Hall Render

JULY 5, 2023

On June 30, 2023, CMS released the CY 2024 Proposed Rule that would increase the payment rates for freestanding End Stage Renal Disease (“ESRD”) facilities and hospital-based facilities by 1.6% and 2.6%, respectively, and the ESRD Prospective Payment System (“PPS”) base rate to $269.99.

Payment Systems 40

Payment Systems Hospitals 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. Applications for this process are due March 31, 2025, and any FTE gained will be effective July 1, 2026.

Hospitals 40

Hospitals Medicare Medicare Payment Systems 40

Redox

JANUARY 24, 2024

While most of the rule focuses on payer requirements, it also requires that Merit-Based Incentive Payment System (MIPS) “Promoting Interoperability Program” eligible providers report on their use of Prior Authorization APIs in a new “Electronic Prior Authorization” measure.

HIPAA 59

HIPAA Compliance Payment Systems 59

Hall Render

MARCH 20, 2024

The Final Rule also imposes additional reporting requirements under the Medicare Promoting Interoperability Program for eligible hospitals and critical access hospitals and for eligible clinicians reporting under the Promoting Interoperability performance category of the Merit-Based Incentive Payment System.

Medicare 40

Medicare Medicare Health Insurance Medicaid 40

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

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”). One of the largest changes to home health payment under PDGM was the move to variable LUPA thresholds.

COVID-19 40

COVID-19 Payment Systems Medicare Medicare 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

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.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

CMS.gov

OCTOBER 2, 2018

economy, and by 2026 the CMS Office of the Actuary projects that one in every five dollars spent in America will be spent on healthcare. As costs are increasing, we must make the healthcare system more efficient. Administrator, Centers for Medicare & Medicaid Services. Modernizing Medicare to Take Advantage of the Latest Technologies.

Medicare 44

Medicare Medicare Payment Systems FDA 44

CMS.gov

DECEMBER 21, 2018

CMS is hard at work to move to a value-based system, not just because we want to, but because the American healthcare system is on an unsustainable trajectory, with one in five dollars spent in our economy projected to be spent on healthcare by 2026.

Medicare 41

Medicare Medicare Payment Systems Fraud 41