The article below is reprinted with permission from The Capital Issue, a quarterly newsletter published by Lancaster Pollard.

"But in the world nothing can be said to be certain except death and taxes."

Benjamin Franklin may need to amend his famous quotation to include the certainty of reimbursement uncertainty for healthcare providers. Considering the size and scope of Medicaid and Medicare, the threat of reimbursement-rate cuts for these programs can be particularly problematic for hospitals as they seek financial stability and plan for future capital projects.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: What is the biggest inefficiency in your practice?

The Valley Orthopaedic Specialists clinic, part of Yakima (Wash.) Valley Memorial Hospital, will close its doors Sept. 30, according to a Yakima Herald-Republic report.

The Centers for Medicare & Medicaid Services division of outpatient care is considering the removal of cervical disc arthroplasty from the Medicare "inpatient only" list, a move which the International Society for the Advancement of Spine Surgery supports.

Approximately 228,435 Medicare and Medicaid beneficiaries where victim to a security breach when former South Carolina HHS employee, Christopher Lykes Jr., allegedly transferred personal information to his email account, according to a CMIO report.

CMS has named the first 27 accountable care organizations to participate in the Medicare Shared Savings Program, effective this month.

The following data, from the National Hospital Discharge Survey, reflects the expected hospital payment source in different regions of the United States. Expected payment source is the type of program or insurance that, upon admission to the hospital, was expected to be the principal payor for the hospital stay.

On Feb. 1, 2012, North American Spine Society sent a letter to House of Representatives member Allyson Schwartz with comments on the Medicare Physician Payment Innovation Act.

In the Medicare Payment Advisory Commission's annual payment policy report (pdf) to Congress, MedPAC officials recommended that Medicare payments for ASCs increase by 0.5 percent for the 2013 calendar year.

On February 16, 2012, the Centers for Medicare & Medicaid Services issued a long-awaited proposed rule to establish regulations regarding the reporting and returning of overpayments to the Medicare program (77 Fed. Reg. 9,179 (Feb. 16, 2012)). The proposed regulations at 42 C.F.R. Part 401, subpart D would implement § 6402(a) of the Affordable Care Act (Public Law 111-148), in part, by outlining the disclosure and repayment policies and procedures applicable to Medicare Part A and Part B providers and suppliers. While the proposed regulations apply only to this subset of providers and suppliers at this time, CMS notes in the preamble of the proposed rule that the statutory requirements of § 1128J(d) of the Social Security Act (regarding the obligation to report and return overpayments) continue to apply to all stakeholders despite the absence of established regulations.