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

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.

Medicare 98

Medicare Medicare Payment Systems Hospitals 98

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

Medisys Compliance

APRIL 11, 2024

You can bill for services provided in various settings, including your private practice office, hospitals, outpatient clinics, and even some telehealth platforms. Telehealth Considerations Telehealth has become an increasingly important aspect of mental healthcare delivery.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

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

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. It is “prospective” because hospitals and other providers know ahead of time what they will be reimbursed.

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Compliance US Department of Health and Human Services Overpayments Overpayment 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

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

AIHC

NOVEMBER 29, 2023

Hospital reimbursement also changed. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay. healthcare system were exorbitant.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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 98

Medicare Medicare Hospitals Compliance 98

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. Patient Access API. (i)

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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. CMS will be phasing the IPO list out over the next three years, with the IPO being completely phased out by CY 2024.

Medicare 40

Medicare Medicare COVID-19 Payment Systems 40

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

AIHC

NOVEMBER 29, 2023

Hospital reimbursement also changed. In 1983 Medicare shifted to the inpatient Prospective Payment System (PPS) and DRGs (Diagnostic Related Groups) and only paying a limited number of days to the hospital regardless of the actual length of stay. healthcare system were exorbitant.

Medicare 52

Medicare Medicare Medicaid 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. Background. Once a facility converts to an REH, it cannot provide inpatient services. New Stark Exception.

Payment Systems 40

Payment Systems Hospitals 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

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 178

Medicare Medicare COVID-19 Telemedicine 178

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

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

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

Healthcare IT Today

AUGUST 13, 2023

At the same time, hospital-owned practices have seen their revenue return to pre-pandemic levels. Additionally, Microsoft announced that New York City’s Mount Sinai Health System has the largest production instance of Epic running on Azure in the world. New York City-based Best Medical Care PC selected eClinicalWorks Cloud.

US Department of Health and Human Services 86

US Department of Health and Human Services Doctors Payment Systems Telemedicine 86

Electronic Health Reporter

JANUARY 15, 2019

The 340B Drug Pricing Program was created in 1992 to give safety net providers — those that deliver a significant level of both healthcare and other health-related services to the uninsured, Medicaid, and other vulnerable populations — discounts on outpatient drugs to “stretch scare federal resources as […].

Medicaid 107

Medicaid Medicaid Payment Systems Medicare 107

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

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

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. hospitals In 2023, experts from McKinsey & Company and Harvard University published their estimates of AI’s financial impact on multiple healthcare stakeholders, including hospitals.

FDA 69

FDA Hospitals Medicare Medicare 69

Hall Render

MAY 2, 2023

Three-Day Prior Hospitalization/Qualifying Hospital Stay. Using the statutory flexibility under Section 1812(f) of the Social Security Act, CMS temporarily waived the requirement for a three-day prior hospitalization for coverage of a SNF stay. The F-Tag associated with this regulation is F-884. Benefit Period Blanket Waiver.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

HIPAA Journal

MARCH 29, 2024

billion has been provided to safety net hospitals and federally qualified health centers that serve high-risk patients and communities. The Washington State Hospital Association ( WSHA ) has also been contacted by its members who have expressed concern about the notification requirements after reading OCR’s letter. 40% of the $3.3

Ransomware 95

Ransomware US Department of Health and Human Services HIPAA Hospitals 95

CMS.gov

NOVEMBER 15, 2018

Administrator, Centers for Medicare & Medicaid Services. Approximately 60 million people live in rural areas – including millions of Medicare and Medicaid beneficiaries. We know that accurate and appropriate Medicare payment rates are essential to all hospitals, especially rural ones. Jeremy.Booth@c…. Seema Verma.

Medicare 50

Medicare Medicare Payment Systems Medicaid 50

Healthcare IT News - Telehealth

AUGUST 19, 2020

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. As the community’s safety-net healthcare provider, AccessHealth will free up hospitals to focus on COVID-19 patients.

COVID-19 175

COVID-19 Telemedicine Compliance HIPAA 175

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.

Medicare 52

Medicare Medicare Payment Systems Governance 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). at 1396b(s).

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

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

AIHC

JANUARY 28, 2022

Medicare Uncompensated Care Payments & DSH Hospitals' charity care and bad debt, together known as uncompensated care, is used to calculate disproportionate-share hospital payments. This is calculated based on the hospital’s relative share of uncompensated care nationally.

Medicare 52

Medicare Medicare Hospitals Payment Systems 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