Farewell. The Flying Pig Has Left The Building.

Steve Hynd, August 16, 2012

After four years on the Typepad site, eight years total blogging, Newshoggers is closing it's doors today. We've been coasting the last year or so, with many of us moving on to bigger projects (Hey, Eric!) or simply running out of blogging enthusiasm, and it's time to give the old flying pig a rest.

We've done okay over those eight years, although never being quite PC enough to gain wider acceptance from the partisan "party right or wrong" crowds. We like to think we moved political conversations a little, on the ever-present wish to rush to war with Iran, on the need for a real Left that isn't licking corporatist Dem boots every cycle, on America's foreign misadventures in Afghanistan and Iraq. We like to think we made a small difference while writing under that flying pig banner. We did pretty good for a bunch with no ties to big-party apparatuses or think tanks.

Those eight years of blogging will still exist. Because we're ending this typepad account, we've been archiving the typepad blog here. And the original blogger archive is still here. There will still be new content from the old 'hoggers crew too. Ron writes for The Moderate Voice, I post at The Agonist and Eric Martin's lucid foreign policy thoughts can be read at Democracy Arsenal.

I'd like to thank all our regular commenters, readers and the other bloggers who regularly linked to our posts over the years to agree or disagree. You all made writing for 'hoggers an amazingly fun and stimulating experience.

Thank you very much.

Note: This is an archive copy of Newshoggers. Most of the pictures are gone but the words are all here. There may be some occasional new content, John may do some posts and Ron will cross post some of his contributions to The Moderate Voice so check back.


Saturday, March 3, 2012

HCR -- Running a Tight Ship

By John Ballard

CMS and the Office of Inspector Genral are making news.

A proposed rule from the Centers for Medicare & Medicaid Services to review Medicare overpayments, dating back to as far as 10 years, could mean undue administrative burdens and costs for health care providers.

The proposal rule, published in the Federal Register Feb. 16, requires that providers and suppliers must report and return self-identified overpayments within 60 days. Before the Affordable Care Act, providers didn't have a set deadline for returning taxpayers' money, but under the Act, there will be a specific time frame by which overpayments must be returned, CMS explained in a statement last month. And providers who fail to report and return the overpayment within that time frame could be violating the False Claims Act and face civil monetary penalties or be excluded from the federal program altogether.

Also under the proposed rule, CMS plans to broaden the look-back period of Medicare overpayments from what is generally four years to up to 10, HealthLeaders Media reported. The expanded time frame could cost as much as $58 million in reporting-related expenses per year for about 125,000 providers and suppliers, the article noted.

Calling it "overkill," Amy E. Nordeng, government affairs counsel for the Medical Group Management Association, said the CMS rule, if enacted, could be particularly burdensome for group practices who might not have billing records that far back.

The other issue at hand is that providers who are overpaid might not be intentionally violating the False Claims Act but rather committing billing errors. "[Ten years] would be under the worst case scenario under the False Claims Act when in fact most of the time when there is some kind of billing error it is just that-an error," Michael Gennett, counsel at Miami-based Akerman Senterfitt Law Firm, said in the article. "It is not a knowingly false claim."

For example, in an Office of Inspector General report released Tuesday, University of California, San Diego, Medical Center complied with Medicare billing requirements for 111 of the 210 inpatient and outpatient claims the OIG audited. But for the other 99 claims, UCSD was overpaid $351,000 for 2008 and 2009. OIG determined that the cause was primarily because the hospital's existing controls did not adequately prevent incorrect billing of the claims. After the audit, the hospital implemented educational programs, leveraged technology, and redesigned the audit and billing process to ensure compliance.

CMS' proposed rule, although worrisome, might not be surprising to providers. The agency has taken a hard-line stance against fraud and waste. CMS already has recovered approximately $5 million in overpayments, the agency said.

Looks like the folks at CMS are catching up with investigative journalists who have been putting out stories about fraud and abuse for years.  The president's opponents sometimes claim this administration isn't doing enough to save money and in the next breath complain about too many regulations and too much government oversight interfering with the private sector. Here are a few links to think about next time you hear that kind of nonsense.

It's like shooting fish in a barrel. Makes me wonder why it has taken so long. I think it has to do with the Reagan Revolution and an asleep-at-the-switch culture that pervaded Washington beginning with his famous "government IS the problem" pronouncement. 

All that complaining about a ten-year lookback is baloney. Anyone who has been downwind of anything having to do with healthcare knows that record-keeping may be more important than blood banks and sanitation. Anybody who has ever been on the receiving end of an insurance claim challenge knows that. If you took a pee at the wrong time a few years ago somebody took note of it and there will be a document to prove it. And when it comes to billing you can bet your last dollar if the record is lost it's because they didn't want it found.  

With this year's presidential election turning into a GOP Suicide Watch I'm starting to think some of the positive trends started under the Obama administration may have time to take root and grow. One can hope. 

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