Medisys Compliance

JULY 19, 2024

Introduction The landscape of Medicare and Medicaid billing for behavioral health services has undergone significant changes recently. Expanded Telehealth Services One of the most notable changes in Medicare/Medicaid billing for behavioral health is the expanded coverage for telehealth services.

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Medicaid Medicaid Medicare Medicare 52

Medisys Compliance

APRIL 11, 2024

A New Era for Mental Health Access The landscape of mental healthcare in the United States underwent a significant change on January 1, 2024. Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose.

Medicare 59

Medicare Medicare Medical Billing Outsourcing Medical Billing 59

HIT Consultant

JULY 15, 2024

– The Centers for Medicare & Medicaid Services (CMS) released a proposed rule outlining changes to Medicare payments under the Physician Fee Schedule (PFS) for services furnished and other Medicare Part B issues on or after January 1, 2025. The final rule will be published later in 2024.

Medicare 52

Medicare Medicare Payment Systems Medicaid 52

Fierce Healthcare

JUNE 12, 2023

Industry hospital groups are pushing the Centers for Medicare & Medicaid Services to consider a higher annual pay bump and to shed some light on why it believes the number of uninsured patients | Public comments submitted to CMS by the hospital lobby were critical of a "woefully inadequate" 2.8%

Hospitals 121

Hospitals Payment Systems Medicaid Medicaid 121

Modern Healthcare

APRIL 10, 2023

The fiscal 2024 Medicare inpatient prospective payment system proposed rule from the Centers for Medicare and Medicaid Services also includes new safety and health equity provisions.

Payment Systems 86

Payment Systems Hospitals Medicare Medicare 86

Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Taking effect on October 1, 2024, the Final Rule confirms CMS will adopt updated market area delineations based on the 2020 census.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

Hall Render

AUGUST 6, 2024

The Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Final Rule (“Final Rule”) on August 1, 2024. Taking effect on October 1, 2024, the Final Rule confirms CMS will adopt updated market area delineations based on the 2020 census.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

HealthIT Answers

JANUARY 31, 2024

The Centers for Medicare & Medicaid Services opened data submission for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2023 performance year of the Quality Payment Program. ET on April 1, 2024. Data can be submitted and updated until 8:00 p.m.

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Payment Systems Medicaid Medicaid Medicare 59

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. In doing so, CMS will finalize changes to its rural floor wage index policy that can drastically change payments for certain hospitals and its extension of the wage index add-on for low-wage hospitals.

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Payment Systems Hospitals Medicare Medicare 40

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. of the Common Agreement and committed to having TEFCA support FHIR-based exchange within 2024.

Public Health 117

Public Health Payment Systems Medicare Medicare 117

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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Hospitals Medicare Medicare Medicaid 40

Hanys

JUNE 30, 2023

At the request of HANYS and our federal advocacy partners, 12 members of the New York delegation joined a bipartisan letter to CMS urging the agency to adjust inadequate payment updates proposed in the FFY 2024 Medicare Inpatient Prospective Payment System rule.

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Payment Systems Hospitals Medicare Medicare 52

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

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. or $140 million in 2024.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

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

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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Payment Systems Medicare Medicare 130

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

Hall Render

NOVEMBER 6, 2024

Effective Date The Final Rule is scheduled to be published on November 7, 2024, with an effective date of January 1, 2025. CMS took regulatory action through the Calendar Year 2022 Home Health Prospective Payment System rule to extend those requirements through December 31, 2024. Revised 42 CFR Section 483.80(g)

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Nursing Homes Nurses Medicaid Medicaid 40

Hall Render

APRIL 12, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the 2025 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). The Proposed Rule is scheduled to be published in the Federal Register on May 2, 2024.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

Compliancy Group

JUNE 28, 2024

On June 24, 2024, the Department of Health and Human Services (HHS) released a final rule establishing disincentives for healthcare providers who have engaged in information blocking. The 2024 rule provides a different penalty for provider information blocking. What Disincentives Does the 2024 Final Rule Establish?

Medicare 59

Medicare Medicare Hospitals HIPAA 59

Hall Render

NOVEMBER 14, 2024

New Policy Requirements In the Final Rule, CMS finalized a new standard at 42 CFR § 484.105(i) that would require HHAs to develop, implement and maintain an acceptance-to-service policy that is applied consistently to each prospective patient referred for home health care.

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Payment Systems Medicare Medicare Medicaid 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. CMS will be phasing the IPO list out over the next three years, with the IPO being completely phased out by CY 2024.

Medicare 40

Medicare Medicare COVID-19 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.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Healthcare IT Today

SEPTEMBER 8, 2024

News Among the proposals in the CMS 2025 Medicare OPPS and ASC payment system proposed rule is a one-year extension of the voluntary reporting of core clinical data elements. The EHR Association supports the extension , noting that the majority of hospitals have been struggling to meet these requirements.

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Payment Systems Hospitals Medicare Medicare 68

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. Applications for Round 23 can be submitted through the MEARIS portal.

Hospitals 40

Hospitals Medicare Medicare Payment Systems 40

Hall Render

SEPTEMBER 5, 2024

On August 1, 2024, the Centers for Medicare & Medicaid Services (“CMS”) released the Fiscal Year 2025 Hospital Inpatient Prospective Payment System Final Rule (“Final Rule”), finalizing the proposed Transforming Episode Accountability Model (“TEAM”). TEAM will begin on January 1, 2026.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

Compliancy Group

OCTOBER 5, 2023

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was signed into law to improve patient healthcare outcomes. Under MACRA, the Centers for Medicare and Medicaid Services (CMS) created regulations to encourage healthcare providers to use secure health information technology. The MIPS rules for 2023 are discussed below.

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HIPAA Medicare Medicare Compliance 52

HIT Consultant

DECEMBER 12, 2023

Its use has increased over the past decade, but still, only about 13% of dialysis patients currently take advantage of in-home dialysis , despite studies showing that it has similar outcomes to in-patient treatment, greater patient satisfaction and reduced Medicare costs.

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Patient Satisfaction COVID-19 Doctors Payment Systems 119

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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Nurses COVID-19 Vaccine COVID-19 Payment Systems 40

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

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

HIT Consultant

OCTOBER 29, 2024

To rectify this, the Centers for Medicare & Medicaid Services (CMS) introduced the Inpatient Prospective Payment System. The most recent data indicates that healthcare costs will be in excess of $5 trillion by the end of 2024, comprising 18% of the U.S. This approach to making U.S. uninsured rate is currently 7.7

Payment Systems 98

Payment Systems Medicaid Medicaid Medicare 98

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. where healthcare systems have traditionally operated under a fee-for-service framework, there’s a growing interest in exploring and implementing value-based care models. In the U.S.,

Hospitals 120

Hospitals Governance Telemedicine Payment Systems 120

Hall Render

MAY 10, 2024

On April 10, 2024, the Centers for Medicare & Medicaid Services (“CMS”) announced its plan to implement the Transforming Episode Accountability Model (“TEAM”), a new mandatory alternative payment model unveiled as part of the 2025 Hospital Inpatient Prospective Payment System proposed rule.

Medicare 40

Medicare Medicare Hospitals Medicaid 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.

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Nurses COVID-19 Vaccine COVID-19 Medicare 40

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.

Medicare 52

Medicare Medicare HIPAA Medicaid 52

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.

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Medical Billing Medical Billing Outsourcing Medicaid Medicaid 52

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.

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Ransomware US Department of Health and Human Services HIPAA Hospitals 99