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Friday, Nov 3 2023

Full Issue

CMS Releases Final Rule That Would Cut Doctor And Hospital Pay Next Year

The final regulation is in line with proposed payment cuts that were published over the summer. Many doctors can expect to see a decrease in their reimbursements, unless Congress steps in. CMS also released another Medicare rule that moves forward with a plan to claw back funds from some hospitals to compensate for 340B overpayments.

Medicare administrators served doctors and hospitals a pair of big payment cuts late Thursday. Doctors will see a 3.4% decrease to a key factor determining their base Medicare pay next year, officials announced in a final rule. That鈥檚 virtually unchanged from what administrators proposed this summer. (Goldman, 11/3)

Physicians will be hit with a 1.25% reduction in Medicare reimbursements next year under a final rule the Centers for Medicare and Medicaid Services issued Thursday. The American Medical Association and other doctor groups sharply criticized the proposed rule CMS published in July, which contained the same pay cut, and have taken their case to Congress that Medicare fees for physicians should not be reduced. (Bennett, 11/2)

Medicare officials are moving forward with a plan to claw back money from certain hospitals to try to remedy overpayments struck down by the Supreme Court, they announced Thursday. A federal court ordered the Department of Health and Human Services to compensate hospitals that receive discounted drugs through the 340B program for billions of dollars of underpayments, but the money had already gone out to hospitals that didn鈥檛 participate in the program. (Cohrs, 11/2)

Providers participating in the 340B drug discount program will receive approximately $9 billion to compensate them for reductions in previous years under a final rule the Health and Human Services Department and the Centers for Medicare and Medicaid Services published Thursday. ... About 1,700 hospitals are due to receive funds by Jan. 1. But because federal law requires this spending to be budget-neutral, CMS offset the cost by reducing reimbursements for other outpatient products and services by $7.8 billion. (Kacik and Bennett, 11/2)

In other Medicare news 鈥

麻豆女优 Health News: Medicare Expands The Roster Of Available Mental Health Professionals聽

Lynn Cooper was going through an awful time. After losing her job in 2019, she became deeply depressed. Then the covid-19 pandemic hit, and her anxiety went through the roof. Then her cherished therapist 鈥 a marriage and family counselor 鈥 told Cooper she couldn鈥檛 see her once Cooper turned 65 and joined Medicare. 鈥淚 was stunned,鈥 said Cooper, who lives in Pittsburgh and depends on counseling to maintain her psychological balance. 鈥淚鈥檝e always had the best health insurance a person could have. Then I turned 65 and went on Medicare, and suddenly I had trouble getting mental health services.鈥 (Graham, 11/3)

On Social Security overpayments 鈥

麻豆女优 Health News: Biden Pick To Lead Social Security Pledges Action On 鈥楬eartbreaking鈥 Clawbacks

President Joe Biden鈥檚 nominee to head the Social Security Administration on Thursday promised senators that he would address hardships the agency has caused by trying to recoup billions of dollars it mistakenly overpays beneficiaries each year. At his confirmation hearing on Thursday, Democratic former Maryland Gov. Martin O鈥橫alley said he would 鈥渁bsolutely prioritize鈥 reducing overpayments and improving the appeals process for millions of people asked to repay money, often years later. (Hilzenrath and Fleischer, 11/3)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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