Latest Morning Briefing Stories

Medicare’s Old Age Problem Is New Again

Is 67 the new 65? Republicans have again proposed hiking Medicare’s eligibility age as a gambit to extend program solvency. Some have championed the plan, but many policy analysts — and much of the public — are resisting the idea.

Paul Ryan’s Radical Plan To Reform Medicare not so Radical

While Republicans’ plan to transform Medicare into a voucher program is being hailed as groundbreaking, the model has been floated for decades. Here’s a look back at the history of Medicare vouchers — and what makes Ryan’s plan different.

$500 Million in Medicare Underpayments in California?

A California attorney has filed a class action lawsuit, saying that Medicare knowingly underpaid physicians in 10 counties in California, as well as dozens of counties in 32 other states. The suit alleges $500 million in underpayments in California, and a total of $3.2 billion throughout the nation.

“Medicare has acknowledged that certain counties are being underpaid, according to standards they set back in 1996,” according to attorney Dario de Ghetaldi, of the Corey, Luzaich, Pliska, de Ghetaldi & Nastari law firm.  “It’s a problem they’ve created, and it’s a problem they’ve allowed to continue to exist.”

San Diego County physicians lead the nation in Medicare underpayment, Ghetaldi said.

Ripple Effect Might Hit Non-Medicare Patients

The poll numbers were not good. About 67% of physicians in America said they’ll likely see fewer Medicare patients, and well over half of American physicians said they intend to cut administrative or clinical staff, if the roughly 30% cut in Medicare reimbursement goes through at the end of this year.

That’s according to a national report this week from the Medical Group Management Association.

“I think you’d find similar answers in California,” Andrew LaMar of the California Medical Association said. “Physicians will be in tough financial straits if they have to take a 30% cut in Medicare. And it will have a huge effect on access to care in California.”

Kudos for Cardoza

The long fight that is national health care reform has had one large skirmish that netted about $3 billion in reimbursement money for California.

That’s the word from the California Hospital Association (CHA), and it is the driving reason behind giving its annual Health Care Hero award to a Congressman from California, Rep. Dennis Cardoza (D-Merced).

“It’s an award to individuals who have done a particularly heroic job in health care,” Jan Emerson of the CHA said. “He played a key role in ensuring that $3 billion that was slated to go to other hospitals in other states, instead stayed in California.”

How Reform Could Affect Four Key Populations

A health policy expert explores how the national health reform would affect four groups of U.S. residents. While younger workers are poised to benefit, Medicare beneficiaries may feel cuts.

Medi-Cal Waiver Gets Senate Committee Approval After Unusual Third Tier of Testimony

You know you’re in murky legislative territory when the format of a health committee meeting has to be changed to accommodate the complicated nature of the proposed bill.

In this case, it was AB 342 by John Perez (D-Los Angeles), which the Senate Health Committee eventually approved at its hearing last week. It is the companion Medi-Cal waiver bill to SB 208, which recently passed the Assembly Health Committee.

Usually, committees hear pro and con testimony, but for AB 342, Senate committee chair Elaine Alquist (D-Santa Clara) made a third category. “It’s a hybrid category just for this one bill,” Alquist said. “For those who are neither opposed nor support, but have concerns.”

Reviews Mixed for New Law on Nursing Home Ratings

Beginning in 2011, California nursing homes that participate in Medicare or Medicaid will be required to post their ratings from CMS’ five-star system.  Supporters of the law say it will help consumers make health care decisions, but nursing home operators say CMS’ system is inaccurate.

Reform Could Shift Medicare Money Away From California

Realigning regional spending on Medicare could help pay for national health reform by saving $1.42 trillion over the next 15 years, but some parts of the country — including California — stand to pay a higher Medicare toll for reform than others.