Issue link: https://beckershealthcare.uberflip.com/i/842028
22 CFO / FINANCE NY Cancer Center Avoids Medicare Reimbursement Cut After $250k Typo By Ayla Ellison C MS decided not to pull $250,000 in Medicare reimbursement from He- matology-Oncology Associates of CNY, a cancer treatment center with loca- tions across New York in Auburn, Camillus, East Syracuse and Onondaga Hill, according to a news release from Senate Minority Lead- er Charles Schumer, D-N.Y. Hematology-Oncology Associates partici- pates in Medicare's Oncology Care Model, which is administered by CMS. When sub- mitting annual performance data the cancer center used the incorrect value modifier. In- stead of using "1P" to identify patient cases the cancer center used "lP." CMS told Hematology-Oncology Associ- ates its Medicare reimbursement would be reduced by $250,000 due to the error. e cancer center appealed the ruling, but CMS stood by its decision. Mr. Schumer and Rep. John Katko, R-N.Y., sent a letter to CMS Administrator Seema Verma asking the agency to reconsider its decision. ey argued the $250,000 cut in Medicare reimbursement due to the clerical error lacked common sense and was overly punitive. Mr. Schumer and Mr. Katko announced May 31 that CMS reversed its decision. "Congressman Katko and I know how im- portant Hematology-Oncology Associates of CNY's work is to this community and those suffering from severe medical conditions. is decision lacked common sense and we knew that we had to push CMS to reconsider," said Mr. Schumer. n Health System CEO Pulls Out $6M Check to Pay Debts During Budget Hearing By Ayla Ellison D aniel Snyder, CEO of Shreveport, La.-based Universi- ty Health System, stunned senators when he brought a check for $6.2 million to a budget hearing to pay debts owed to Baton Rouge-based Louisiana State University. Biomedical Research Foundation of Northwest Louisiana in Shreveport operates University Health System's hospitals in Shreveport and Monroe, La. Under a state contract, LSU physicians and students provide services at the two hospi- tals and University Health System is required to pay LSU for those services. However, the system has fallen behind on its payments. During the budget hearing May 26, LSU Health Sciences Center Shreveport Chancellor G.E. Ghali, DDS, MD, told senators University Health System owes $12 million for ser- vices provided by LSU physicians. When senators questioned Mr. Snyder about the debt, he said the bills had not been paid because the invoices sent by LSU didn't have sufficient supporting documentation, in- cluding details regarding the physician services provided. After additional questioning regarding the unpaid debts, Mr. Snyder surprised senators when he pulled out a check for $6.2 million from his coat pocket to present to Dr. Ghali. Finance Chairman Sen. Eric LaFleur said he had never seen anything like this occur during a budget hearing. "If this is how you conduct business, the future doesn't seem to be too bright," he told Mr. Snyder during the hearing. Dr. Ghali said he would work to get Mr. Snyder additional documentation, but he noted the additional details are not required under the contract between the parties. n Study: 41% of Healthcare Spending Attributed to 12% of Americans By Ayla Ellison U .S. adults with five or more chronic conditions spend 14 times more on health services on aver- age than those with no chronic conditions, accord- ing to a RAND Health report prepared for the Partnership to Fight Chronic Disease. For the study, researchers analyzed the Medical Expendi- ture Panel Survey from Agency for Healthcare Research and Quality. MEPS is a nationally representative sample of the noninstitutionalized U.S. adult population. The study revealed 60 percent of U.S. adults had at least one chronic condition in 2014, the most recent year data is available. Forty-two percent of U.S. adults had more than one chronic condition, according to the study. The study showed people with more chronic conditions require more healthcare services. For example, the study revealed people with five or more chronic conditions av- erage 20 physician visits per year, while those with three or four chronic conditions average 12 physician visits annually. The study also showed spending on healthcare services ris- es with the number of chronic conditions a person has. U.S. adults with one or two chronic conditions make up 31 per- cent of the population and 23 percent of total healthcare spending. Those with five or more chronic conditions make up 12 percent of the population but account for 41 percent of total healthcare spending, according to the study. For the study, researchers defined healthcare spending as the amount spent on all inpatient and outpatient care across all payers, including out-of-pocket payments. n