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. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

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. Background on Rural and Urban Delineations Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

Medicare 40

Medicare Medicare Payment Systems Hospitals 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”). The Proposed Rule did not contain the details of the payment policies for REHs, which CMS will develop in separate notice and comment rulemaking.

Hospitals 70

Hospitals Payment Systems Medicare Medicare 70

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

Healthcare Law Blog

JANUARY 17, 2024

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. The OIG explained that the Requestor provides consulting services for practice optimization to physician practices (i.e.,

Medicare 52

Medicare Medicare Payment Systems Compliance 52

YouCompli

FEBRUARY 22, 2023

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). For Medicare, this typically includes IPPS and OPPS.

Compliance 52

Compliance US Department of Health and Human Services Overpayments Overpayment 52

Hall Render

FEBRUARY 14, 2025

The Centers for Medicare & Medicaid Services (CMS) recently finalized a rule (Final Rule) that expands its ability to impose a Provisional Period of Enhanced Oversight (PPEO) on providers, including post-acute providers, reactivating their Medicare enrollment. CMS finalized new 42 CFR Sec. Specifically, new 42 CFR Sec.

Medicare 52

Medicare Medicare Compliance Payment Systems 52

Health Blawg

JULY 2, 2018

Joe has a couple of books out, is an active blogger at The cHealth Blog , and chairs the Connected Health conference. Some of these payment systems will work better for certain types of providers.). Joe anticipates having a CMS decision on whether to adopt these codes for Medicare payment purposes in time for January 2019.

Payment Systems 60

Payment Systems Electronic Medical Records Medicare Medicare 60

Health Blawg

JULY 2, 2018

Joe has a couple of books out, is an active blogger at The cHealth Blog , and chairs the Connected Health conference. Some of these payment systems will work better for certain types of providers.). Joe anticipates having a CMS decision on whether to adopt these codes for Medicare payment purposes in time for January 2019.

Payment Systems 60

Payment Systems Electronic Medical Records Medicare Medicare 60

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

Health Blawg

JULY 2, 2018

Joe has a couple of books out, is an active blogger at The cHealth Blog , and chairs the Connected Health conference. Some of these payment systems will work better for certain types of providers.). Joe anticipates having a CMS decision on whether to adopt these codes for Medicare payment purposes in time for January 2019.

Payment Systems 60

Payment Systems Electronic Medical Records Medicare Medicare 60

Health Blawg

JULY 2, 2018

Joe has a couple of books out, is an active blogger at The cHealth Blog , and chairs the Connected Health conference. Some of these payment systems will work better for certain types of providers.). Joe anticipates having a CMS decision on whether to adopt these codes for Medicare payment purposes in time for January 2019.

Payment Systems 60

Payment Systems Electronic Medical Records Medicare Medicare 60

Health Blawg

JULY 2, 2018

Joe has a couple of books out, is an active blogger at The cHealth Blog , and chairs the Connected Health conference. Some of these payment systems will work better for certain types of providers.). Joe anticipates having a CMS decision on whether to adopt these codes for Medicare payment purposes in time for January 2019.

Payment Systems 60

Payment Systems Electronic Medical Records Medicare Medicare 60

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”). Background Medicare classifies hospitals by rural and urban status for a variety of payment purposes.

Medicare 40

Medicare Medicare Payment Systems Hospitals 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

Hall Render

APRIL 4, 2024

The Requestor’s services further include offering physician practices training related to the Medicare Merit-Based Incentive Payment System (“MIPS”), which could result in higher Medicare reimbursement to the Requestor’s clients. Hall Render blog posts and articles are intended for informational purposes only.

Payment Systems 40

Payment Systems Medicare Medicare Fraud 40

Hall Render

AUGUST 10, 2023

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. CMS also uses the hospital wage index for the Outpatient Prospective Payment System. percentage points.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

Hall Render

NOVEMBER 14, 2024

Hall Render blog posts and articles are intended for informational purposes only. More information about Hall Render’s Post-Acute and Long-Term Care services can be found here. For ethical reasons, Hall Render attorneys cannot give legal advice outside of an attorney-client relationship.

Payment Systems 40

Payment Systems Medicare Medicare Medicaid 40

Hall Render

NOVEMBER 6, 2024

CMS took regulatory action through the Calendar Year 2022 Home Health Prospective Payment System rule to extend those requirements through December 31, 2024. Hall Render blog posts and articles are intended for informational purposes only. Due to the nature of interim final rules, this requirement would have expired in May 2023.

Nursing Homes 40

Nursing Homes Nurses Medicaid Medicaid 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. One notable difference, however, is that the entity must enroll in Medicare as an REH. Background.

Payment Systems 40

Payment Systems Hospitals Medicare Medicare 40

Hall Render

APRIL 20, 2022

The release of the Proposed Rule and the accompanying tables also triggers the start to several deadlines for hospitals, including the unofficial start of the Medicare Geographic Classification Review Board (“MGCRB”) application process. The Medicare program also has an “in between” status called “Lugar status.” Background.

Medicare 40

Medicare Medicare Hospitals Payment Systems 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

APRIL 18, 2023

Background The Medicare Hospital Inpatient Prospective Payment System (“IPPS”) is designed to pay hospitals for services provided to Medicare beneficiaries based on a national standardized amount adjusted for the patient’s condition and related treatment.

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

Hospitals 40

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

Hospitals 40

Hospitals Medicare Medicare Payment Systems 40

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

MedTrainer

JANUARY 12, 2024

Medicare and Medicaid (1960s): The introduction of government-funded healthcare programs brought about increased scrutiny and regulation. MACRA (2015): The Medicare Access and CHIP Reauthorization Act (MACRA) introduced the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs).

Compliance 52

Compliance HIPAA Telemedicine ACA 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.

Hospitals 40

Hospitals Payment Systems Nurses Medical Device Industry 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

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 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

Healthcare Law Blog

JANUARY 26, 2024

On December 13, 2022, the Centers for Medicare and Medicaid Services (“CMS”) issued a proposed rule, titled Advancing Interoperability and Improving Prior Authorization Processes (“Proposed Rule”), to improve patient and provider access to health information and streamline processes related to prior authorizations for medical items and services.

US Department of Health and Human Services 52

US Department of Health and Human Services Medicare Medicare Medicaid 52

Healthcare Law Blog

JUNE 20, 2022

Nevertheless, on January 1, 2019, HHS effectuated its 2019 Outpatient Prospective Payment System rule, which continued the 340B Program cuts first implemented in the prior year, and expanded them to additional hospital locations. Instead, HHS appealed the District Court decisions to the U.S.

Hospitals 52

Hospitals Payment Systems 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 25, 2024

When a nursing facility submits a claim to Medicare or Medicaid for reimbursement, the claim submission form includes certifications that the claimed services were provided in compliance with all applicable statutes, regulations and rules. Hall Render blog posts and articles are intended for informational purposes only.

Nurses 40

Nurses Compliance Compliance Officers Medicare 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. Also read our blog to know about the 90833 CPT. 2022: $112.29

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. CMS is finalizing this proposal. Deactivation.

Medicare 40

Medicare Medicare Payment Systems Medicaid 40