Centers for Medicare & Medicaid Services

HIPAA Overhaul Coming?

The U.S. Department of Health and Human Services has issued a request for information about stakeholders’ views on regulations implementing the Health Insurance Portability and Accountability Act, popularly known as HIPAA, leading to conjecture that the administration may be planning to revise the federal government’s application of the federal health care privacy law enacted in 1996. According to an HHS news release, “This RFI is another crucial step in our Regulatory Sprint to Coordinated Care, which is taking a close look at how regulations like HIPAA can be fine-tuned to incentivize care coordination and improve patient care, while ensuring that [...]

iqtsupport2018-12-17T06:00:58-05:00December 17, 2018|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|

CMS Proposes New Medicaid Managed Care Regulation

Just two years after a major overhaul of Medicaid managed care regulations, the Centers for Medicare & Medicaid Services is again proposing changes in how the federal government regulates the delivery of managed care services to Medicaid beneficiaries. Under the newly proposed regulation, states would: be free to implement more changes in their managed care programs without seeking federal permission; have slightly more flexibility in how supplemental payments are made to hospitals through managed care plans and implement some such changes without federal approval; be permitted to redefine what constitutes an adequate provider network for managed care plans; and not [...]

iqtsupport2018-11-14T06:00:22-05:00November 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicaid, Medicaid managed care, Medicaid regulations|

New Home Health Reg Brings Changes

A new home health care regulation finalized by the Centers for Medicare & Medicaid Services brings major changes in how Medicare will pay for home health services in the future. In addition to updating Medicare payment rates, the new rule also: introduces a new home health payment system called the Patient-Driven Groupings Model that de-emphasizes the volume of care provided; authorizes Medicare payments for remote patient monitoring; adds a new home infusion therapy benefit; and reduces the amount of quality data home health providers must report. To learn more about the new regulation, which takes effect on January 1, 2019, [...]

iqtsupport2018-11-02T06:00:49-04:00November 2, 2018|Centers for Medicare & Medicaid Services, Medicare regulations, Medicare reimbursement policy|

Physicians Push Back Against Medicare Telemedicine Proposal

A proposal to enable Medicare to make greater use of telemedicine as a means of serving patients is receiving surprising pushback from physicians. The Centers for Medicare & Medicaid Services has proposed paying doctors $14 for what would amount to a five-minute telephone “check-in” call with patients. Some physicians note that they already have such telephone conversations patients – and do not charge for those calls. Others fear the new service will increase their patients’ health care costs because they would incur a co-pay for such conversations. The chairman of the Medicare Payment Advisory Commission (MedPAC), himself a physician, has [...]

iqtsupport2018-10-11T13:00:46-04:00October 11, 2018|Centers for Medicare & Medicaid Services, Medicare regulations|

CMS Proposes Easing Regulatory Requirements

In a newly proposed rule, the Centers for Medicare & Medicaid Services proposes easing the regulatory burden on health care providers. The proposed regulation, which weighs in at 285 pages, covers a broad range of government regulation of health care providers and would, CMS projects, save hospitals more than $1 billion a year while cutting millions of hours of administrative work. Learn more about what CMS proposes by reading its fact sheet on the proposed regulation or going here to see the proposed regulation itself.

iqtsupport2018-09-24T06:00:42-04:00September 24, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations|

Medicare Joint Replacement Program Produces Savings

The first reporting period for Medicare’s Comprehensive Care for Joint Replacement Model found that participating providers cut costs for episodes of care by more than $900, or 3.3 percent. Most of the savings, the Centers for Medicare & Medicaid Services reports, were achieved by sending patients to less-expensive post-acute-care settings or by reducing patients’ length of stay in such facilities. CMS also found that the program’s mandatory participants, located in 67 metropolitan statistical areas, achieved these savings without compromising quality of care as measured by post-discharge emergency room visits, hospital readmissions, and deaths. Learn more about CJR’s early results in [...]

iqtsupport2018-09-14T06:00:50-04:00September 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare|

Ways and Means Praises CMS for Red Tape Efforts, Seeks More

Leaders of the House Ways and Means Committee have written to Centers for Medicare & Medicaid Services administrator Seema Verma to praise her agency’s work in eliminating Medicare red tape – but also asking her to “…take further steps to improve patient care by alleviating administrative and regulatory burdens for Medicare providers.” In three separate letters, committee chairman Kevin Brady (R-TX) and Health Subcommittee chairman Peter Roskam (R-IL) expressed their pleasure with CMS’s recent efforts but specified areas where they would like to see further action. For hospitals, they wrote that they seek further red-tape cutting in the areas of [...]

iqtsupport2018-09-11T06:00:49-04:00September 11, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations|

HHS Seeks Feedback on Anti-Kickback Challenges

The Office of the Inspector General of the U.S. Department of Health and Human Services has issued a request for information from health care stakeholders on how the federal government might modify current safe-harbor and anti-kickback laws and regulations in ways that might promote the provision of better health care at lower costs. The RFI explains that The Office of Inspector General (OIG) seeks to identify ways in which it might modify or add new safe harbors to the anti-kickback statute and exceptions to the beneficiary inducements civil monetary penalty (CMP) definition of “remuneration” in order to foster arrangements that [...]

iqtsupport2018-08-28T14:45:40-04:00August 28, 2018|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

Medicare Announces FY 2019 Inpatient Payments

The Centers for Medicare & Medicaid Services has released its FY 2019 payment schedule for Medicare inpatient services. Highlights of the FY 2019 inpatient prospective payment system regulation include: A 1.75 percent increase in fee-for-service rates. A $1.5 billion increase in Medicare disproportionate share hospital payments (Medicare DSH). Major reductions of the quality measures hospitals must report for Medicare’s inpatient quality reporting and value-based purchasing programs. A requirement that hospitals post their standard charges on the internet. Learn about these and other aspects of Medicare’s FY 2019 inpatient prospective payment system regulation by seeing this Medicare fact sheet or going [...]

iqtsupport2018-08-06T06:00:07-04:00August 6, 2018|Centers for Medicare & Medicaid Services, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations|

New Reg Pushes Medicare Toward Site-Neutral Outpatient Payments

Medicare would make more payments for outpatient services on a site-neutral basis under a newly proposed regulation just released by the Centers for Medicare & Medicaid Services. The 2019 Medicare outpatient prospective payment system regulation, published in proposal form, calls for: paying physician fee schedule rates rather than hospital outpatient rates at excepted off-campus provider-based departments; slashing payments for office visits; extending this year’s 340B prescription drug discount payments, already cut nearly 30 percent this year, to additional providers; and raising ambulatory surgical center rates and expanding the list of procedures that can be performed in such facilities so they [...]

iqtsupport2018-07-27T06:00:18-04:00July 27, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations|