HHS OIG EXPECTS TO RECOVER BILLIONS IN 2014: The Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued its semi-annual report to Congress announcing that it would recover an estimated $3.1 billion in improper payments and fraudulent activities for the first half of this year. The report referenced a 2013 OIG study that said “surgeons performed more spinal surgeries at hospitals that purchased from PODs, and those hospitals experienced increased rates of growth in the number of spinal surgeries performed in comparison to the rate for all hospitals.”
WHITE HOUSE ADVISORS SAY FFS BARRIER TO IMPROVING CARE: Recently, the President’s Council of Advisors on Science and Technology (PCAST), said in a report that Fee-For-Service (FFS) is a major barrier to improving health related outcomes for beneficiaries and is a major driver of costs in the Medicare program. Among the recommendations, the council urged HHS to “convene public and private payers (including Medicare, Medicaid, State programs, and commercial insurers) and employers to discuss how to accelerate the transition to outcomes based payment, promote transparency, and provide tools and supports for practice transformation.”
GAO SAYS SELF-REFERRAL FOR PHYSICAL THERAPY DOWN: Last week, the Government Accountability Office (GAO) released a report on self-referrals related to physical therapy (PT). The report was generally positive, as it found that from 2004 to 2010, non-self-referred PT services increased at a faster rate than self-referred PT services. NASS has been tracking this issue over concerns about the efforts to eliminate the in-office ancillary services exception (IOASE) to the Stark Law on the federal/state levels. The full report can be accessed here.
GAO ANNOUNCES NEW MEDPAC MEMBERS:On May 29, the GAO announced the appointment of three new members to the Medicare Payment Advisory Commission (MedPAC). The appointed members are Kathy Buto, MPA; Francis “Jay” Crosson, MD, Group Vice President, American Medical Association in Chicago, Illinois; and Warner Thomas, MBA, President and CEO of the Ochsner Health System in New Orleans, Louisiana. MedPAC advises Congress on payments to providers in Medicare’s traditional fee-for-service programs.