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.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Hall Render

APRIL 4, 2024

The Requestor’s services further include offering physician practices training related to the Medicare Merit-Based Incentive Payment System (“MIPS”), which could result in higher Medicare reimbursement to the Requestor’s clients.

Payment Systems 40

Payment Systems Medicare Medicare Fraud 40

Medisys Compliance

NOVEMBER 21, 2023

With Medicare Part A serving as a primary payer for many residents, understanding the intricate landscape of SNF billing is crucial to ensure proper reimbursement and compliance. Know the SNF Billing Requirements SNFs bill Medicare Part A using Form CMS-1450 (UB-04) or its electronic equivalent.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

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

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

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

AUGUST 10, 2023

In doing so, CMS will finalize changes to its rural floor wage index policy that can drastically change payments for certain hospitals and its extension of the wage index add-on for low-wage hospitals. CMS also uses the hospital wage index for the Outpatient Prospective Payment System. percentage points.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

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. million per year) for 2023.

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”). 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

Healthcare IT Today

OCTOBER 4, 2022

Thanks to the regulations included as part of meaningful use, the Medicare Access and CHIP Reauthorization Act (MACRA) and the Merit-Based Incentive Payment System (MIPS), every healthcare provider using certified electronic health record technology (CEHRT) has access to Direct Secure Messaging. Tell us what you think.

Payment Systems 81

Payment Systems HIPAA Medicare Medicare 81

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

Hall Render

JULY 12, 2022

Under the voluntary EOM model, Physician Group Practices (“PGPs”) will be accountable for their patients’ health care quality and total spend during six-month episodes of care for Medicare patients with breast cancer, chronic leukemia, small intestine/colorectal cancer, lung cancer, lymphoma, multiple myeloma and prostate cancer.

Medicare 40

Medicare Medicare Payment Systems 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

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

Hall Render

APRIL 18, 2023

Background The Medicare Hospital Inpatient Prospective Payment System (“IPPS”) is designed to pay hospitals for services provided to Medicare beneficiaries based on a national standardized amount adjusted for the patient’s condition and related treatment.

Medicare 40

Medicare Medicare Hospitals Payment Systems 40

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. During the 2022 QP Performance Period, eligible clinicians will be able to become Qualifying Alternative Payment Model Participant (QPs) through the All-Payer Combination Option.

Medical Billing 52

Medical Billing Medical Billing Outsourcing 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. 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

APRIL 20, 2022

The release of the Proposed Rule and the accompanying tables also triggers the start to several deadlines for hospitals, including the unofficial start of the Medicare Geographic Classification Review Board (“MGCRB”) application process. The Medicare program also has an “in between” status called “Lugar status.” Background.

Medicare 40

Medicare Medicare Hospitals Payment Systems 40

Medisys Compliance

JUNE 16, 2022

Medicare’s 3-day (or 1-day) payment window applies to outpatient services that hospitals and hospital wholly owned or wholly operated Part B entities furnish to Medicare beneficiaries. If the admitting hospital is a Critical Access Hospitals (CAHs), the payment window policy doesn’t apply.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Hospitals Medicare 52

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

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

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. Your primary Hall Render contact.

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

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

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. CMS is finalizing this proposal. Deactivation.

Medicare 40

Medicare Medicare Payment Systems Medicaid 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.

Medicare 52

Medicare Medicare Payment Systems Governance 52

HIPAA Journal

MARCH 29, 2024

HHS Issues Guidance for Providers Affected by Change Healthcare Ransomware Attack The Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS), and the Administration for Strategic Preparedness and Response (ASPR) have issued guidance to help entities impacted by the Change Healthcare ransomware attack.

Ransomware 95

Ransomware US Department of Health and Human Services HIPAA Hospitals 95

HIT Consultant

JUNE 7, 2023

PTs are being squeezed to optimize productivity while maintaining standards for clinical documentation and compliance, recording standardized outcome measures, Merit-Based Incentive Payment System (MIPS) reporting, all while focusing on professional development.

Payment Systems 52

Payment Systems FDA Medicaid Medicaid 52

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. "Using a patient service coordinator to schedule and contact patients to gain necessary paperwork and payments proved to be an effective workflow.

COVID-19 171

COVID-19 Telemedicine Compliance HIPAA 171

Hall Render

MAY 2, 2023

The CMS Memo provides that this means that all new SNF stays beginning on or after May 12, 2023 will require a qualifying hospital stay before Medicare coverage. The F-Tag associated with this regulation is F-884. This waiver will terminate at the end of the PHE. Benefit Period Blanket Waiver.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

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”). CMS recognizes a need to smooth these transitions and help to ensure stability in Medicare payments.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40