Hall Render

AUGUST 1, 2022

The proposed payment policies include an initial monthly facility fee of approximately $268,000 per month, which will adjust in future years based on a market-basket update. Public comments on the payments policies and other proposed policies are due September 13, 2022. Proposed REH Payments. 5 Percent OPPS Increase.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Hall Render

AUGUST 10, 2023

On August 1, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued its Final Hospital Inpatient Prospective Payment System (“IPPS”) and Long-Term Care Hospital (“LTCH”) PPS rule for fiscal year (“FY”) 2024 (“Final Rule”). The Final Rule increases the rate for IPPS payments by 3.3%

Hospitals 40

Hospitals Medicare Medicare Medicaid 40

YouCompli

FEBRUARY 22, 2023

Price increases can sometimes result in inappropriate outlier payments. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS).

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

Hall Render

JULY 7, 2022

On June 30, 2022, the Centers for Medicare & Medicaid Services (“CMS”) released proposed regulations (“Proposed Rule”) addressing the Conditions of Participation (“CoPs”) that a provider will need to meet to qualify as an REH. This facility payment will be adjusted each year by the annual hospital market basket update factor.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

Verisys

JUNE 13, 2023

Centers for Medicare & Medicaid Services : The US Department of Health and Human Services has issued a final rule update concerning guidelines for COVID-19 vaccination requirements for Long-Term Care Facilities (LTC) and Intermediate Care for Individuals with Intellectual Disabilities (ICFs-IID). All are effective July 5, 2023.

COVID-19 Vaccine 52

COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

C&M Health Law

DECEMBER 23, 2022

The regulations impact CMS-regulated payers and provide incentives for providers and hospitals that participate in the Medicare Promoting Interoperability Program and the Merit-based Incentive Payment System (MIPS). Most of the Proposed Rule’s provisions will be effective on January 1, 2026. Our initial takeaways are summarized below.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

A 2022 report from the Commonwealth Fund U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. healthcare system were exorbitant. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Hall Render

SEPTEMBER 2, 2022

On July 26, 2022, the Centers for Medicaid and Medicare (“CMS”) published the 2023 Hospital Outpatient Prospective Payment System (OOPS) and Ambulatory Surgery Center Payment System Proposed Rule. CMS is currently seeking public comments to the proposed changes with comments due on September 13, 2022.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

AIHC

NOVEMBER 29, 2023

A 2022 report from the Commonwealth Fund U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. healthcare system were exorbitant. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

HIT Consultant

JUNE 7, 2023

turnover , over the last 5 years, according to Daily Pay’s Healthcare Turnover Rates [2022 Edition]. Recently introduced by the Center for Medicare and Medicaid Services (CMS), remote therapeutic monitoring (RTM) codes are revolutionizing the way care is delivered. What’s contributing to such high levels of burnout?

Payment Systems 52

Payment Systems FDA Medicaid Medicaid 52

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Hall Render

MAY 20, 2022

On May 10, 2022, CMS published its proposed revisions to the Inpatient Prospective Payment System for 2023. First, CMS proposed to update the way that it calculates direct GME (“DGME”) payments for fellows in some training programs, responding to the court’s decision in Milton S.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Hall Render

JULY 14, 2023

On Friday, June 20, 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 (“PPS Rule”), which has since been published in the Federal Register and is currently open for comment. in June 2022.

Medicare 52

Medicare Medicare Payment Systems Governance 52

Redox

OCTOBER 12, 2023

In 2022, the FDA announced that some types of risk-scoring tools were to be regulated as medical devices. AI reimbursement Medicare and Medicaid are beginning to reimburse for AI applications on a per-use basis, though adoption is still in its infancy. 63, 20 May 2022. phData , 18 Feb. Accessed 3 Oct. NCSL, www.ncsl.org.

FDA 69

FDA Hospitals Medicare Medicare 69

Hall Render

JUNE 22, 2022

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”). CY 2023 HH Payment Update. payment update. Permanent BA Adjustment Factor.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40

Hall Render

MAY 2, 2023

In the CY 2022 Rule, CMS set December 31, 2024, as a termination date for most COVID SNF notification requirements. CMS ended several of the SNF blanket waivers in 2021 and 2022. The F-Tag associated with this regulation is F-884. The F-Tag associated with this regulation is F-885.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

Medisys Compliance

JUNE 20, 2022

If a patient receiving home infusion therapy is also under a home health plan of care and receives a visit that is unrelated to the administration of the home infusion drug, then payment for the home health visit would be covered under the Home Health Prospective Payment System (HH PPS) and billed on the home health claim.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Health Care Law Brief

NOVEMBER 17, 2021

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) released its final rules for the 2022 Medicare Physician Fee Schedule (PFS Final Rule) and 2022 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS Final Rule). 77492 (Dec.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Medisys Compliance

AUGUST 4, 2022

Proposed ESRD Payment System. This rule also proposes an update to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2023. Direct nursing services include registered nurses, licensed practical nurses, technicians, social workers, and dietitian.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

AIHC

JANUARY 28, 2022

For more information on filing compliance cost reports, attend the Medicare Cost Report Camp in March 2022 presented by KraftCPAs and sponsored by the American Institute of Healthcare Compliance. LTCHs are paid under the Long-Term Care Hospital Prospective Payment System (LTCH PPS).

