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. REHs would also get a 5 percent add-on to most outpatient payments. Proposed REH Payments. 5 Percent OPPS Increase.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

YouCompli

FEBRUARY 22, 2023

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

HIT Consultant

APRIL 21, 2022

What You Should Know: – Centers for Medicare & Medicaid Services’ (CMS) payment adjustments did not adequately address hospitals increased costs for FY 2021, according to new data from Premier. CMS is expected to release proposed rules for the Inpatient Prospective Payment System (IPPS). PINC AI™ Data Analysis.

Hospitals 52

Hospitals COVID-19 Payment Systems Medicaid 52

Hall Render

JULY 7, 2022

The Consolidated Appropriations Act, 2021 (the “Act”) signed into law on December 27, 2020, created a new Medicare provider type called a Rural Emergency Hospital (“REH”). The Proposed Rule did not contain the details of the payment policies for REHs, which CMS will develop in separate notice and comment rulemaking.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

Hall Render

MARCH 1, 2023

Following this reporting, impacted providers and teaching hospitals will have until May 15, 2023, to review reported payments and investments and to dispute any incorrect reports. For more details regarding the 2022 updates to the Sunshine Act reporting requirements, please access our prior alert here.

Hospitals 40

Hospitals Payment Systems Nurses Medical Device Industry 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. These different Acts initiated the testing of alternate forms of delivering care and payment methodologies.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Natalia Mazina

APRIL 25, 2023

On another, Medicare Part B recently challenged payments to 340B providers. Medicare reimbursement cut In 2018, CMS implemented a 28.5% reduction to payments for most drugs purchased through the 340B Program and paid under the Outpatient Prospective Payment System (“OPPS”).

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Payment Systems 52

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

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. These different Acts initiated the testing of alternate forms of delivering care and payment methodologies.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Medisys Compliance

APRIL 18, 2022

An Alternative Payment Model (APM) is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care. All-Payer Advanced Alternative Payment Models. In order to do so, a clinician must be in a Medicare Advanced APM.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 52

Hall Render

APRIL 20, 2022

The FFY 2023 IPPS Proposed Rule (“Proposed Rule”) was released on April 18, 2022, and CMS published the associated tables on its website. Further, Social Security Act Section 1886(d)(3)(E) requires that the standardized amount be adjusted for differences in hospital wage levels, which CMS implemented through the wage index system.

Medicare 40

Medicare Medicare Hospitals Payment Systems 40

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. One notable difference, however, is that the entity must enroll in Medicare as an REH. Background.

Payment Systems 40

Payment Systems Hospitals 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

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). Patient Access API.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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

Healthcare Law Blog

JUNE 20, 2022

On June 15, 2022, in a win for hospitals, the Supreme Court issued its opinion in American Hospital Association et. HHS did not revert to its prior payment methodology for 340B Program drugs, nor did it make retroactive payment adjustments to providers. The 340B Program, in which some 40% of U.S.

Hospitals 52

Hospitals Payment Systems Medicare Medicare 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

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

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. Two states have enacted such measures. phData , 18 Feb.

FDA 69

FDA Hospitals Medicare Medicare 69

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

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

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).

Medicare 40

Medicare Medicare Payment Systems Medicaid 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. This waiver will terminate at the end of the PHE.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 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

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

Health Law Advisor

NOVEMBER 2, 2022

Announced in the Consolidated Appropriations Act of 2021, Rural Emergency Hospitals (REHs) will be a new type of Medicare provider starting January 1, 2023. Under the OPPS Final Rule, REHs will be paid both on a per-service basis at an OPPS +5% rate and a monthly facility payment. attorney.

Medicare 52

Medicare Medicare Hospitals Malpractice 52

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. We can assist you in receiving accurate and timely Medicare reimbursement for delivered services.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Payment Systems Medicare 59

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

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

MARCH 28, 2023

Blanket Waivers During the PHE, the Centers for Medicare & Medicaid Services (“CMS”) issued many versions and revisions to its memorandum entitled “COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers” that announced blanket waivers for providers, including SNFs. When the PHE ends, the hotlines will be shut down.

Public Health 40

Public Health Nurses Nursing Homes COVID-19 40

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. Kwon, JD, MHA.

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% 1 CMS final rule boosts Medicare hospice payments by 3.1% to settle Medicare fraud claims Maine in top 10 for health care, No. To Address SDOH Needs U.S. To Address SDOH Needs U.S. ranked by U.S.

COVID-19 40

COVID-19 Hospitals Nursing Homes Nurses 40

Hall Render

SEPTEMBER 15, 2023

University of Pittsburgh’s annual health care hackathon event for college students returns Why UPMC selected Epic for its EHR Rural Pennsylvania hospital launches $1.5m

US Department of Health and Human Services 40

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

Hall Render

APRIL 21, 2023

into cutting opioids in hospitals ISU and University of Utah partnership aims to combat Idaho’s mental health crisis Presbyterian-UnityPoint merger moves forward St.

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

Children’s National makes first high-level executive appointments under new CEO DC plans to open emergency department in one of its most underserved communities D.C.

US Department of Health and Human Services 40

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