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. – The data reveals this discrepancy has resulted in hospitals receiving only a 2.4 PINC AI™ Data Analysis.

Hospitals 52

Hospitals COVID-19 Payment Systems Medicaid 52

Medisys Compliance

APRIL 11, 2024

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. This milestone represents a major victory for the mental health professions, expanding access to much-needed care for Medicare beneficiaries and offering exciting new possibilities for MFTs and MHCs.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

HIT Consultant

OCTOBER 30, 2023

The impact on eligible hospitals would be the loss of 75 percent of the annual market basket increase; for CAHs, payment would be reduced to 100 percent of reasonable costs instead of 101 percent. The Promoting Interoperability performance category score typically can be a quarter of a clinician or group’s total MIPS score in a year.

Medicare 98

Medicare Medicare Payment Systems Hospitals 98

Medisys Compliance

FEBRUARY 9, 2024

Hospital Outpatient Prospective Payment System (OPPS) Updates OPPS is a payment system used by Medicare to reimburse hospitals for outpatient services, including some wound care procedures. These updates reflect changes in healthcare costs and utilization patterns.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

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. Importantly, however, an REH cannot provide any inpatient hospital services.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

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”). Critical access hospitals (“CAHs”) and rural hospitals with 50 beds or fewer could transition to REH status starting January 1, 2023.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

Hall Render

MAY 10, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) announced its plan to implement the Transforming Episode Accountability Model (“TEAM”), a new mandatory alternative payment model unveiled as part of the 2025 Hospital Inpatient Prospective Payment System proposed rule.

Medicare 40

Medicare Medicare Hospitals Medicaid 40

Hall Render

APRIL 12, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). Background Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

Medicare 40

Medicare Medicare Payment Systems Hospitals 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

Written by Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS The Federal Hospital Price Transparency Rule helps Americans know the cost of a hospital item or service before receiving it. The regulation aims to improve the affordability of hospital care by promoting price competition.

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

Health Law Attorney

DECEMBER 18, 2020

The Centers for Medicaid & Medicare Services ( CMS ) recently released the 2021 Outpatient Prospective Payment System ( OPPS ) and Ambulatory Surgical Center ( ASC ) Final Rule, which may be accessed here. Continue Reading ?.

Medicare 40

Medicare Medicare COVID-19 Payment Systems 40

Healthcare IT Today

NOVEMBER 15, 2023

The technique involves finding data from public sources such as Centers for Medicare & Medicaid Services (CMS). Resilient Healthcare Employs Extensive Data Analytics Resilient Healthcare provides in-home care for conditions that have traditionally required a hospital stay. offering in-home treatment.

Medicare 94

Medicare Medicare Hospitals Compliance 94

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

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”). in FY 2024 but applies a 0.2% from FY 2023 to FY 2024.

Hospitals 40

Hospitals Medicare Medicare Medicaid 40

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. During the Dispute Period, Covered Recipients may use CMS’ Open Payments system to formally dispute any information they believe is incorrect.

Hospitals 40

Hospitals Payment Systems Nurses Medical Device Industry 40

YouCompli

FEBRUARY 22, 2023

Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. It is “prospective” because hospitals and other providers know ahead of time what they will be reimbursed. These additional payments are called outlier payments.”

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

AIHC

NOVEMBER 29, 2023

Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement. Hospital reimbursement also changed. healthcare system were exorbitant. The poor quality of care, inefficiencies, and total cost to the U.S.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

AIHC

NOVEMBER 29, 2023

Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement. Hospital reimbursement also changed. healthcare system were exorbitant. The poor quality of care, inefficiencies, and total cost to the U.S.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Healthcare IT Today

DECEMBER 31, 2020

To further support clinicians during the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services (CMS) has extended the deadline for COVID-19 related 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception applications to February 1, 2021.

