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The Milwaukee Journal Sentinel: “The frustration of finding out what hospitals and doctors charge for common services — from routine office visits to diagnostic tests and surgical procedures — could soon get a lot easier in Wisconsin…

Several news organization have “fact checks” on the reconciliation procedure and health reform provisions. The Associated Press examined then-candidate Barack Obama’s Oct. 2007 statement of “We’re not going to pass universal health care with a 50-plus-one strategy…

New Century Infusion Solutions, Inc. (NCIS), the first Oncology Benefit Management (OBM) company, is pleased to announce the publication of a white paper by the Lewin Group: “Medicare Cancer Care Coordination Using The Integrated Single Specialty Provider (ISSP) Model.” The report estimates that over a 10-year horizon, a payer could realize oncology savings of “$16…

Building on previous studies that found racial differences in hospice use, a new study from the Institute for Aging Research of Hebrew SeniorLife and Boston University School of Medicine finds that blacks and Hispanics use hospice for advanced heart failure at a rate of up to 50 percent less than whites, despite a markedly higher rate of incidence of the disease in these populations…

If Reform Fails The New York Times Any change as big as this is bound to cause anxiety. Republicans have happily fanned those fears with talk of “dangerous experiments” on the “best health care system in the world.” The fact is that the health care system is broken for far too many Americans. And the country cannot afford the status quo (3/6)…

Medicare payment issues including rising costs, caps on physical therapy and other outpatient services for some patients are in the news. The Dallas Morning News reports that Medicare Advantage plans with drug benefits are getting more expensive: “Seniors in those plans will pay an average of $39.61 a month this year in premiums, up 14…

The Dallas Morning News: “Lawmakers have been thinking ahead to a massive shortfall, topping $10 billion, that’s probably coming when they write the next budget in 2011. But state officials told them Monday that they’ll have to fix a hole in the current budget, too. Rising health care costs have dug a hole of about $1.7 billion, the officials said…

The Washington Post has a section today titled “Scenes from the 21st century doctor’s office.” One feature, written by Manoj Jain, an infectious-disease specialist in Memphis, advocates for a new system of “bundled” Medicare payments to doctors. He notes that currently, “patients, insurance companies and Medicare pay separately for each procedure in the predominant ‘fee-for-service’ model…

Consumers eligible for Medicare should enroll in Medicare Part B during the 2010 General Enrollment Period (GEP), which ends on March 31. Consumers who are not enrolled in Medicare, but should be, are urged to enroll by March 31 for Part B coverage, which would take effect July 1. Medicare Part B covers doctor visits and other outpatient care…

The Fiscal Times reports on medical miracles and their place in the national health care reform debate with a likely subheading: high health care costs. “The idea of foregoing heroic efforts and new technologies to save dying patients is anathema for most Americans…

The Obama administration and insurance industry executives are continuing their battle over rate increases. Politico: “Insurance industry executives sat down with administration officials in the White House last week to justify their rising premium costs, attributing them to increasing medical costs. But it’s an answer President Barack Obama apparently wasn’t buying…

The Senate is poised to consider a measure today that would include extending subsidies for COBRA benefits and unemployment insurance, prevent the Medicare payment cut for doctors and provide additional funding to state Medicaid programs…

Purchases of cholesterol and diabetes prescription drugs by elderly Medicare beneficiaries reached nearly $19 billion in 2007 – about one-fourth of the approximately $82 billion spent for medications for the elderly, according to the latest AHRQ News and Numbers…

The Boston Globe: “A group of Massachusetts mayors, fed up with what they say is legislative inaction on skyrocketing municipal health care costs, has launched a ballot initiative for 2012 aimed at giving cities and towns more flexibility in reducing expensive benefits for employees, retirees, and elected officials” (Murphy, 3/10)…

The Senate is set to vote Wednesday on a jobs bill that would extend the COBRA subsidy program and Medicaid funding for states and prevent a Medicare reimbursement cut for doctors. The Associated Press: The bill “extends health insurance subsidies for the unemployed through December. It would add $132 billion to the budget deficit over the next year and a half. …

The Boston Globe: “President Barack Obama said Tuesday he’ll bring in high-tech bounty hunters to help root out health care fraud, grabbing a populist idea with bipartisan backing in his final push to overhaul the system. … Obama’s anti-fraud announcement was aimed directly at the political middle.” “Waste and fraud are pervasive problems for Medicare and Medicaid. …

