More penalized Georgia hospitals . . . and more controversy

By Jordan Rau and Andy Miller Medicare has penalized 21 Georgia hospitals for having the highest rates of patient infections and potentially avoidable complications. That’s up slightly from the 18 hospitals in the state that drew penalties in the last round of federal assessments. For the penalized hospitals, Medicare payments are reduced by 1% for…

PruittHealth to pay $4.2M to settle case over billing allegations

A large Georgia-based health care company and its affiliates have agreed to pay $4.2 million to resolve allegations in a false-claims case involving its home health business, federal officials announced Monday. Besides providing home care services, PruittHealth, based in Norcross in metro Atlanta, is one of the South’s largest nursing home chains, with more than 50…

Commentary: Medicare pay cuts will do harm

Physical therapists can help seniors stay active and independent. And this therapy can also reduce the risk of falls, which lead to more than 30,000 deaths annually. But proposed federal payment cuts under Medicare threaten the financial stability of physical therapists, says Zach Walston, an Alpharetta-based physical therapist, in a new GHN Commentary. “Additionally, with…

A misguided plan for Medicare cuts

By Zach Walston Specialty care providers in Georgia have worked tirelessly through the pandemic to ensure their patients have maintained access to vital care, including physical, occupational, and speech therapy. However, steep payment cuts proposed by the federal Centers for Medicare & Medicaid Services (CMS) threaten patient access to quality care –– worrying patients, providers,…

Medicare penalties hit U.S. hospitals hard, including in Georgia

Medicare is reducing payments to nearly half of the nation’s hospitals for excessive patient readmissions, including 81 in Georgia, Kaiser Health News reported Thursday. The total penalized in Georgia represent 55 percent of the state’s hospitals, higher than the national average of 47 percent. But if you remove facilities that are exempt from penalties from…

Wellstar-United contract ends without a deal, affecting thousands

Tens of thousands of UnitedHealthcare members will now face higher out-of-pocket fees if they go to Wellstar Health System hospitals and doctors. The contract between the two organizations ended Sunday without a new agreement. An estimated 80,000 United members will be affected. Payment for medical services is the sticking point.  United says the Wellstar demands…

Hospitals unsure of vaccine mandate’s effects, but it may curb nurse job-jumping

Georgia hospital officials were scrambling Friday to gauge the impact of President Biden’s order for health care workers to get vaccinated for Covid-19. The mandate would apply to health care facilities that treat Medicare and Medicaid patients – virtually all hospitals – as well as dialysis centers, surgery centers and home care operations. (Nursing homes…

Georgia near bottom in rate of required nursing home inspections

Georgia is second to last among states in conducting comprehensive inspections of its nursing homes, according to a federal report. More than 90 percent of Georgia nursing homes had gone without a thorough inspection for at least 16 months as of May 31, the report found. Federal health agencies require these “standard surveys’’ to be…

For many, insurance doesn’t prevent high costs from prescriptions

Half of Americans take no prescription drugs. At the other end of the spectrum are people like Karen Milligan. She needs several drugs and pays a lot for them. She has dealt with multiple sclerosis for three decades. It’s disease of the central nervous system with no cure.  At 65, Karen is seeing her drug costs continue to increase, even for the…

Most Georgia hospitals getting penalized for readmissions

More than 80 Georgia hospitals will receive lower reimbursements from Medicare because of their high rates of patient readmissions. Federal statistics compiled by Kaiser Health News show that just 12 eligible hospitals in the state will get no penalty due to readmissions. The readmission penalties are required under the Affordable Care Act. The latest round…