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  • Tom Boyd

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Hospitals Settle Cases After Playing Risky Games With Provider Identification Numbers

AIS’s Health Business Daily, August 9, 2011

 In one of the largest civil monetary penalty settlements with a hospital, University of North Texas Health Science Center has agreed to pay $859,500 to settle allegations that it billed Medicare, Medicaid and TRICARE for services under the provider identification numbers of 103 physicians who didn’t provide or supervise the services.  Other physicians performed the services, but their enrollment applications were still pending so they lacked billing numbers, says Ellen Slavin, senior counsel in the HHS Office of Inspector General’s administrative and civil remedies branch. …

Nurses have more career opportunities under healthcare reform (excerpt)

Healthcare Finance NewsWeek, August 9, 2011

 In the age of healthcare reform and the advent of coordinated care models such as accountable care organizations, nurses have an increasing number of career opportunities, say industry insiders.  Topping the list are care managers and leadership roles in the C-suite – positions key to controlling healthcare costs. 

$28 Million Awarded To Help Establish New Community Health Centers (excerpt)

Kaiser Health News, August 10, 2011

The Hill:  HHS Awards $28 Million For Community Health Centers

The Health and Human Services Department announced $28 million in grants … to help establish new community health centers.  The department said 286,000 people will gain access to health care through the new health centers.  Community health centers exist primarily in rural and urban areas without easy access to health care.  Some 40 percent of the people who use community health centers are uninsured, Health and Human Services Secretary Kathleen Sebelius told reporters.  She said expanded access to clinics in schools, churches, and other community centers has been shown to reduce hospital and emergency-room services (Baker, 8/9).

Many Low-Income Seniors Go Without Enhanced Medicare Drug Coverage (excerpt)

Kaiser Health News, August 10, 2011

CQ HealthBeat:  CMS: Many Seniors Missing Out Needlessly On Full Medicare Drug Coverage

About 2 million low-income beneficiaries are needlessly going without enhanced prescription drug coverage available to them in the Medicare program, federal officials announced ….  To help whittle down that number, officials are publicizing the fact that it’s easier than it used to be to qualify for the benefits offered by the Low-Income Subsidy (LIS), or “Extra Help” program, as it’s marketed to consumers.  That’s because certain assets and types of income that might have disqualified an applicant from receiving the extra drug coverage in the past are no longer counted toward eligibility (Reichard, 8/9). 

USA Today:  Ration Health Care With Medicare Cuts

 Life-extending drugs debut frequently, and they usually seem exorbitantly expensive when weighed against their promise of adding a few weeks or months of life to someone with a terminal illness.  In these prostate-cancer cases, one new drug costs $5,000 a month, another $8,000 every three weeks and a third $93,000 for a full course of treatment.  The costs in this instance are even more relevant because most of them would be paid by Medicare.  This, in turn, raises hard questions about public policy, ethics and moral judgments that Americans are going to have to face even as elected officials in Washington try to avoid them (Don Campbell, 8/9).

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