The Centers for Medicare & Medicaid Services (CMS) today terminated its contract with Fox Insurance Company. After an onsite review of the plan and its services, CMS determined that the plan’s significant deficiencies – not meeting Medicare’s requirements to provide enrollees with prescription drugs according to recognized standards of care – jeopardized the health and safety of Fox enrollees…

Medill Reports: “Unless federal legislation closes the Medicare coverage gap colloquially known as the ‘doughnut hole,’ seniors may opt for online drug imports to alleviate steep prescription costs. … ‘As seniors start falling into the doughnut hole, they are going online to find deals on prescription drugs, whether they’re based in the U.S…

Congressional Democrats, reportedly closing in on a final health reform agreement, are seeking to alleviate concerns of reluctant members. The Associated Press: “It will come down to a phenomenal effort by congressional leaders and the White House to win over skittish lawmakers after a year of incendiary debate …

Two Republican members of Kentucky’s House are attaching antiabortion-rights amendments to several unrelated bills that are awaiting a chamber vote, a move that is threatening to derail changes related to children’s Medicaid coverage, among other things, the Lexington Herald-Leader reports. The amendments — sponsored by Reps…

Grady Memorial Hospital in Atlanta will continue to finance dialysis treatments for some illegal immigrants. The New York Times: “In early October, when Grady, Atlanta’s public hospital, closed its outpatient dialysis unit for budgetary reasons, it agreed to pay for three months of dialysis at private clinics for about 50 dislocated patients…

Here’s a look at some last-minute lobbying campaigns and what impact they may have had. The Washington Post: “Language in both the House and Senate bills would reward hospitals for efficiency in their Medicare spending, a dramatic change in the formula for parceling out the public dollars, which can account for as much as half of a hospital’s budget…

The Centers for Medicare & Medicaid Services (CMS) has launched the fifth annual health care provider satisfaction survey of the Medicare fee-for-service (FFS) contractors that process and pay more than $370 billion in Medicare claims each year…

A special deal reached by Senate Democratic leaders and Sen. Ben Nelson, D-Neb., regarding funding for his state in the context of health reform’s proposed Medicaid expansion, is drawing increasing criticism…

The Medicare Rights Center will receive a Public Service Award from the Social Security Administration (SSA) on Friday, January 8. Joe Baker, president of Medicare Rights, will accept the award on behalf of the organization…

Comparative Effectiveness And Health Care Spending – Implications The New England Journal Of Medicine If we can induce hospitals and health plans to improve efficiency and not just cut costs, then health costs in the United States will come down and outcomes will improve (Milton Weinstein and Jonathan Skinner, 1/6)…

The Wall Street Journal: “Four years ago, the U.S. government offered subsidized prescription-drug insurance to 43 million elderly and disabled, the biggest expansion of government-backed health care in decades. Today, the program is working better than many expected.” One lesson could be for proposed health insurance exchanges…

A federal report released last week on Medicare claims for power wheelchairs confirms that the regulatory documentation requirements are confusing, onerous, and must be improved, says the American Association for Homecare, the nation’s largest association representing providers of durable medical equipment and services, including wheelchairs…

Despite government warnings and professional recommendations about diabetes risks associated with second-generation antipsychotic drugs, fewer than one-third of Medicaid patients who are treated with these medications undergo tests of blood glucose or lipid levels, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals…

Facing criticism from both opponents and longtime supporters, Sen. Ben Nelson (D-Neb.) on Wednesday defended his critical 60th vote in favor of the Senate health care reform bill (HR 3590) in a television advertisement airing in his home state, the New York Times reports. In the ad, Nelson said, “With all the distortions about health care reform, I want you to hear directly from me…

For Indiana hospitals, Medicaid rates have long lagged behind other types of payers – with no increase since 1993 – but after a year of deep recessions and state budget cuts, those hospitals are now looking at a five percent cut, The (Fort Wayne) Journal Gazette reports. Reactions to the cuts among hospitals varied…

The San Diego Union-Tribune reports that an elderly care program is allowing senior citizens to retain their independence by providing medical care and home assistance through a nonprofit program.The program, St. Paul’s Program of All-Inclusive Care for the Elderly, “functions like a health maintenance organization, is the only one of its kind in the county and one of 70 nationwide…

Nominal health spending in the United States grew 4.4 percent in 2008, to $2.3 trillion or $7,681 per person. This was the slowest rate of growth since the Centers for Medicare & Medicaid Services started officially tracking expenditures in 1960. Despite slower growth, however, health care spending continued to outpace overall nominal economic growth, which grew by 2…

