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.

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Hanys

JULY 29, 2022

Charles Schumer and Kirsten Gillibrand joined 28 other senators in sending CMS a bipartisan letter asking the agency to change the final 2023 Medicare Inpatient Prospective Payment System rule, leveraging existing authority, to more accurately reflect the cost of providing hospital care to patients.

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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. These changes become effective on January 1, 2024. CMS anticipates the changes will increase MSSP participation by 10% to 20%.

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HealthIT Answers

APRIL 18, 2023

On April 10, 2023, CMS issued the fiscal year 2024 Medicare hospital inpatient prospective payment system and long-term care hospital prospective payment system proposed rule. The post FY 2024 CMS Hospital IPPS and LTCH PPS Proposed Rule appeared first on Health IT Answers.

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HIT Consultant

JUNE 24, 2024

These disincentives are implemented through existing healthcare programs: Medicare Promoting Interoperability Program: Hospitals or critical access hospitals found to be information blocking will not be considered meaningful EHR users, leading to a loss of potential financial rewards.

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HealthIT Answers

OCTOBER 20, 2022

By Alex Baker & Elisabeth Myers - On August 1, 2022, CMS announced final changes to its payment program for acute care hospitals in 2023. The FY 2023 Inpatient Prospective Payment System final rule also included policies for the 2023 Medicare Promoting Interoperability Program, which rewards.

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Healthcare Law Blog

JANUARY 17, 2024

On December 28, 2023, the Office of Inspector General (the “OIG”) issued a favorable Advisory Opinion (No. workflow and performance assessment, data analytics, and certain Medicare eligibility and performance assistance). On December 28, 2023, the Office of Inspector General (the “OIG”) issued a favorable Advisory Opinion (No.

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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.

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Healthcare Law Today

JANUARY 20, 2023

The panel suggested providers ask themselves “What is your core competency” and “Where do local Medicare Advantage plans have gaps in their coverage and care delivery models” 2.

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Medicare Medicare Patient Satisfaction Payment Systems 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.

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Hall Render

APRIL 20, 2022

The FFY 2023 IPPS Proposed Rule (“Proposed Rule”) was released on April 18, 2022, and CMS published the associated tables on its website. Further, Social Security Act Section 1886(d)(3)(E) requires that the standardized amount be adjusted for differences in hospital wage levels, which CMS implemented through the wage index system.

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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.

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Hanys

NOVEMBER 4, 2022

The Medicare Outpatient Prospective Payment System final rule for 2023 contains several HANYS advocacy priorities including a 3.8% Further details are available to members online.

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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.

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Medical Billing Outsourcing Payment Systems Medical Billing Medicare 59

MRO Compliance

OCTOBER 23, 2023

This transformation aims to enhance patient care quality and better align ACO reporting with the Quality Payment Program (QPP) Merit-Based Incentive Payment System (MIPS). Reporting via eCQM is optional in 2023 and 2024, but it becomes mandatory in 2025. Therefore, it is essential for ACOs to use their time wisely.

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Healthcare IT Today

NOVEMBER 12, 2023

News The 2024 Medicare Physician Fee Schedule continues many telehealth flexibilities first adopted during the public health emergency, such as an expanded scope of originating sites an expanded definition of qualified practitioners. Healthcare management services company Care About selected Innovaccer for population health management.

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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.

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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.

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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. million per year) for 2023. 5 Percent OPPS Increase.

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Hospitals Payment Systems Medicare Medicare 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.

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Hall Render

AUGUST 10, 2023

CMS released the FFY 2024 IPPS Final Rule (“Final Rule”) on August 1, 2023, publishing a fact sheet on its website. The Final Rule is expected to be published in the Federal Register on August 28, 2023. CMS also uses the hospital wage index for the Outpatient Prospective Payment System.

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Payment Systems Hospitals 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”). Critical access hospitals (“CAHs”) and rural hospitals with 50 beds or fewer could transition to REH status starting January 1, 2023. CAH Proposed CoPs.

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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%

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Natalia Mazina

APRIL 25, 2023

On another, Medicare Part B recently challenged payments to 340B providers. Medicare reimbursement cut In 2018, CMS implemented a 28.5% reduction to payments for most drugs purchased through the 340B Program and paid under the Outpatient Prospective Payment System (“OPPS”). 2023) 58 F.4th 2023) 58 F.4th

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US Department of Health and Human Services Medicare Medicare Payment Systems 52

Compliancy Group

NOVEMBER 16, 2022

In 2015, legislation known as the Medicare Access and CHIP Reauthorization Act (MACRA) was enacted. 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.

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Healthcare IT Today

SEPTEMBER 19, 2024

However, the Centers for Medicare and Medicaid Services (CMS) took an important step to accelerate the adoption of the model in the U.S. Since its inception, the AHCAH initiative has led to a significant expansion of at-home care programs , with 277 hospitals in 37 states approved to offer care under the waiver as of March 2023.

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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

Hall Render

APRIL 18, 2023

The FFY 2024 IPPS Proposed Rule (“Proposed Rule”) was released on April 10, 2023, and CMS published the associated tables on its website. Further, Social Security Act Section 1886(d)(3)(E) requires that the standardized amount be adjusted for differences in hospital wage levels, which CMS implemented through the wage index system.

Medicare 40

Medicare Medicare Hospitals Payment Systems 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.

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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. AI’s net savings for U.S.

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FDA Medicare Medicare Hospitals 69

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.

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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.

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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.

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AIHC

NOVEMBER 29, 2023

Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement. healthcare system were exorbitant. These different Acts initiated the testing of alternate forms of delivering care and payment methodologies.

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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.

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Nurses COVID-19 Vaccine COVID-19 Medicare 40

AIHC

NOVEMBER 29, 2023

Medicare changed reimbursement methodology in the 1980s by introducing Relative Value Units (RVUs) and the RBRVS (Resource-Based Relative Value System) for physician reimbursement. healthcare system were exorbitant. These different Acts initiated the testing of alternate forms of delivering care and payment methodologies.

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Medicare Medicare Medicaid Medicaid 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

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