COVID-19 52

COVID-19 Payment Systems Medicaid Medicaid 52

Hall Render

MARCH 20, 2024

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

Healthcare IT News - Telehealth

DECEMBER 14, 2021

This is why, as the new year approaches, Healthcare IT News has sat down with an expert in value-based care to get his views on what 2022 will hold for the payment system. Caravan Health is a privately held company formed to create sustainable methodologies for health systems to excel in value-based care.

Medicare 173

Medicare Medicare COVID-19 Telemedicine 173

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. (i)

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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

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

MedTrainer

JANUARY 12, 2024

Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. MACRA (2015): The Medicare Access and CHIP Reauthorization Act (MACRA) introduced the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

Compliance 52

Compliance HIPAA Telemedicine ACA 52

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

The Health Law Firm

AUGUST 30, 2013

Board Certified by The Florida Bar in Health Law On August 2, 2013, the Centers for Medicare and Medicaid Services (CMS) released the 2014 Inpatient Prospective Payment System (IPPS) Final Rule (the 2014 IPPS Final Rule). Indest III, J.D.,

Hospitals 40

Hospitals Payment Systems Medicaid Medicaid 40

Hall Render

AUGUST 11, 2023

On August 7, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule (“Final Rule”) that updated Medicare payment policies and rates for skilled nursing facilities (“SNFs”) under the Skilled Nursing Facility Prospective Payment System (“SNF PPS”) for fiscal year (“FY”) 2024.

Nurses 40

Nurses COVID-19 Vaccine COVID-19 Payment Systems 40

Hall Render

MAY 20, 2022

On May 10, 2022, CMS published its proposed revisions to the Inpatient Prospective Payment System for 2023. CMS proposed two changes that would affect reimbursement for graduate medical education (“GME”) programs at teaching hospitals. and 10 fellows (weighted 0.5), it would pay the hospital as if it were training 95 FTE.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Hall Render

MAY 30, 2023

On April 4, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released a proposed rule (“Proposed Rule”) that would update Medicare payment policies and rates for skilled nursing facilities (“SNFs”) under the Skilled Nursing Facility Prospective Payment System (“SNF PPS”) for fiscal year 2024.

Nurses 40

Nurses COVID-19 Vaccine COVID-19 Medicare 40

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% 1 CMS final rule boosts Medicare hospice payments by 3.1% 1 CMS final rule boosts Medicare hospice payments by 3.1% To Address SDOH Needs U.S. To Address SDOH Needs U.S.

COVID-19 40

COVID-19 Hospitals Nursing Homes Nurses 40

Hall Render

MARCH 15, 2024

NATIONAL 3 things to expect from the pharmaceutical supply chain in 2024 Absence of AI hospital rules worries nurses American Academy of Dermatology votes to keep its diversity policies after anti-DEI proposal Are digital health partnerships replacing M&A? From -6.8%

US Department of Health and Human Services 40

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

HIT Consultant

SEPTEMBER 7, 2021

With the No Surprises Act taking effect in less than four months, it is critical that hospitals and providers leverage technology to ensure patients are informed about their expected care costs prior to receiving services. Kwon, JD, MHA, R1 Manager, Advisory & Assurance – Regulatory.

Medical Billing 52

Medical Billing Hospitals Patient Satisfaction Medicaid 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. Three-Day Prior Hospitalization/Qualifying Hospital Stay. Expedited Enrollment.

Public Health 40

Public Health Nurses Nursing Homes COVID-19 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. Deactivation.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Redox

OCTOBER 12, 2023

AI reimbursement Medicare and Medicaid are beginning to reimburse for AI applications on a per-use basis, though adoption is still in its infancy. While direct reimbursement AI technology remains limited, AI can nevertheless be successfully integrated into other existing payment models. Two states have enacted such measures.

FDA 69

FDA Hospitals Medicare Medicare 69

HIT Consultant

AUGUST 28, 2023

.” The standard playbook for success in the medical facility industry focuses on factors like identifying and delivering in-demand services, establishing a strong brand and building relationships with local hospitals and physicians to create a referral network. But mergers and acquisitions can lead to major headaches for AP processes.

Payment Systems 103

Payment Systems Compliance Medicaid Medicaid 103