iqtsupport, Author at DeBrunner & Associates

Good News and Bad for Hospitals on Outpatient Payments

A federal court has provided relief to hospitals that saw reduced Medicare payments for some outpatient services in 2019. But that relief is only partial. In response to a suit filed by several hospital groups, a federal court ruled that the Centers for Medicare & Medicaid services had illegally reduced Medicare payments for services provided in some hospital off-campus outpatient departments beginning on January 1, 2019 and ordered the federal government to repay the hospitals for the Medicare revenue they lost. The reduced payments were part of a new Medicare site-neutral payment policy for outpatient services, and CMS has announced [...]

iqtsupport2019-12-17T09:40:07-05:00December 17, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The Medicaid and CHIP Payment and Access Commission kicked off its December meeting with highlights from its forthcoming issue of MACStats: Medicaid and CHIP Data Book, due out December 18, 2019. MACStats brings together statistics on Medicaid and State Children’s Health Insurance Program (CHIP) enrollment and spending, federal matching rates, eligibility levels, and access to care measures, which come from multiple sources. Later the Commission discussed a proposed rule that the Centers for Medicare [...]

iqtsupport2019-12-16T13:50:19-05:00December 16, 2019|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicaid upper-payment limit|

MedPAC Meeting Transcript Now Available

Last week the Medicare Payment Advisory Commission met in Washington, D.C. The Medicare payment issues on its agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment adequacy and updating payments: Long-term care [...]

iqtsupport2019-12-13T06:00:56-05:00December 13, 2019|hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Considers No Pay Raise for Ambulatory Surgical Centers

Next month MedPAC will likely vote to recommend that ambulatory surgical centers receive no increase in their Medicare payments in 2021. Meeting last week in Washington, D.C., members of the Medicare Payment Advisory Commission appeared to support strongly a staff recommendation to keep Medicare ambulatory surgical center payments where they are now – enough so to expedite resolution of the issue by voting on it at MedPAC’s next meeting, in mid-January. MedPAC also will vote on a proposal to require ambulatory surgical centers to provide annual cost reports to the Centers for Medicare & Medicaid Services. CMS would use those [...]

iqtsupport2019-12-12T06:00:31-05:00December 12, 2019|Medicare reimbursement policy, MedPAC|

President, VP Attempt to Mediate HHS Feud

President Trump and Vice President Pence have stepped into a feud between Health and Human Services Secretary Alex Azar and Centers for Medicare & Medicaid Services administrator Seema Verma. Azar and Verma have apparently clashed on numerous occasions in recent months, with Verma criticizing at least one Azar proposal during an Oval Office meeting and Azar being overruled by the president on several occasions. According to Politico, President Trump “…instructed Azar to smooth things over.” Verma, meanwhile, met with Vice President Pence, with whom she worked when Pence was governor of Indiana. As head of CMS, Verma oversees the country’s [...]

iqtsupport2019-12-11T06:00:21-05:00December 11, 2019|Centers for Medicare & Medicaid Services, Medicaid, Medicare|

Prescription Drug Bill Would Kill Two Years of Medicaid DSH Cuts

Two years of Medicaid DSH cuts would be eliminated under a new prescription drug bill released last week by the Senate Finance Committee. The Prescription Drug Pricing Reduction Act includes a provision that would eliminate two years of Affordable Care Act-mandated cuts in the allocation of federal money to the states for Medicaid disproportionate share hospital payments (Medicaid DSH). Those cuts have been delayed several times by Congress but were scheduled to begin in October of 2019 and run through federal FY 2025, only to be delayed again twice by continuing resolutions adopted by Congress to fund the federal government [...]

iqtsupport2019-12-10T13:00:30-05:00December 10, 2019|Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. The issues on MedPAC’s December agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment [...]

iqtsupport2019-12-10T06:00:07-05:00December 10, 2019|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

Home Health Agencies Expanding Scope of Endeavor

In the coming years, home health agencies will be providing a broader scope of services. With many such agencies already offering medication management technology, remote patient monitoring, image-sharing technology, and mobile apps for e-visits, many are planning to do more. More than a quarter of home health providers plan to move into or expand their telehealth offerings in the coding years and many already provide chronic care services, with more planning to do so in the coming years. Home health providers also are moving into palliative care, veteran-specific services, and mental health services. Behind some of this expansion of scope [...]

iqtsupport2019-12-09T06:00:21-05:00December 9, 2019|Medicare, Telehealth|

Hospitals Sue Over Hospital Price Transparency Requirement

The federal government should be prohibited from implementing its new price transparency requirement for hospitals, a group of hospital trade groups and health systems has declared in a lawsuit against the U.S. Department of Health and Human Services. The requirement exceeds the federal government’s authority, the suit maintains, and its implementation would create an undue burden on hospitals, cost a great deal of money, require hospitals to divulge proprietary information, inhibit competition, and overwhelm their information systems. Even after all of that, the suit claims, consumers would still not have useful information because insurers, not hospitals, are the key in [...]

iqtsupport2019-12-06T06:00:38-05:00December 6, 2019|hospitals, Medicare regulations|

Pennsylvania Moves to Establish its Own Health Insurance Exchange

Pennsylvania plans to move away from participating in the federal health insurance exchange and to establish its own exchange in time for the 2021 open enrollment season. The shift away from using the federal exchange and developing a state-based exchange was approved by Pennsylvania’s General Assembly earlier this year. That shift took a major step forward recently when the state hired a contractor to create the site’s platform. State officials estimate that once the state’s site is up and running it will costs $25 million a year to operate; currently, Pennsylvania pays $95 million a year to participate in the [...]

iqtsupport2019-12-05T06:00:31-05:00December 5, 2019|Affordable Care Act|

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