Tuesday, January 13, 2004

Foundation Aims At Taking Consumer-Directed Service Model For Medicaid To National Level
A press release from the Robert Wood Johnson Foundation - "When Medicaid beneficiaries of various ages and disabilities have the option to direct their own supportive services, their quality of life is improved, satisfaction with services is increased, unmet needs for care are reduced, access to home care is increased, and nursing home usage is reduced - without compromising the beneficiaries' health or safety. Further, the option costs Medicaid no more than traditional agency services. The Robert Wood Johnson Foundation (RWJF) announced today that the model Cash & Counseling program that achieved these results will be expanded with a new $7 million authorization approved by the Foundation."  
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Payments Go Under a Microscope
Washington Post story on "the growing concern among private and government health insurers about the accuracy of physicians' claims and the system for calculating reimbursements. The largest insurer of all, the federal government, recently estimated that the Medicare program overpaid doctors, hospitals and other health-care providers by $11.6 billion in 2002, according to an audit of 128,000 claims. The audit found many providers submitted insufficient documentation (45 percent), billed for medically unnecessary services (22 percent) and used incorrect codes to describe patient visits (12 percent). A larger audit is planned this year."  
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