Medicare Monitor
The Palm Beach Post's veteran Washington correspondent, Larry Lipman, tracks policy makers and interest groups who are shaping the future of the federal health insurance program for the elderly.Medicare Web Resources
Government
•Medicare
•Medicare Frequently Asked Questions
•Medicare Booklet
•Centers for Medicare & Medicaid Services
•Medicare Payment Advisory Commission
Organizations
•AARP
•America's Health Insurance Plans
•Brookings Institution
•Center for Medicare Advocacy
•Center on Budget and Policy Priorities
•Century Foundation
•Commonwealth Fund
•Families USA
•Florida 50+
•Heritage Foundation
•Kaiser Family Foundation
•Medicare Rights Center
•National Committee to Preserve Social Security and Medicare
•National Academy of Social Insurance
•National Center for Policy Analysis
Blogs
•AARP Issues Blog: Medicare
•Cato Institute Health Care Blog
•Entitled to Know National Committee to Preserve Social Security and Medicare
•The Health Care Blog
Medicare at a glance
Medicare is the federal health care system that covers about 36 million people age 65 and older, plus 7 million disabled. It has four parts:
Financed by a 2.9 percent payroll tax divided equally between employees and employers.
Financed by beneficiary premiums and federal general revenue. Current monthly premiums are $93.50. Starting this year, individuals whose taxable income is more than $80,000 will pay a higher premium.
Financed by Medicare and beneficiary premiums, which vary among plans.
The plans are private and financed by Medicare and beneficiary premiums, which vary among plans.
-- Larry Lipman
RSS feed
What's on this page →
All the entries posted on April 24, 2008.
Categories
Commenting is open from 8 a.m. to 5 p.m. M-F
Recent entries
Home > Medicare Monitor > Archives > 2008 > April > 24
Thursday, April 24, 2008
Senators seek meeting with Leavitt
Seven Republican senators have called for a meeting with Health and Human Services Secretary Michael O. Leavitt over concerns about how Medicare handled a competitive bid process for 10 categories of medical equipment that has resulted in hundreds of companies being shut out of future business with the program.
“The vast majority of rejected bidders were informed that they had not submitted sufficient financial information, when in many cases, bidders have evidence they had,” the letter continued.
The senators also express concern over reports that some of the selected bidders are headquartered far from the areas where they won contracts and have never served those areas.
Officials from the federal Centers for Medicare and Medicaid Services met with congressional staffers Monday to attempt to explain how the bidding process worked. According to one source familiar with the discussion, congressional staffers expressed a lot of frustration at that meeting with how the bids were handled.
Under a provision in a 2003 Medicare law, CMS held a year-long round of competitive bids in 10 metropolitan areas including one covering Palm Beach, Broward and Miami-Dade counties. Only companies that won the bids will be allowed to deal with Medicare for those items after July 1.
Although the names of the companies have not yet been released, industry officials say only 44 providers of medical oxygen in the three-county area were selected out of 501 providers.
Before the bids were announced, the providers warned that the system would reduce patients’ access to equipment. CMS argued that the bids would significantly reduce fraud that has plagued the industry and would lower cost to beneficiaries.
Since the bids were announced, providers have argued that CMS did not follow the rules it originally established and that the bids were mishandled resulting in hundreds of companies being disqualified for clerical errors caused by the contractor hired to handle the bid process.
Rob Brandt, CEO of City Medical Services in Miami, said his bids for two contracts were rejected by CMS because the contractor, Palmetto GBA of Columbia, S.C., said one document was missing from each of the bids.
But Brandt said his bid was reviewed by a law firm and that 69 other medical equipment providers also say their bids were rejected because the contractor claimed paperwork was missing. Brandt said the contractor may have mishandled hundreds of documents. The contractor referred all inquiries to Medicare.
CMS spokesman Peter Ashkenaz said, “If a supplier believes they submitted all the proper documentation, they should contact CMS’ contractor, who along with CMS has an established process for a case-by-case review of the concerns.”
Brandt said bidders didn’t know that there may have been a problem with their applications because Medicare changed its bidding rules last fall, six weeks after his and other companies submitted their bids. Before the rule change, the companies had been promised that they would be notified if any documents were missing from their bids. But he said the rule was quietly changed weeks later to eliminate the notification requirement.
Ashkenaz said CMS had hoped to use an electronic system for monitoring applications that would have allowed the agency to contact bidders who did not submit all their documents.
But, he said, that did not work.
“So we changed the request for bids … to state that each submitter would need to make sure that each bid was fully complete - just like they must do for all federal contracts. And we told them four different times that they would need to check their submissions. We did update the on-line bid submission system to allow bidders to check the status of their hardcopy bid documents and to be able to confirm the submissions were received.”
The Senate letter was signed by Sens. George Voinovich, R-Ohio, Arlen Specter, R-Pa., Pat Roberts, R-Kan., Richard Burr, R-N.C., Johnny Isakson, R-Ga., John Cornyn, R-Texas, and Jim DeMint, R-S.C.
Permalink | Comments (8) | Post your comment |
Lawmakers: don’t cut Medicare-financed nursing homes
More than 40 bipartisan members of the House have sent a letter to House Speaker Nancy Pelosi and Minority Leader John Boehner urging them to stave off possible cuts in Medicare funding of nursing home care.
The lawmakers object to a Bush budget proposal to eliminate the inflation adjustment for skilled nursing facilities. That is estimated to have a $1 billion impact on nursing homes next year. The letter notes that other proposed regulatory changes would slash another $4.7 billion from nursing homes by 2013.
According to the American Health Care Association, the combined cuts would mean a nearly $19 per patient per day reduction in Medicare nursing home reimbursements next year.
“We are deeply concerned about the impact that cuts of this magnitude would have on America’s most vulnerable seniors and the workers who care for them,” said the letter co-authored by Reps.Tim Walz, D-Minn., and Chris Shays, R-Conn.
“At a time when Congress is working to stimulate economic activity and jobs growth, these Medicare cuts would jeopardize direct care jobs - 86 percent of which are held by women whose salaries are modest and whose families depend on receiving annual cost of living increases. We feel strongly that that these dedicated direct care workers are a key reason we have seen meaningful quality improvement in skilled nursing care in recent years.
“Nursing homes already operate on razor-thin margins, the lowest of any health care provider group. Without stable Medicare payments, many SNFs will lack the resources they need to continue to invest in the building facilities and health information technology necessary to providing the highest quality of care.”