Uwe Reinhardt: Medicare And Hospital Payments
Uwe E. Reinhardt is an economics professor at Princeton. He has some financial interests in the health care field.
In a previous post, I described how Medicare came to adopt price schedules for hospitals and physicians that are now derided as Soviet in origin. Actually, as I noted, this was a home-grown American idea that Presidents Ronald Reagan and George H.W. Bush embraced and introduced to Medicare.
In this and the next post I would like to describe how this system works, starting with inpatient hospital services. I will draw on the excellent literature provided by Medpac, the independent Medicare Payment Advisory Commission established in 1997 by Congress to advise it on issues affecting the Medicare program.
December 7, 2010
Children’s Hospitals Lose Some Drug Discounts
By ROBERT PEAR
WASHINGTON — In an unintended consequence of the new health care law, drug companies have begun notifying children’s hospitals around the country that they no longer qualify for large discounts on drugs used to treat rare medical conditions.
As a result, prices are going up for these specialized “orphan drugs,” some of which are also used to treat more common conditions.
Fraud Charges
Three pharmaceutical firms agreed to pay more than $421 million to settle claims of defrauding Medicare and Medicaid — the latest in a string of large healthcare fraud settlements announced by the Justice Department.
The drug companies charged one set of prices to doctors and pharmacies but reported another set of inflated figures that were used as benchmarks by government insurers reimbursing healthcare providers, authorities said. The difference in price, or spread, amounted to kickbacks to the companies' customers, according to Tony West, assistant attorney general for the Justice Department's civil division, who announced the settlements Tuesday.
The practice of inflating the benchmark, known as the Average Wholesale Price, was so widespread that its acronym, AWP, was said by industry insiders to mean "Ain't What's Paid," West said, adding that "the only purchasers who paid the inflated, reported drug price were you, the American taxpayers."
UnitedHealthcare Hits Some Insulin Users In The Wallet -- Latimes.com
We hear frequently about how higher rates charged by health insurers impact people's access to medical treatment. But what about the pharmaceutical side of things?
Turns out that insurers' profits can come before patients on that front as well.
In Breakaway, Big Health Insurers Seek To Boost Washington Clout : Shots
Five of the nation's largest health insurance companies are looking to build their own inside-the-Beltway coalition to influence implementation of the new health law and congressional efforts to change it.
The companies – Aetna, Cigna, Humana, UnitedHealthcare and WellPoint — are shopping around Washington for a public relations firm to represent them, according to a source familiar with their work. Public Strategies andAPCO Worldwide are among PR firms that have spoken with the insurers, the source said.
Health Care Costs Sap Aid For Massachusetts Schools
Hundreds of millions of dollars the state has provided to local school districts to improve classroom education has instead been gobbled up by soaring health care costs for school employees, according to a new report that questions whether Massachusetts has fulfilled the ambitious goals of its 1993 education reform law.
Caritas Owner To Buy 2 Massachusetts Community Hospitals
The new owner of the Caritas Christi hospital chain didn’t take long to expand its reach in Massachusetts.
Under a tentative sales deal to be unveiled today, Steward Health Care System LLC, the company formed by a New York private equity firm to run the six Caritas Christi Health Care hospitals it acquired last month, has agreed to buy two more community hospitals in the state.
Health Law Fix To Save Children’s From Added Costs
WASHINGTON — The Senate voted last night to fix an error in the federal health care law that could cost Children’s Hospital Boston and others like it millions of dollars in added drug costs to treat children with rare diseases.
No comments:
Post a Comment