News in brief - March 13, 2000

HCFA looks for Medicare carriers' errors - Health status, insurance access vary widely by state, AARP finds

HCFA looks for Medicare carriers' errors

Washington -- In an attempt to strengthen oversight of its Medicare contractors, the Health Care Financing Administration will measure the accuracy of the private companies that pay and process Medicare claims. The program will measure each contractor's progress toward correctly processing and paying Medicare claims, similar to the annual audits now used to measure Medicare's national error rate.

But the AMA is urging Congress to hold a hearing to analyze the annual audit of Medicare's improper payment rate, its underlying methodologies and Medicare contractors' targeting of honest physicians.

The widely touted annual audit of improper payments is unable to differentiate between improper billings and fraudulently submitted claims, AMA Executive Vice President E. Ratcliffe Anderson Jr., MD, wrote House Speaker J. Dennis Hastert (R, Ill.) and other House leaders. The AMA pointed to abusive audits, regulatory overload, statutory overkill and misleading data in the annual audit. Dr. Anderson said HCFA's punitive approach should be changed to be more educational.

Health status, insurance access vary widely by state, AARP finds

Washington -- Wide disparities exist among the states on their residents' health status, access to care and the adequacy of safety net protections for low-income families, according to a new AARP report that compares 100 key health indicators state by state.

Nearly 18% of Americans younger than 65 have no health insurance. Being uninsured is particularly prevalent among those with incomes below the national median, the study says.

Among additional findings:

More than one-quarter of Arizona's residents and 19% of Arkansas' reported they did not see a physician because of cost. But only 6.5% of Nebraska residents cited cost as a factor in preventing them from receiving care.
Medicaid is reaching only half of poor adults and children in 35 states. Medicaid reaches only 28% of Nevada's poor people, while 61% of the poor in the District of Columbia receive care.
Medicare fee-for-service payments averaged $5,416 per beneficiary and varied from a high of $7,548 in the District of Columbia to a low of $3,650 in North Dakota.
Death rates from heart disease varied from 188 per 100,000 in Mississippi to 93 per 100,000 in Minnesota.