Medicare is beginning a new federal policy that covers HIV screening for seniors…

Wisconsin State Journal: “Wisconsin’s rural hospitals hope to offset a state Medicaid cut with a tax that would bring more federal money to the hospitals. The proposed tax on the state’s 59 ‘critical access’ hospitals, all in rural areas, would prevent the hospitals from closing important services, officials say…

Newspapers report on the controversy about variations in individual state costs for a Medicaid expansion in health care overhaul legislation. “Gov. Phil Bredesen [D-Tenn…

Medicare recipients with diabetes who have a gap in their Part D prescription drug benefits-known as the “doughnut hole” – have higher out-of-pocket drug costs and are less likely to stick to their medications than those who have supplemental drug benefits, a new study confirms. Surprisingly, generic-only drug plans to cover the gap only modestly improve the situation…

Modern HealthCare reports that the Centers for Medicare and Medicaid “has launched its fifth annual healthcare provider-satisfaction survey regarding Medicare fee-for-service contractors that process and pay more than $370 billion in Medicare claims each year…

Dow Jones Newswires/The Wall Street Journal reports that House Democrats who favor a government-run public insurance plan on Tuesday signaled “they are willing to agree to a final health overhaul bill without a government-run health insurance option if other parts of the bill would fulfill the same goals…

Once Obama’s Target, Lobbyist Tauzin Now His Pet The Washington Examiner The White House’s open door for [Billy Tauzin, the top lobbyist for the prescription drug industry], whom candidate Obama attacked as the embodiment of the revolving door and the corrupt collusion between politicians and industry, further dismantles the myth of Obama as the scourge of special interests (Timothy P…

Crain’s New York Business: “Independent New York pharmacies say new state budget cuts will drive more drugstores out of business. Albany’s deficit reduction plan calls for $18.5 million in savings from Medicaid and Elderly Pharmaceutical Insurance Coverage (EPIC) pharmacy reimbursement rates…

USA Today reports that the health care bills moving through Congress have dozens of “lesser-known provisions” that include ideas that failed to gain traction in the past but are benefiting by hitching their proposal to health care reform…

What My Amendment Won’t Do The New York Times The language in our amendment is completely consistent with the Hyde Amendment, which in the 33 years since its passage has done nothing to inhibit private health insurers from offering abortion coverage…

Coverage of the Senate’s “broad agreement” to create a national health insurance plan continues, with Democratic leaders remaining mum on details while insisting the compromise leaves a “public” option in the bill. (See KHN’s Tuesday night breaking news round-up)…

Kaiser Health News staff writers Julie Appleby and Mary Agnes Carey write: “Hospitals, doctors and insurers lined up in opposition Tuesday to allowing people under 65 to join Medicare – an idea being debated as Senate negotiators struggle to put together the 60 votes needed to pass sprawling health care legislation” (12/9). Read entire story…

A Bloomberg poll conducted Dec. 3-7 found, on health care, “about half of poll respondents saying they disapprove of the plans in Congress to overhaul the system. Sixty-two percent of Americans say they are mostly pessimistic they would benefit from [a health-care bill Congress may pass.] The youngest Americans are more optimistic, with 47 percent of those under 35 saying they would benefit…

“Despite the economic downturn that’s busting state budgets from Sacramento to Tallahassee, 26 states this year made it easier for low-income children, parents or pregnant women to get health coverage, according to a report released Tuesday by the Kaiser Family Foundation,” Kaiser Health News and The Miami Herald report (KHN is a program of the foundation)…

Reuters: “Americans enrolled in the U.S. government-run Medicare health insurance program will now be covered for tests that screen for HIV, The Centers for Medicare and Medicaid Services (CMS), which oversees the program for the elderly and disabled, said on Tuesday…

AIDS Healthcare Foundation (AHF), the largest global AIDS organization, lauded the Centers for Medicare and Medicaid (CMS), for its decision earlier today to cover HIV testing for Medicare beneficiaries who may be at increased risk for HIV exposure (MSM, IDU) as well as women who are pregnant, and beneficiaries of any age that request to be tested. The decision is effective immediately…

The Centers for Medicare & Medicaid Services (CMS) today announced its final decision to cover Human Immunodeficiency Virus (HIV) infection screening for Medicare beneficiaries who are at increased risk for the infection, including women who are pregnant and Medicare beneficiaries of any age who voluntarily request the service. The decision is effective immediately…