

The change is in response to stakeholder concerns about significant financial challenges created by the current rates for suppliers, as well as concerns that the number of suppliers in certain areas continues to decline. It is projected to result in a $70 million dollar Medicare cost-sharing increase to beneficiaries. This increase may be covered by supplemental insurance programs like Medigap, and for dual eligible beneficiaries, Medicaid pays the cost sharing. However, beneficiaries who do not have supplemental insurance or who are not dual eligible will have increased cost sharing.

Full story at acl.gov

Congress voices concern over CMS’ response to nursing facility abuse

Republican lawmakers on Monday told the CMS they are concerned the agency may not be doing enough to prevent patient abuse in skilled-nursing facilities.

In a letter to CMS Administrator Seema Verma, members of the House Energy and Commerce Committee highlighted recent media reports describing instances of abuse, neglect and patient harm occurring at nursing facilities across the country.

“These reports raise serious questions about the degree to which the CMS is fulfilling its responsibility to ensure federal quality of care standards are being met, as well as its duty to protect vulnerable seniors from elder abuse and harm in facilities participating in the Medicare and Medicaid programs,” the letter stated.

Full story at Modern Healthcare

Life and death: Team finds hospital readmissions sometimes save lives

A group of Johns Hopkins physicians and researchers has published an article in the Journal of Hospital Medicine suggesting that data on mortality and hospital readmission used by the United States Centers for Medicare and Medicaid (CMS) suggest a potentially problematic relationship.

Daniel J. Brotman, M.D., and his colleagues examined three years of CMS’s publicly available data from hospitals across the US. They looked at nearly 4,500 acute-care facilities’ hospital-wide readmission rates and compared them with those facilities’ mortality rates in six areas used by CMS: heart attack, pneumonia, heart failure, stroke, chronic obstructive pulmonary disease (COPD) and coronary artery bypass.

The researchers found that hospitals with the highest rates of readmission were actually more likely to show better mortality scores in patients treated for heart failure, COPD and stroke.

Full story of hospital readmission and higher mortality rates at Science Daily

Risk factors for hospital readmissions identified

Hospital readmission, an important measure of quality care, costs the United States an estimated $17 billion each year. And according to the Centers for Medicare and Medicaid Services (CMS), about half of those readmissions could be avoided.

Therefore, there is significant interest in identifying factors that influence readmission rates, especially those that can be identified prior to discharge. To pinpoint which stroke patients are most at risk, researchers at Wake Forest Baptist Medical Center undertook a retrospective case-control study to determine factors associated with readmission within 30 days. The study is published in the June 11 online edition of the American Journal of Medical Quality.