Medicare Compliance & Reimbursement

INDUSTRY NOTES:

Congress Still Struggles To Put DRA To Bed

Plus: HSAs, HDHPs may top new plan growth this year, survey predicts.

Congressional representatives are now hopping on the bandwagon to defeat the Deficit Reduction Act.

Rep. Henry Waxman (D-CA) is calling on fellow lawmakers to investigate "the White House's knowledge of the constitutional defects" of the DRA, which President Bush signed into law on Feb. 8--a move that could have big implications for DME suppliers.

The version of the DRA that the President signed (S. 1932) is not the same as the version passed in the House on Feb. 1. The House version requires Medicare to lease durable medical equipment to beneficiaries for up to 36 months, while the version the President signed limits such leases to 13 months. For DME suppliers, the shorter lease period could mean a cut in Medicare revenue of $2 billion over five years.

For an overview of Waxman's allegations, go to www.democrats.reform.house.gov/story.asp?ID=1033.

HSAs, HDHPs Likely To Show The Most Growth, Survey Says

Health savings accounts and high-deductible health plans recently beat out mini-med plans and Medicare Advantage plans as next year's "most likely to succeed."

More than 100 C-level health care executives--including health insurance carriers, reinsurance intermediaries, managing general underwriters and third-party administrators--participated in a climate survey at the seventh annual American Re Healthcare Symposium late last month. More than one-third of the survey participants agree that HSAs and HDHPs will see the most significant growth over the next year. In contrast, 13 percent believe that mini-med plans will be the frontrunners, while 12 percent have their highest expectations in MA plan growth.

In addition, the rising cost of health care is still a major concern. Among the survey participants, 44 percent agree that health care costs are becoming "too expensive for employers to provide at current levels."

"As many strengthen their belief that the U.S. healthcare system is in urgent need of a better balance, the debate for reform intensifies," says American Re HealthCare president Robert Trainer. "Our annual Symposium, which brings together leaders from throughout the health care field, facilitates this debate."

To view the symposium survey's results, visit www.americanrehealthcare.com.

In Other News...

• CMS reduces managed care system glitches. Providers may see a reduction in the number of patients whose switch to a Medicare managed care plan fails to show up in the Common Working File for months on end. CMS identified system problems with the beneficiary records for managed care plans and has corrected most of the problems, an agency staffer explained at a recent Open Door Forum.

Claims should process appropriately and inquiries should successfully give accurate information most of the time, the official promised. While "a smattering of issues" may persist, CMS will continue its efforts to make sure the managed care information is up-to-date and accurate, she pledged. [...]
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