Healthcare Law Blog

FEBRUARY 1, 2023

On January 30, 2023 , the Centers for Medicare & Medicaid Services (“CMS”) released the long-delayed final rule on risk adjustment data validation (“RADV”) audits of Medicare Advantage (“MA”) organizations (the “Final Rule”). One thing that is certain, CMS can expect further challenges to its RADV audit methodology. 3d 1, 18 n.19

Medicare 105

Medicare Medicare Overpayment Overpayments 105

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). This is known as the hospital “market basket.”

Medicare 40

Medicare Medicare Hospitals Payment Systems 40

Healthcare IT Today

JUNE 29, 2023

Medicare Certification ASCs must sign a contract with Medicare and meet its Conditions for Coverage (CFC) to be paid. ASCs must also meet Medicare’s Conditions for Coverage. Medicare Payment Resources CMS implemented an Ambulatory Payment Classification-based payment methodology in 2008.

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Compliance Medicare Medicare Medical Billing 52

Healthcare Law Blog

JUNE 20, 2022

HHS’ move to reduce 340B drug reimbursement originated in 2017, when it issued a final rule reducing hospital reimbursement under the 340B Program for 2018 from 6% over each drug’s average sales price to 22.5% below the average sales price, resulting in a total reimbursement reduction of $1.6

Hospitals 52

Hospitals Payment Systems Medicare Medicare 52

CMS.gov

NOVEMBER 8, 2018

Administrator, Centers for Medicare & Medicaid Services. Quality Payment Program (QPP) Year 1 Performance Results. Earlier this year, we released preliminary participation data on clinicians eligible to participate in the Merit-based Incentive Payment System (MIPS) under the Quality Payment Program (QPP).

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Payment Systems Medicare Medicare Medicaid 43

HIT Consultant

DECEMBER 12, 2024

Director of Quality Strategy and Innovation, The US Oncology Network and McKesson The Centers for Medicare and Medicaid Services (CMS) introduced the MIPS Value Pathways (MVPs) as part of its ongoing revisions to the Merit-Based Incentive Payment System (MIPS) program, which was established in 2017 to encourage ongoing and consistent quality, efficiency, (..)

Payment Systems 52

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

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COVID-19 Payment Systems Medicare Medicare 40