Medicare 52

Medicare Medicare Hospitals Payment Systems 52

Hall Render

MARCH 28, 2023

The end of the PHE has a significant impact on skilled nursing facilities (“SNFs”) as it ends the remaining regulatory blanket waivers, revisits resident Medicaid eligibility and changes many COVID regulations that were issued during the PHE. CMS ended several of the SNF blanket waivers in 2021 and 2022.

Public Health 40

Public Health Nurses Nursing Homes COVID-19 40

Health Law Advisor

NOVEMBER 2, 2022

In the 2023 Outpatient Prospective Payment System Final Rule (OPPS Final Rule), released in pre-publication form on November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) adopts final regulations governing REHs. CMS did not finalize the proposed exception for ownership or investment interests in an REH.

Medicare 52

Medicare Medicare Hospitals Malpractice 52

Hall Render

JULY 12, 2022

CMS recently announced the Enhancing Oncology Model (“EOM”), which will build on the Oncology Care Model that ended on June 30, 2022. The MEOS payment will be higher for beneficiaries dually eligible for Medicare and Medicaid. Applications will be accepted through September 30, 2022. PGP’s across the U.S.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Hall Render

NOVEMBER 28, 2023

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. 7,137 2022 4,770 78.0% 7,872 2018 5,851 77.1%

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

C&M Health Law

AUGUST 10, 2022

On July 29, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare payment policies and rates for skilled nursing facilities (SNFs) and enacts changes to the SNF Quality Reporting Program and the SNF Value-Based Purchasing Program beginning in FY 2023.

Medicare 52

Medicare Medicare COVID-19 Nursing Homes 52

AIHC

NOVEMBER 15, 2022

The Centers for Medicare & Medicaid Services (CMS) is the federal agency responsible for enforcement and has been working with the American Hospital Association (AHA) to comply with challenges related to compliance. In June 2022, CMS issued CMP notices to two hospitals for failure to comply with the final rule.

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

HIT Consultant

SEPTEMBER 7, 2021

The No Surprises Act, in addition to recent revisions to existing Centers for Medicare and Medicaid Services (CMS) price transparency regulations 1 and a policy push by President Biden 2 , aims to continue the trend toward more patient-centric healthcare that makes it easier for patients to navigate the inherent complexity. References.

Medical Billing 52

Medical Billing Hospitals Patient Satisfaction Medicaid 52

Hall Render

AUGUST 4, 2023

1 CMS final rule boosts Medicare hospice payments by 3.1% Will Nemours’ Medicaid move leave 10,000 special-needs kids behind? To Address SDOH Needs U.S. sues UnitedHealth over ‘thousands’ of denied claims What’s a fair price for a prescription drug?

COVID-19 40

COVID-19 Hospitals Nursing Homes Nurses 40

Hall Render

SEPTEMBER 15, 2023

GoFundMe page RHODE ISLAND Police: RI Hospital nurse ‘violently assaulted’ by patient Blue Cross certifies 37 new LGBTQ Safe Zones Miriam Hospital attains national accreditation for rectal cancer care R.I.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes COVID-19 Nurses 40

Healthcare IT Today

MARCH 12, 2023

Reports By the middle of 2022, behavioral health visit volume was 18% higher that pre-pandemic levels , according to an analysis from Trilliant Health. in January 2023 compared to January 2022) was offset by bad news about month-over-month margins (down 2.2% The good news about year-over-year margins (up 3.7% from December to January).

Telemedicine 95

Telemedicine Medicaid Medicaid Payment Systems 95

Hall Render

APRIL 21, 2023

health-tech startup MemoryWell pivots, eyes new funding to roll out software for insurers Department of Veterans Affairs health system kicks off multiyear Greater Washington expansion Georgetown to open Southeast D.C.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nurses Nursing Homes 40

Hall Render

MARCH 15, 2024

of Labor projects 6000 health care job openings per year Negotiations between Local 17 Nurses and Providence St. Patrick Hospital to take place at later date St.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40