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Commissioner of Social Security, today announced that the agency has released its Open Government plan.  The plan, available at www.socialsecurity.gov/open, reflects the agency’s commitment to increase transparency, expand opportunities for citizen participation and collaboration, and make open government sustainable at Social Security.  Three flagship initiatives are highlighted in the plan — the Spanish-Language Retirement Estimator, Online Service Enhancement, and an Online Life-Expectancy Calculator.  These initiatives support the agency’s mission, goals, and objectives, as well as showcase the value of open government principles.

“I applaud President Obama’s commitment to opening the federal government to the people it serves and I am especially proud of the three flagship initiatives we have chosen to implement by the end of this year,” said Commissioner Astrue. “These initiatives signify Social Security’s ongoing commitment to transparency, citizen participation, and collaboration as we improve the services we provide to the public.”

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Patients that have similar clinical characteristics and similar costs are assigned to an MS-DRG. The MS-DRG will be associated with a fixed payment amount based on the average cost of patients in the group. Patients are assigned to a MS-DRG based on diagnosis, surgical procedures, age and other information. Medicare uses this information that is provided by hospitals on their bill to decide how much they should be paid. Hospital Compare shows information for each hospital on selected MS-DRGs from October 2007 through September 2008. If a MS-DRG has “Complications” or “Comorbidities” in its title, it means the hospital may have treated more complicated patients.

Because MS-DRGs are highly technical, patients and other consumers may need to work with a doctor or other healthcare provider to understand these terms as well as the payment and volume information. ‘CC’ refers to complications or comorbidities. MCC refers to major complications or comorbidities. When Medicare pays a hospital based on the MS-DRG, it takes into account the following (case mix): Read the rest of this entry »

 
Cartoons of woman walking in sunshine, calcium rich foods and a woman lifting weights.Our bones are alive. We might not think of them that way—but to keep themselves strong and usable, our bones are always changing. “Bone is living, growing tissue,” says Dr. Joan McGowan, a scientist at NIH. “It’s constantly breaking down and building up. It keeps refreshing itself.”

But as you get older, your bones may be at increased risk for osteoporosis (oss-tee-oh-pore-OH-sis), when the bones become weak, fragile and more likely to break. And once they break, they take longer to heal. This can be both painful and expensive. Current estimates suggest that around 10 million people in the U.S. have osteoporosis, and 34 million more have low bone mass, which places them at increased risk. 

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Manufacturer reporting of Average Sales Price (ASP) data: A manufacturer’s ASP must be calculated by the manufacturer every calendar quarter and submitted to CMS within 30 days of the close of the quarter.  Each report must be certified by one of the following: the manufacturer’s Chief Executive Officer (CEO); the manufacturer’s Chief Financial Officer (CFO); an individual who has delegated authority to sign for, and who reports directly to, the manufacturer’s CEO or CFO.

Manufacturers must report the ASP data to us in Microsoft Excel using the template provided in Addendum A, the ASP Data Form.  Both this and the ASP Certification Form (Addendum B), are available in the ‘Downloads’ section below.

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CMS ANNOUNCES MEDICARE PREMIUMS, DEDUCTIBLES FOR 2010

Most Medicare beneficiaries will not see a Part B monthly premium increase as a result of a “hold harmless” provision in the current law.  This allows for 73 percent of beneficiaries to be protected from an increase raising the 2010 Part B monthly premiums from $96.40 to $110.50.  The Administration continues to urge Congressional action that would protect all beneficiaries from higher Part B premiums and eliminate the inequity of a high premium for the remaining 27 percent of beneficiaries.

By law, the Centers for Medicare & Medicaid Services (CMS) is required to announce the Part A deductibles and Part B premium amount – a notice that is published annually in the Federal Register.

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HOW NEW STANDARDS FOR TOUGHER ERROR RATE WERE APPLIED IN THIS YEARS 2009 IMPROPER PAYMENTS REPORT

For 2009, CMS improved how it reviews Medicare claims for inpatient hospital services and eliminated the use of past billing records as part of a complex medical review.  As a result of this heightened scrutiny and more complete accounting of Medicare FFS claims, CMS is reporting a 2009 FFS error rate of 7.8 percent, or $24.1 billion, compared to 3.6 percent in 2008.  In addition, for 2009:

  • The baseline composite Medicare Advantage, or Part C, error rate, based on payment year 2007, is 15.4 percent, or $12.0 billion.
  • The Medicare Part D composite error rate is under development, and three components are being reported this year: the payment system error of 0.59 percent, the low-income subsidy payment error of 0.25 percent, and payment error related to Medicaid status for dual eligible Part D enrollees 1.06 percent.
  • The composite Medicaid error rate is 8.7 percent, compared to 10.5 percent for states measured in 2007.

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Mars Snackfood US ISSUES ALLERGY ALERT ON UNDECLARED PEANUTS In Dove Caramel Pecan Perfection Ice Cream
Mon, 26 Oct 2009 15:54:00 -0500

Today, Mars Snackfood US announced a voluntary recall of its Dove Caramel Pecan Perfection ice cream with the lot number 931AB5YN07 because it may contain undeclared peanuts. People who have an allergy or severe sensitivity to peanuts run the risk of serious or life-threatening allergic reaction if they consume these products. No related illnesses have been reported to date.

Accusure Insulin Syringes (Qualitest Pharmaceuticals) – Recall

Audience: Diabetes healthcare professionals and patients

Qualitest Pharmaceuticals and FDA notified healthcare professionals of a nationwide recall of Accusure Insulin Syringes. All syringes, regardless of lot number, are subject to this recall. These syringes were distributed between January 2002 and October 2009 to wholesale and retail pharmacies nationwide (including Puerto Rico). The syringes in these lots may have needles which detach from the syringe. If the needle becomes detached from the syringe during use, it can become stuck in the insulin vial, push back into to the syringe, or remain in the skin after injection. Consumers who have any Accusure insulin syringes should stop using them and contact Qualitest at 1-800-444-4011 for reimbursement.

Read the complete MedWatch 2009 Safety summary, including a link to the firm’s press release and previous August 2009 recall, at:

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