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). PINC AI™ Data Analysis.

Hospitals 52

Hospitals COVID-19 Payment Systems Medicaid 52

Medisys Compliance

FEBRUARY 9, 2024

Separate Payment for Disposable Negative Pressure Wound Therapy (dNPWT) Devices in Home Health Before January 1, 2024, home health agencies bundled dNPWT devices with other wound care services under a single billing code. The Consolidated Appropriations Act of 2023 mandated separate billing for dNPWT devices used in home healthcare settings.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

Hall Render

JULY 7, 2022

Critical access hospitals (“CAHs”) and rural hospitals with 50 beds or fewer could transition to REH status starting January 1, 2023. CAHs and other small rural hospitals may convert to REH status and qualify for enhanced payments starting on January 1, 2023. CAH Proposed CoPs. The Proposed Rule also includes updates for CAHs.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

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

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.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

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.

Medicare 105

Medicare Medicare Overpayments Overpayment 105

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.

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COVID-19 Vaccine US Department of Health and Human Services COVID-19 Licensing 52

Compliancy Group

NOVEMBER 16, 2022

healthcare system since 2010’s Affordable Care Act. Under MACRA, the Centers for Medicare and Medicaid Services created regulations for healthcare providers’ use of health information technology. One of these incentives is the Merit-Based Incentive Payment System, or MIPS.

Medicare 52

Medicare Medicare HIPAA Medicaid 52

Hall Render

AUGUST 1, 2022

A CAH or hospital that converts to an REH can start participating in Medicare as an REH as early as January 1, 2023. REHs may not operate swing beds but may maintain a distinct part skilled nursing facility, which will be paid under the skilled nursing facility prospective payment system. Proposed REH Payments.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Redox

OCTOBER 12, 2023

In 2023 at least 11 states considered healthcare AI legislation, according to the National Conference of State Legislatures (NCSL) AI legislation tracker. AI reimbursement Medicare and Medicaid are beginning to reimburse for AI applications on a per-use basis, though adoption is still in its infancy. AIMultiple , 12 June, 2023.

FDA 69

FDA Medicare Medicare Hospitals 69

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

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). The deadline to submit comments is March 13, 2023. Our initial takeaways are summarized below.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Hall Render

NOVEMBER 6, 2024

Due to the nature of interim final rules, this requirement would have expired in May 2023. CMS took regulatory action through the Calendar Year 2022 Home Health Prospective Payment System rule to extend those requirements through December 31, 2024.

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 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

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. Once a facility converts to an REH, it cannot provide inpatient services.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

AIHC

NOVEMBER 29, 2023

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. Hospital reimbursement also changed. AIHC is a non-profit organization.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Hall Render

NOVEMBER 25, 2024

Nursing Facility ICPG, together with OIG’s General Compliance Program Guidance (“GCPG”) issued in November 2023, serve as OIG’s updated and centralized source of voluntary compliance program guidance for nursing facilities. It is intended only to assist nursing facilities in evaluating and mitigating their own particular risk areas.

Nurses 40

Nurses Compliance Compliance Officers 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

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

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”). CY 2023 HH Payment Update. CY 2023 National, Standardized 30-Day Period Payment.

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.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

AIHC

NOVEMBER 29, 2023

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. Hospital reimbursement also changed. AIHC is a non-profit organization.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Hall Render

NOVEMBER 29, 2023

On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2024 Medicare Physician Fee Schedule Final Rule (“Final Rule”) for calendar year (“CY”) 2024. Standards for benchmarking and data completeness for the Medicare CQM collection type will mirror the MIPS benchmarking and scoring policies.

Medicare 40

Medicare Medicare Nurses Payment Systems 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 COVID-19 52

Hall Render

MAY 2, 2023

CMS expects all providers to be in compliance with the requirements for PASARR with all admissions taking place after May 11, 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. Benefit Period Blanket Waiver.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 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. 2022: $112.29 2021: $103.28 2020: $94.55 between 2020 to 2021.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

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. 0.97110 1.0124 1.0012 0.9998 1.030 $2,038.13

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

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 99

Ransomware US Department of Health and Human Services HIPAA Hospitals 99

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

Healthcare IT Today

AUGUST 13, 2023

RockHealth.org announced its 2023 cohort of Innovation Fellows , with founders focused in areas such as mental health, end-of-life care, pediatric telehealth, and trauma care. Practice management vendor Practice Better launched Practice Better Payments , a fully integrated payment system.

US Department of Health and Human Services 75

US Department of Health and Human Services Doctors Telemedicine Payment Systems 75

Hall Render

MARCH 28, 2023

On January 30, 2023, the Biden Administration announced the COVID public health emergency (“PHE”) will expire and end on May 11, 2023. There are several key areas of focus for SNFs to assess what will change and what will not change as May 11, 2023 approaches. The F-Tag associated with this regulation is F-884.

Public Health 40

Public Health Nurses Nursing Homes COVID-19 40

Hall Render

JULY 12, 2022

EOM is the next phase in the Biden Administration’s Cancer Moonshot initiative and will run from July 2023 through July 2028. The MEOS payment will be higher for beneficiaries dually eligible for Medicare and Medicaid. PGP’s across the U.S. are eligible to apply.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Healthcare IT Today

MARCH 12, 2023

in January 2023 compared to January 2022) was offset by bad news about month-over-month margins (down 2.2% Health Payment Systems announced that PayMedix increases cash yield for healthcare organizations as much as 9.5%. Clinical research accelerator Curebase was named one of Y Combinator’s 2023 Top Private Companies.

Telemedicine 75

Telemedicine Medicaid Medicaid Payment Systems 75

Hall Render

JANUARY 26, 2024

Researchers secure $1.5 New Ranking UMMS to get $100M in state funding for new Eastern Shore hospital University of Maryland Shore Regional Health Planning $539.5M Louis nursing home endangered residents, report says Man pleads guilty to stabbing employee inside Missouri ASC A Missouri nursing home shut down suddenly. Cori Bush joins St.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

AUGUST 4, 2023

1 CMS final rule boosts Medicare hospice payments by 3.1% 1 CMS final rule boosts Medicare hospice payments by 3.1% Will Nemours’ Medicaid move leave 10,000 special-needs kids behind? To Address SDOH Needs U.S. sues UnitedHealth over ‘thousands’ of denied claims What’s a fair price for a prescription drug?

COVID-19 40

COVID-19 Nursing Homes Hospitals Nurses 40

Hall Render

SEPTEMBER 15, 2023

billion clawback in Northern District of Texas Fort Worth The Hospital at Westlake Medical Center files for Chapter 11 bankruptcy protection 11 best hospitals in Texas for orthopedic surgery Johns Hopkins physician leader to join UT Southwestern Medical City Fort Worth’s New CEO and Texas Health Stephenville’s $12.5

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

NATIONAL 6 health systems using GPT and AI tools 100,000 nurses left industry during the pandemic, report finds AHA backs bill to delay Medicaid DSH cuts by 2 years AHA launches info hub for healthcare quality leaders AHA opposes MedPAC recommendations to Congress on site-neutral, Part B drug, wage index policies AHA ramps up 340B protection efforts (..)

US Department of Health and Human Services 40

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