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

Hall Render

AUGUST 1, 2022

The proposed payment policies come just a few weeks after CMS released proposed regulations addressing the Conditions of Participation (“CoPs”) that a provider will need to meet to qualify as an REH. The Consolidated Appropriations Act, 2021 (the “Act”) signed into law on December 27, 2020, established the new REH provider type.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

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.

Medicare 40

Medicare Medicare COVID-19 Payment Systems 40

Hall Render

AUGUST 29, 2024

On August 28, 2024, the Centers for Medicare & Medicaid Services (“CMS”) published the Fiscal Year 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”), which can be found here. The Final Rule finalizes CMS’s policy proposal to implement this distribution.

Hospitals 40

Hospitals Medicare Medicare 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

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 Act specifies that REHs will be paid for outpatient services at 105% of the otherwise applicable rates under the Outpatient Prospective Payment System (“OPPS”).

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

Physician Credentialing Company

OCTOBER 25, 2024

Medicare and Medicaid may have different payment systems from those of the private health insurance plans. The lack of documentation may result in an audit, leading to claim denial and fines for noncompliance with Medicare and Medicaid regulations. 2021: $103.28 between 2020 to 2021. 2022: $112.29

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

Hall Render

AUGUST 27, 2024

The Centers for Medicare & Medicaid Services (“CMS”) will publish the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) in the Federal Register on August 28 with an effective date of October 1, 2024.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

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.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

AIHC

NOVEMBER 15, 2022

Noncompliance with the Hospital Price Transparency Rule The Hospital Price Transparency Final Rule (“the final rule”) was published in November 2019 and went into effect on January 2021. Since January, 2021, articles and studies have revealed the lack of compliance, bringing this issue to the attention of Congress.

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

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. Our initial takeaways are summarized below.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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’s data shows a downward trend in utilization in 2020 but then an increase in utilization in 2021.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 40

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. 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.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Hall Render

MAY 2, 2023

In May 2021, CMS issued an interim final rule that required SNFs to educate staff and residents on the risks and benefits of COVID vaccination and to offer or assist in accessing COVID vaccination for staff and residents. CMS ended several of the SNF blanket waivers in 2021 and 2022. COVID Vaccine Education. COVID Staff Vaccine.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 40

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. 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.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

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

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). 39104 (July 23, 2021).

Medicare 40

Medicare Medicare Payment Systems Medicaid 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. 7,215 2021 5,532 77.5% 7,872 2018 5,851 77.1%

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. Speech Therapy 0.21

Medicare 52

Medicare Medicare Payment Systems COVID-19 52

Redox

DECEMBER 4, 2020

Unfortunately, despite this good news, there are still major technological and logistic hurdles between now and us all meeting up at HIMSS 2021 like “Wow, what a year that was, huh?”. As we barrel towards 2021, though, this infrastructure is only just coming into place. We are well on our way back towards normalcy, right?

Public Health 52

Public Health Governance Doctors Medicare 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. CMS ended several of the SNF blanket waivers in 2021 and 2022. COVID Vaccine Education.

Public Health 40

Public Health Nurses Nursing Homes COVID-19 40

Health Law Advisor

NOVEMBER 2, 2022

Announced in the Consolidated Appropriations Act of 2021, Rural Emergency Hospitals (REHs) will be a new type of Medicare provider starting January 1, 2023. Under the OPPS Final Rule, REHs will be paid both on a per-service basis at an OPPS +5% rate and a monthly facility payment.

Medicare 52

Medicare Medicare Hospitals Malpractice 52

HIT Consultant

SEPTEMBER 7, 2021

The No Surprises Act, in addition to recent revisions to existing Centers for Medicare and Medicaid Services (CMS) price transparency regulations 1 and a policy push by President Biden 2 , aims to continue the trend toward more patient-centric healthcare that makes it easier for patients to navigate the inherent complexity. About Ogi C.

Medical Billing 52

Medical Billing Hospitals Medicaid Medicaid 52

Healthcare IT Today

MARCH 12, 2023

The latest data brief from ONC shows that 87% of office-based physicians used telemedicine in 2021 , compared to just 15% in 2018 – though the majority (53%) used if for less than 25% of their total visit volume. Health Payment Systems announced that PayMedix increases cash yield for healthcare organizations as much as 9.5%.

Telemedicine 98

Telemedicine Medicaid Medicaid Payment Systems 98

Hall Render

SEPTEMBER 15, 2023

million in 2021, more than the hospital spent on charity care in three years Could telehealth be the solution for the nursing shortage in hospitals? Jefferson Health thinks so Financially struggling rural Pa. hospital creates GoFundMe page with $1.5M

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes COVID-19 Nurses 40

Hall Render

APRIL 21, 2023

health-tech startup MemoryWell pivots, eyes new funding to roll out software for insurers Department of Veterans Affairs health system kicks off multiyear Greater Washington expansion Georgetown to open Southeast D.C.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nurses Nursing Homes 40

Kaiser Health News

JUNE 29, 2022

The watchdogs also recommended imposing limits on home-based “health assessments,” arguing these visits can artificially inflate payments to plans without offering patients appropriate care. Enrollment more than doubled over the past decade, reaching nearly 27 million people in 2021. Bliss said Medicare paid $2.6

Medicare 107

Medicare Medicare Governance Overpayments 107