Healthcare Roundup: Slow Medicare Advantage Season, Feds Probe AtriCure, Drug-Insurance Costs Up, and More
Medicare Advantage selling season has slow start -- Medicare's efforts to clamp down on high broker commissions that may have encouraged some agents to churn seniors into new Medicare Advantage plans has slowed the pace of the 2009 selling season. Many providers of the privatized healthcare plans report confusion over how to comply with Medicare's latest directive on commissions. [Source: Medicare Advantage News]
AtriCure probed over marketing practices -- A amaker of heart-surgery equipment, AtriCure, said the Justice Department is looking into its marketing practices. The investigation is looking into charges that AtriCure promoted its devices for unapproved uses and encouraged hospitals to use incorrect billing codes for its surgical-ablation procedures. [Source: WSJ]
Medicare drug-benefit premiums, co-pays to rise -- Premiums at the 10 largest Medicare prescription-drug plans are expected to rise 31 percent next year, with some increases exceeding 60 percent. Co-payments, especially for brand-name drugs, are also likely to rise steeply -- as high as $40 in some large plans. [Source: WSJ]
Hospitals get OK to share performance bonuses with doctors -- The Department of Health and Human Services ruled that hospitals participating in private insurers' pay-for-performance plans can share their bonuses with their staff doctors. Under the opinion, hospitals can share up to 50 percent of their bonus payments with physicians who help the facilities achieve quality goals. [Source: American Medical News]
Hospitals fail to subsidize IT for doctors -- Federal rules allow hospitals to pick up 85 percent of electronic medical-record costs for affiliated doctors, but many hospitals remain reluctant to take on new IT projects while physicians themselvesseem largely uninterested. One exception to the trend is Tufts Medical Center, which just announced that it will pick up an undisclosed portion of the costs of electronic-records and practice-management software for doctors in its network. [Source: American Medical News, Health Data Management]
Former National Century prez guilty in $1.9B fraud case -- A federal jury found Lance Poulsen, former president of National Century Financial Enterprises, guilty on all counts related to a $1.9 billion fraud case. The company bought unpaid medical bills from hospitals, but allegedly paid excessive amounts to firms associated with National Century execs and hid the arrangements from investors. [Source: Modern Healthcare]
West Penn overstates patient revenue by $67M -- The five-hospital chain West Penn Allegheny Health Systems has inflated its patient revenue by $67 million since 2006. The error resulted from mistakes in estimating contractual allowances, bad debt and expected payments by patients. [Source: Modern Healthcare]
Eastern Connecticut system acquires Johnson Memorial -- Eastern Connecticut Health Network, a two-hospital system, has agreed to acquire Johnson Memorial Hospital. Terms weren't disclosed; Johnson's parent company last week cut 56 jobs and is expected to file for bankruptcy protection. [Source: Modern Healthcare]
Medicare drug spending falls $6B -- Greater use of generic drugs played a big role in trimming costs by $6 billion at the Medicare prescription-drug program in the year ended Sept. 30. Other savings resulted from fewer enrollees than initially expected and seniors rationing their drug use to avoid the "doughnut hole" in coverage, which forces them to pick up the full tab for annual drug costs between $2,510 and $4,050. [Source: USAT via kaisernetwork.org]