News in brief - April 18, 2005

Government Web site offers hospital quality report cards - Raising the issue of the uninsured - Contractors named for Medicare recovery audit - Partnership promotes private, public drug-assistance programs

Government Web site offers hospital quality report cards

The Centers for Medicare & Medicaid Services has launched a Web site where physicians and patients can see how hospitals compare when it comes to quality of care.

Nearly 4,200 hospitals have volunteered data on 17 measures related to heart attack, heart failure and pneumonia. Facilities are rated based on what percentage of heart attack patients receive beta blockers upon arrival. Hospitals that do not submit a sufficient amount of data will receive a 0.4% reduction in their Medicare reimbursements. Data on hospital quality are available online (www.hospitalcompare.hhs.gov).

Federal officials have said that the initiative can serve as a model for future efforts to assess other Medicare participants, including physicians. Publicizing the results would spur quality improvements within individual practices, they said.

Raising the issue of the uninsured

Cover the Uninsured Week officially runs from May 1 through May 8, but will feature events held during April and May across the country. These include health fairs, business seminars, campus activities and faith-based meetings. The initiative, for which the AMA is a co-sponsor, was launched three years ago to raise awareness of the problem among both the public and policy-makers.

"We are concerned that millions of Americans are at risk for losing both private and public health care coverage, yet solving the problem of dwindling health care coverage is not getting the attention it requires," said Risa Lavizzo-Mourey, MD, president and CEO of the Robert Wood Johnson Foundation, a project co-sponsor.

Contractors named for Medicare recovery audit

Centers for Medicare & Medicaid Services officials have unveiled the names of the firms that will examine Medicare physician claims starting in May to determine whether overpayments or underpayments have taken place.

The agency has contracted with Diversified Collection Services, Livermore, Calif.; Public Consulting Group, Boston; HealthDataInsights Inc., Las Vegas; Connolly Consulting, Atlanta; and PRG-Schultz International Inc., Atlanta, to review claims in California, Florida and New York over the course of the three-year demonstration program. Physicians will be required to return any overpayments that the recovery audit contractors discover. The contractors will be paid based only on how much money they return to the government.

CMS plans to schedule an open-door forum on the recovery audits. Information on such meetings can be found on the agency's Web site (www.cms.hhs.gov/opendoor).

Partnership promotes private, public drug-assistance programs

A new service offers to link low-income, uninsured patients with 150 drug-assistance programs offered by drugmakers and another 125 offered through public programs, such as Medicare, Medicaid and the State Children's Health Insurance Program. The Partnership for Prescription Assistance is being supported by the Pharmaceutical Research and Manufacturers of America and 50 national organizations.

"Millions of Americans already benefit from patient-assistance programs, but we know that millions more who may be eligible have not yet enrolled," said Mary E. Frank, MD, president of the American Academy of Family Physicians, a member of the partnership. "Because of this effort on the part of the pharmaceutical industry to simplify and broaden their assistance programs, each patient's personal physician will find it easier to help them get the medications they need."

Patients can access the service online (www.pparx.org) or by phone, 888-4PPA-NOW.