KaiserNetwork Health Reports noted more troublesome news from HHS --
they are proposing reduced Medicare/Medicaid reimbursements for
"thousands of outpatient procedures." Among the proposed reductions are
reimbursements for treatments involving "new technology."
Unfortunately the article below is very vague about what "new
technologies" would be affected. For example, could this proposed rule
affect Medicare coverage of outpatient DBS adjustments and follow up
treatments?
The proposed changes should be on the Centers for Medicare and Medicaid
Services (formerly HCFA) web site tomorrow.
""The Federal Register will publish the proposed rule, CMS-1159-P, on
Aug. 24 . CMS will open the proposed rule to public comment until Oct. 3
(Washington Post, 8/21). To view the proposed rule on the CMS Web site,
go to
http://www.hcfa.gov/regs/cms1159p.htm."
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This story was sent to you from kaisernetwork.org Daily Reports.
Date: Thu, 23 Aug 2001 12:03:10 -0400
MEDICARE
"Medicare to Boost Reimbursement for Outpatient Services 2.3%, But May
Reduce 'Pass-Through Payments' for New Technologies, HHS Confirms
HHS announced yesterday that Medicare will boost reimbursement rates
2.3% for outpatient services in hospitals next year, but the agency also
may reduce payments for "certain drugs and medical devices," the
Washington Post reports.
Under a proposed rule issued yesterday, the Centers for Medicare and
Medicaid Services (formerly HCFA) may impose an "across-the-board
reduction" on payments for new medical technologies, which Congress
capped at 2.5% of total outpatient reimbursements in a 1999 law that took
effect last year (Washington Post, 8/21). CMS has "threatened to cut"
extra payments for new technologies by up to 80%. According to the
agency, "The information we have collected thus far suggests that a
significant reduction could be required for 2002." In "early agency
estimates," CMS found that Medicare spent $1 billion more than the $400
million limit that Congress set on extra payments for new medical
technologies (Bloomberg News, 8/20). An HHS spokesperson said that the
number of new medical devices has "roughly quadrupled" in the past year.
Experts Worry Cuts Could Drive Up Costs
Some medical experts have warned that limiting reimbursements for new
medical devices would force hospitals to admit more patients, which would
drive up Medicare costs (Washington Post, 8/21). Medicare provides
larger reimbursements for inpatient care (Kaiser Daily Health Policy
Report, 8/20). In addition, medical device manufacturers, including
Guidant Corp. and **Medtronic Inc., have lobbied to stop CMS from
"slashing the payments." Bloomberg News reports that reducing
reimbursement rates for medical devices may prompt hospitals to "stop
using the companies' latest products" to avoid financial losses. The
Federal Register will publish the proposed rule, CMS-1159-P, on Aug. 24
(Bloomberg News, 8/20). CMS will open the proposed rule to public
comment until Oct. 3 (Washington Post, 8/21). To view the proposed rule
on the CMS Web site, go to
http://www.hcfa.gov/regs/cms1159p.htm.
Information Gap?
In an editorial, the Los Angeles Times warns that a decision to reduce
Medicare payments for new medical devices "should be based on better
information" than CMS officials have used, adding, "Curbing costs is
good, but doing it with a bludgeon is not." The editorial points out
that the debate over the issue has "drawn attention to a long-ignored
flaw" in the U.S. public health system -- the "lack of any coherent
system for assessing what works, what gives the biggest medical benefit
for the buck." According to the editorial, "Making quality information
public pushes hospitals and doctors to focus on effective treatments and
reduce medical errors." The editorial points out that the proposed rule
faces "political trouble," concluding, "If the government had
better-quality information, it would be able to fend off critics and
defend its cuts" (Los Angeles Times, 8/21)."
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