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CMS Issues Long-Awaited Medicare Advantage RADV Final Rule

Healthcare Law Blog

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. See also Ratanasen v.

Medicare 105
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Quality Payment Program (QPP) Year 1 Performance Results

CMS.gov

Administrator, Centers for Medicare & Medicaid Services. Quality Payment Program (QPP) Year 1 Performance Results. Earlier this year, we released preliminary participation data on clinicians eligible to participate in the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program (QPP).

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AccessHealth uses telemedicine to boost mental health visits by 10% during COVID-19

Healthcare IT News - Telehealth

Staff members were unsure if Medicare and Medicaid would honor the prospective payment-system rate. Decisions were not made yet on the level of payment. In 2017, AccessHealth set goals that were modeled after the Department of Health and Human Service’s Healthy People 2020 Program.

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Home Health PPS Proposed Rule for CY2023: More Bad News for the Home Health Industry

Hall Render

On Friday, June 17, 2022, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2023 Home Health Prospective Payment System Rate Update (“PPS Rule”). One of the largest changes to home health payment under PDGM was the move to variable LUPA thresholds.

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On National Rural Health Day, We Recommit to Improving Rural Health

CMS.gov

Administrator, Centers for Medicare & Medicaid Services. Approximately 60 million people live in rural areas – including millions of Medicare and Medicaid beneficiaries. Our flexible approach resulted in notable successes for clinicians in rural practices during the 2017 performance year. Jeremy.Booth@c…. Seema Verma.

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Uncompensated Care and DSH (Medicare disproportionate share hospitals)

AIHC

Medicare Uncompensated Care Payments & DSH Hospitals' charity care and bad debt, together known as uncompensated care, is used to calculate disproportionate-share hospital payments. LTCHs are paid under the Long-Term Care Hospital Prospective Payment System (LTCH PPS).

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Home Health PPS Final Rule for CY 2024: CMS Steps Back from the Brink

Hall Render

On November 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) posted a pre-publication copy of the Calendar Year (“CY”) 2024 Home Health Prospective Payment System Rate Update Final Rule (“2024 Final Rule”), which has since been filed in the Federal Register. 7,872 2018 5,851 77.1% 7,589 2019 5,871 79.3%