iqtsupport, Author at DeBrunner & Associates

Most Hospitals Hit With Medicare Readmissions Penalties

Nearly 2600 hospitals will be penalized by Medicare in FY 2020 for excessive patient readmissions under Medicare’s hospital readmissions reduction program, according to the Centers for Medicare & Medicaid Services. In all, 83 percent of hospitals covered by the program will be penalized, forfeiting up to three percent of their Medicare payments with an average penalty of 0.71 percent of those payments. The cumulative penalties for these hospitals will amount to $563 million in FY 2020. In all, 1177 hospitals will be penalized more than they were last year and 1148 will be penalized less. 56 hospitals will be assessed [...]

iqtsupport2019-10-08T06:00:52-04:00October 8, 2019|Medicare, Medicare reimbursement policy|

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 October agenda were: restructuring Medicare Part D improving Medicare payment for low-volume and isolated outpatient dialysis facilities updates to the methods used to assess the adequacy of Medicare’s payments for physicians and other health professionals population-based outcome measures: avoidable hospitalizations and emergency department visits aligning benefits and cost-sharing under a unified payment system for post-acute care policy options to modify the hospice aggregate cap MedPAC is an independent congressional agency that advises Congress on issues involving the [...]

iqtsupport2019-10-07T06:00:37-04:00October 7, 2019|Medicaid, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

New in Medicaid Medical Transportation: Uber and Lyft

State Medicaid programs focused on ensuring that beneficiaries keep their doctor appointments are increasingly looking to ride-sharing services to supplement the providers already participating in their medical transportation programs. Today, Lyft is working with approximately 35 state Medicaid programs while Uber, at least so far, participates only in Arizona’s program. While ride-sharing is not going to replace other medical transportation programs – for one thing, most Uber and Lyft cars are not equipped to serve individuals with serious disabilities – they can help supplement services that today typically require patients to reserve rides days ahead of time and then share [...]

iqtsupport2019-10-03T09:48:35-04:00October 3, 2019|Medicaid|

ACA May be Improving, Saving Lives

The insurance expansion made possible by the Affordable Care Act may be improving and even saving lives, some studies and anecdotal evidence suggest. While observers warn that it is difficult to attempt to render a final verdict on the reform law’s insurance expansion and its impact, various studies and observations point to encouraging developments. Among them: High blood pressure is being detected at a higher rate now among people who bought insurance as a result of the ACA than it was prior to the law’s passage. Fewer 19-26 year-olds, now permitted to remain on their parents’ health insurance, are choosing [...]

iqtsupport2019-10-02T15:48:44-04:00October 2, 2019|Affordable Care Act, Medicaid|

CMS Adopts Methodology for Medicaid DSH Cuts

Medicaid DSH money will be allocated among states based on a new methodology under a regulation adopted this week by the Centers for Medicare & Medicaid Services. But it is not clear when that new methodology may actually be used. Cuts in Medicaid disproportionate share hospital (Medicaid DSH) allotments to states were mandated by the Affordable Care Act based on the expectation that the law would greatly reduced the number of uninsured Americans. While this has been the case, the decline in the number of uninsured has not been as great as expected. For this reason, Congress has on several [...]

iqtsupport2019-09-25T10:47:09-04:00September 25, 2019|Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments|

Court Halts Medicare Site-Neutral Payment Changes

The Centers for Medicare & Medicaid Services did not have the authority to implement the site-neutral payment system for Medicare-covered outpatient services that it introduced last year, a federal court has concluded. According to the court, CMS exceeded its authority because it …was not authorized to ignore the statutory process for setting payment rates in the Outpatient Prospective Payment System and to lower payment rates only for certain services provided by certain providers. In general, hospitals oppose the movement toward site-neutral payments and independent physician groups support it. The court did not order CMS to reimburse affected physician practices for [...]

iqtsupport2019-09-19T06:00:43-04:00September 19, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations, Medicare reimbursement policy|

Millions Eligible for Health Insurance Remain Uninsured

More than 15 million Americans who are currently entitled to free or subsidized health insurance are currently uninsured. Among them are 11 million who are eligible for Medicaid but have not applied for benefits and 4.2 million who could afford insurance with the help of federal premium subsidies and either have decided not to take advantage of those subsidies or are unaware of the availability of such subsidies. In addition, another two million people would be eligible for Medicaid if their states expanded their Medicaid program as authorized by the Affordable Care Act. In light of such figures, it is [...]

iqtsupport2019-09-16T06:00:48-04:00September 16, 2019|Affordable Care Act, Medicaid|

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 September agenda were: context for Medicare payment policy the effects of Medicare Advantage “spillover” on Medicare fee-for-service spending and coding evaluation of the hospital readmissions reduction program examining the effects of competitive bidding for diabetes testing supplies and improving payment policies for DMEPOS products excluded from competitive bidding a value incentive program for post-acute-care providers Medicare indirect medical education (IME) policy, concerns, and considerations for revising MedPAC is an independent congressional agency that advises Congress on issues [...]

iqtsupport2019-09-12T09:50:13-04:00September 12, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

ACA Has Reduced Insurance Disparities

The Affordable Care Act is responsible for a major reduction in the disparity of insurance status among racial and ethnic minorities. According to a new Commonwealth Fund analysis, All U.S. racial and ethnic groups saw comparable, proportionate declines in uninsured rates… However, because uninsured rates started off much higher among Hispanic and black non-Hispanic adults than among white non-Hispanic adults, the coverage gap between blacks and whites declined from 11.0 percentage points in 2013 to 5.3 percentage points in 2017. Likewise, the coverage gap between Hispanics and non-Hispanic whites dropped from 25.4 points to 16.6 points. Learn more about specific [...]

iqtsupport2019-08-23T11:40:37-04:00August 23, 2019|Affordable Care Act, Medicaid|

Uninsured Rate Rose in 2017

The rate of uninsured Americans rose in 2017, the first such increase since implementation of the Affordable Care Act. According to a new Urban Institute study, The increasing uninsurance rate between 2016 and 2017 was driven by losses of private nongroup coverage, such as that purchased in the health insurance marketplaces, and decreases in Medicaid and Children’s Health Insurance Program (CHIP) coverage (-0.4 percentage points each). In addition, Overall, coverage losses were concentrated in the 19 states that did not expand Medicaid eligibility under the Affordable Care Act by July 1, 2017…Between 2016 and 2017, uninsurance held stable in Medicaid [...]

iqtsupport2019-08-21T10:58:26-04:00August 21, 2019|Affordable Care Act, Medicaid|

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