Electronic Health Reporter

JANUARY 15, 2019

The 340B Drug Pricing Program was created in 1992 to give safety net providers — those that deliver a significant level of both healthcare and other health-related services to the uninsured, Medicaid, and other vulnerable populations — discounts on outpatient drugs to “stretch scare federal resources as […].

Medicaid 107

Medicaid Medicaid Payment Systems Medicare 107

Healthcare IT Today

NOVEMBER 12, 2023

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Health Payment Systems selected Madaket Health to manage its provider directory and roster requirements for No Surprises Act compliance.

Public Health 117

Public Health Payment Systems Medicare Medicare 117

Healthcare IT Today

NOVEMBER 15, 2023

The previous article in this series explained some of the ways payers, providers, and digital health companies demonstrate that they have made a positive difference in their patients’ lives. ” This article looks at the measurements and reporting strategies used by some specific companies. offering in-home treatment.

Medicare 115

Medicare Medicare Hospitals Compliance 115

Healthcare IT Today

AUGUST 13, 2023

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Practice management vendor Practice Better launched Practice Better Payments , a fully integrated payment system.

US Department of Health and Human Services 98

US Department of Health and Human Services Doctors Telemedicine Payment Systems 98

Hall Render

AUGUST 1, 2022

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. CMS ultimately proposed a monthly facility payment of $268,294 (just over $3.2 5 Percent OPPS Increase.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

Hall Render

AUGUST 15, 2024

TempoPay, a health care financing and payments platform, was acquired by PayMedix. PayMedix is a health care financing and payment solutions provider owned by Health Payment Systems, a health care technology and services organization. Hall Render blog posts and articles are intended for informational purposes only.

Payment Systems 40

Payment Systems Medicaid Medicaid 40

Hall Render

AUGUST 15, 2024

TempoPay, a health care financing and payments platform, was acquired by PayMedix. PayMedix is a health care financing and payment solutions provider owned by Health Payment Systems, a health care technology and services organization. Hall Render blog posts and articles are intended for informational purposes only.

Payment Systems 40

Payment Systems Medicaid Medicaid 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. Hall Render blog posts and articles are intended for informational purposes only.

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. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 40

Medicare Medicare Payment Systems Hospitals 40

YouCompli

FEBRUARY 22, 2023

Price increases can sometimes result in inappropriate outlier payments. Most federal healthcare payors such as Medicare and Medicaid reimburse most providers on a prospective basis. This is why Medicare publishes its rules on their Inpatient Prospective Payment System (IPPS) or its Outpatient Prospective Payment System (OPPS).

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

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

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. Special thanks to Zachary Renier, Summer Associate, for his assistance in preparing this article.

Hospitals 40

Hospitals Medicare Medicare Payment Systems 40

AIHC

JANUARY 28, 2022

Medicare Uncompensated Care Payments & DSH Hospitals' charity care and bad debt, together known as uncompensated care, is used to calculate disproportionate-share hospital payments. LTCHs are paid under the Long-Term Care Hospital Prospective Payment System (LTCH PPS).

Medicare 52

Medicare Medicare Hospitals Payment Systems 52

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

JULY 7, 2022

On June 30, 2022, the Centers for Medicare & Medicaid Services (“CMS”) released proposed regulations (“Proposed Rule”) addressing the Conditions of Participation (“CoPs”) that a provider will need to meet to qualify as an REH. This facility payment will be adjusted each year by the annual hospital market basket update factor.

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

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”). Hall Render blog posts and articles are intended for informational purposes only.

Medicare 40

Medicare Medicare Payment Systems Hospitals 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. Hall Render blog posts and articles are intended for informational purposes only.

Hospitals 40

Hospitals Payment Systems Medicare Medicare 40

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. 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.

Medicare 59

Medicare Medicare Medicaid Medicaid 59

Compliancy Group

JUNE 28, 2024

This article covers the disincentives that can be imposed on a provider found to have engaged in information blocking. HHS OIG determines whether a provider information blocking violation has occurred, and then notifies the Centers for Medicare and Medicaid Services (CMS) of its determination. CMS may then apply the disincentive.

Medicare 59

Medicare Medicare Hospitals HIPAA 59

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

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. A special thanks to Julian Caruso, Summer Associate, for her assistance with this article.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

AIHC

NOVEMBER 29, 2023

We recommend reading Leadership in a Value-Based Care (VBC) Environment in addition to this article. 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.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Physician Credentialing Company

OCTOBER 25, 2024

In this article, we will discuss detailed information regarding what the 90834 CPT code means, who can assign it, and the services covered by it. Medicare and Medicaid may have different payment systems from those of the private health insurance plans.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

AIHC

NOVEMBER 15, 2022

The Centers for Medicare & Medicaid Services (CMS) is the federal agency responsible for enforcement and has been working with the American Hospital Association (AHA) to comply with challenges related to compliance. Just a few published press releases are cited below. Where Can We Obtain More Information to Comply?

Hospitals 52

Hospitals US Department of Health and Human Services Compliance Governance 52

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 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. Your primary Hall Render contact.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 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

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. Special thanks to summer associate, Liliann Stoll, for her assistance with this article.

Medicare 40

Medicare Medicare Nurses Payment Systems 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.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Hall Render

MAY 2, 2023

Hall Render blog posts and articles are intended for informational purposes only. The F-Tag associated with this regulation is F-884. More information about Hall Render’s Post-Acute and Long-Term Care services can be found here.

Nursing Homes 40

Nursing Homes Public Health Nurses COVID-19 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

JULY 12, 2022

The MEOS payment will be higher for beneficiaries dually eligible for Medicare and Medicaid. EOM includes two (2) risk arrangements, both of which are expected to qualify as a Merit-Based Incentive Payment System Alternative Payment Model beginning July 2023. PGP’s across the U.S. are eligible to apply.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40

Hall Render

MARCH 28, 2023

The end of the PHE has a significant impact on skilled nursing facilities (“SNFs”) as it ends the remaining regulatory blanket waivers, revisits resident Medicaid eligibility and changes many COVID regulations that were issued during the PHE. Hall Render blog posts and articles are intended for informational purposes only.

Public Health 40

Public Health Nurses Nursing Homes COVID-19 40

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

Healthcare IT Today

MARCH 12, 2023

This article will be a weekly roundup of interesting stories, product announcements, new hires, partnerships, research studies, awards, sales, and more. Health Payment Systems announced that PayMedix increases cash yield for healthcare organizations as much as 9.5%. Higher education virtual health platform Timely MD ranked No.

Telemedicine 98

Telemedicine Medicaid Medicaid Payment Systems 98