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

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. CMS is expected to release proposed rules for the Inpatient Prospective Payment System (IPPS).

Hospitals 52

Hospitals COVID-19 Payment Systems Medicaid 52

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

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. Background. 5 Percent OPPS Increase.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 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

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

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

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

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

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

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

AIHC

NOVEMBER 29, 2023

Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes indicates that in 2021 the U.S. Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement.

Medicare 52

Medicare Medicare Medicaid Medicaid 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’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

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. By FY 2027, these changes will increase IPPS spending by $459 million.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 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 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

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). 77492 (Dec.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

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

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

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

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

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

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

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 COVID-19 Nursing Homes Nurses 40

Hall Render

APRIL 21, 2023

Billion in Community Benefit in 2021 OhioHealth buys land in Canal Winchester – 3 miles from competitor’s ER Quipt Home Medical inks $26M stock deal with Beacon Securities, Canaccord Genuity Corp.,

US Department of Health and Human Services 40

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

Kaiser Health News

JUNE 29, 2022

Congress should crack down on Medicare Advantage health plans for seniors that sometimes deny patients vital medical care while overcharging the government billions of dollars every year, government watchdogs told a House panel Tuesday. Medicare Advantage plans accept a set fee from the government for covering a person’s health care.

Medicare 107

Medicare Medicare Governance Overpayments 107