HealthIT Answers

OCTOBER 20, 2022

By Alex Baker & Elisabeth Myers - On August 1, 2022, CMS announced final changes to its payment program for acute care hospitals in 2023. The FY 2023 Inpatient Prospective Payment System final rule also included policies for the 2023 Medicare Promoting Interoperability Program, which rewards.

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Payment Systems Medicare Medicare Hospitals 52

HIT Consultant

NOVEMBER 9, 2022

A report by Bain and Company , 2022 Healthcare Provider IT Report: Post-Pandemic Investment Priorities, found that clinician shortages and wage inflation are driving demand for solutions that improve productivity and alleviate labor needs.

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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.

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Hospitals Payment Systems Nurses Medical Device Industry 40

Healthcare IT Today

AUGUST 14, 2022

HIMSS has released its 2022 Future of Healthcare Report , and survey results suggest that payers and providers look at big technology companies differently. Health Payment Systems, Inc. News and Studies. Clinical data platform MRO named Nathan Eastman as Chief Financial Officer.

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Nurses COVID-19 Hospitals Payment Systems 78

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.

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HIT Consultant

APRIL 21, 2022

. – The data CMS uses to account for real inflation in the cost of labor and other expenses is unlikely to reflect reality and produce an accurate payment update for the FY 2023 IPPS rule, due this spring. CMS is expected to release proposed rules for the Inpatient Prospective Payment System (IPPS). PINC AI™ Data Analysis.

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Healthcare It News

MAY 2, 2024

Dr. Kim Schrier, D-Washington, also asked questions about the 2022 merger, which the U.S. While efforts to address the situation, and advance payments are appreciated, she said, "The reality is that this massive far-reaching attack has disproportionately impacted small, independent practices that were already struggling to stay afloat.

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US Department of Health and Human Services HIPAA Ransomware Governance 275

YouCompli

FEBRUARY 22, 2023

This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS). However, there are certain circumstances when Medicare, for example, will reimburse additional amounts beyond the prospective payment rate.

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Compliance US Department of Health and Human Services Overpayments Overpayment 52

Compliancy Group

OCTOBER 5, 2023

One of these incentives is the Merit-Based Incentive Payment System, or MIPS, program. Ground Rules The MIPS ground rules for 2023 are similar to the MIPS ground rules for 2022. Providers who meet MIPS requirements may receive more favorable Medicare reimbursement rates. The MIPS rules for 2023 are discussed below.

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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.

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Hospitals Payment Systems Medicare Medicare 70

Natalia Mazina

APRIL 25, 2023

reduction to payments for most drugs purchased through the 340B Program and paid under the Outpatient Prospective Payment System (“OPPS”). At the end of 2022, HHS introduced a new proposed rule. Medicare reimbursement cut In 2018, CMS implemented a 28.5%

US Department of Health and Human Services 52

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

Hall Render

FEBRUARY 24, 2022

Following this reporting, impacted providers and teaching hospitals will have the opportunity to review reported payments and investments and to dispute any incorrect reports until May 15, 2022. Changes in Reporting Year 2022. Background. New Affected Parties. These categories are: Debt Forgiveness.

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Healthcare IT Today

NOVEMBER 11, 2022

Widespread autonomous medical coding is one of the first steps to rebuilding America’s healthcare payments system into something that actually works for providers, payors, and patients,” said Andrew Lockhart, Fathom CEO and CoFounder. Originally announced November 9th, 2022. Galym Imanbayev, M.D.,

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Payment Systems 52

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.

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Payment Systems Hospitals Medicare Medicare 40

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.

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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. Becerra (“ Becerra ”), overturning massive reimbursement reductions in the 340B drug pricing program (“340B Program”). The 340B Program, in which some 40% of U.S.

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Hospitals Payment Systems Medicare Medicare 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.

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Medicare Medicare Payment Systems Governance 52

Redox

JANUARY 24, 2024

While most of the rule focuses on payer requirements, it also requires that Merit-Based Incentive Payment System (MIPS) “Promoting Interoperability Program” eligible providers report on their use of Prior Authorization APIs in a new “Electronic Prior Authorization” measure.

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HIPAA Compliance Payment Systems 59

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.

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Hospitals Payment Systems Medicare Medicare 40

HIT Consultant

FEBRUARY 9, 2023

In just the first six months of 2022, the healthcare sector suffered about 337 breaches according to Fortified Health Security’s mid-year report. Today, the cost of a data breach comes with a hefty price tag – an average of $9.44 million in the U.S. alone, according to IBM Security’s 2022  Cost of a Data Breach Report.

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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%

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Hospitals Medicare Medicare Medicaid 40

Verisys

JUNE 13, 2023

If online applications and payments were submitted during this time period, please do not resubmit without checking the status of the license or registration. Payment Systems Notice The Iowa Board of Pharmacy has made the following updates and amendments to the board administrative rules. All are effective July 5, 2023.

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

HIT Consultant

JUNE 7, 2023

turnover , over the last 5 years, according to Daily Pay’s Healthcare Turnover Rates [2022 Edition]. Looking at the physical therapy (PT) profession as a whole, there is an average turnover rate of 13.6% , a significant portion of the current healthcare industry’s staggering rate of 100.5% What’s contributing to such high levels of burnout?

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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.

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COVID-19 Payment Systems Medicare Medicare 40

Medisys Compliance

APRIL 18, 2022

MIPS Eligible clinicians participating in Advanced APMs are included in MIPS if they do not meet the threshold for payments or patients sufficient to become a Qualifying APM Participant (QP). All-Payer Advanced Alternative Payment Models. The MIPS eligible clinician will be scored under MIPS according to the APM scoring standard.

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Medical Billing Medical Billing Outsourcing Medicaid 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. Primarily, CMS covers AI reimbursement with AI-specific Current Procedural Terminology (CPT) codes created by the American Medical Association CPT Editorial Panel or by establishing New Technology Add-on Payments (NTAPs) for AI devices.

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FDA Hospitals Medicare Medicare 69

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.

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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.

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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.

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Medicare Medicare Payment Systems 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).

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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. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. Why this Trend of Value-Based Care?

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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. We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. Why this Trend of Value-Based Care?

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Medicare Medicare 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.

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US Department of Health and Human Services Medicare Medicare Medicaid 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. 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). billion in FY 2021, or 2.7

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Medicare Medicare Hospitals Payment Systems 52

Bill of Health

NOVEMBER 6, 2023

This necessitates the integration of markets, the implementation of uniform online payment systems, the standardization of taxation and duties, and cross-border trade facilitation. The AU’s blunder stands in stark contrast with China’s policy on data commercialization, which was also released in 2022.

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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.

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