Volume III, Issue 26

June 27, 2016
Is MACRA All It's Cracked Up to Be?
'Payment gap' for docs may grow over time,
analyst warns


Joyce Frieden, News Editor for MedPage Today reports on 6.23.16:

Physicians are likely to be hurt by the legislation passed to repeal Medicare's sustainable growth rate reimbursement formula, several experts said at a briefing here <Washington, D.C.> Thursday on the Medicare trustees' report sponsored by the Brookings Institution and the American Enterprise Institute (AEI).


"Doctors are going to be livid when they absorb the fact that they spent so much political capital to enact MACRA [the Medicare Access and CHIP Reauthorization Act] only to find out ... that under the current payment system, doctors are going to get paid less; that gap will grow over time," said Robert Moffit, PhD, senior fellow in the Center for Health Studies at the Heritage Foundation, a right-leaning think tank here. "When they absorb that fact, I think we're going to see more trouble on Capitol Hill over physician payment."
House Republican Unveil Long-Awaited Plan to Replace ACA 
Julie Rovner reports for KHN on June 22, 2016:

The 37-page white paper, called "A Better Way," includes virtually every idea on health care proposed by Republicans going back at least two decades.

...The plan starts with repeal of the health law and its requirements and taxes, but it would then put back many of its most popular elements: Allowing young adults to stay on their parents' health plan to age 26; banning insurers from charging people with pre-existing health problems higher premiums; and forbidding insurers from dropping coverage if a policyholder gets sick.

It would repeal the current scheme of exchanges where consumers buy insurance and government tax credits to help moderate-income Americans pay their premiums if they don't have an employer to help. Instead, everyone buying policies in the individual market would receive tax credits. Older people charged more by insurers would receive larger credits...
According to Ms. Rovner:

Six years after promising a plan to "repeal and replace" the federal health law, House Republicans are finally ready to deliver.
SoFla part of historic crackdown
Wouldn't you know it? It's the biggest health care fraud sting in U.S. history and 100 South Floridians were allegedly involved according to SFBJ reporter Nina Lincoff in a 6.22.16 post.

The feds said the Southern District of Florida is home to about one-third of the hundreds of defendants charged over the past three days, and about one-fourth of the allegedly fraudulent $900 million in false billings. Click here to read more, including how the alleged perpetrators sought the public funds.



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Florida Health Industry Week in Review is published every Monday by FHIcommunications

Each Monday morning we share the top healthcare headlines of the previous week and summarize What Happened (WH) and Why It Matters (WIM).

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