House issues bill to speed up Part D payments
Community pharmacies have been plagued with slow and low reimbursement under Medicare Part D, according to sponsors of legislation to speed up Medicare’s pharmacy payments. Reps. Marion Berry (D-Ark.) and Walter Jones (R-N.C.) said on Sept. 6 that their co-sponsored bill, HR 1474, would require that payments to community pharmacies be made within 14 days. Currently, insurance companies offering Medicare Part D plans are waiting as long as they can – in some cases more than 90 days – to reimburse community pharmacies, said Charles Sewell, senior vice president of government affairs for the National Community Pharmacists Association.
Survey suggests ‘domino effect’ of medicare cuts
The scheduled 9.9 percent cut to physicians’ Medicare payments in 2008 will have a domino effect throughout the insurance industry, the Medical Group Management Association concluded in a recent survey. MGMA found that many practices reported receiving lower rates from private insurers who benchmark their payments on the Medicare physician fee schedule. The cuts would also affect patient access to care, MGMA said. More than 41 percent of survey respondents said they may have to limit the number of Medicare patients they see, while more than 19 percent said they would be forced to stop accepting new Medicare patients.
Racism linked to nursing home quality, finance
Black Americans are more likely than whites to live in nursing homes with financial problems, inspection deficiencies and staffing shortages, according to a recent Commonwealth Fund-supported study. The study found that the trend is closely linked to racism and is most acute in the Midwest, particularly in Milwaukee. Blacks were found to be nearly twice as likely as whites to be located in a nursing home that had been terminated from Medicare and Medicaid participation due to poor quality of care. Futhermore, blacks were found to be three times as likely to be housed in nursing homes predominantly housing Medicaid patients. The authors’ recommendations include improving payment structures for nursing homes with a high proportion of Medicaid residents and closing the gap between the amount paid to nursing homes by Medicaid and private payers.