hospitals

Surprise Bill Law’s “Good-Faith Estimate” to Challenge Providers

The requirement to give patients “good-faith estimates” of the costs associated with planned medical procedures will pose one of the biggest challenges to providers seeking to meet the implementation requirements of the 2020 No Surprises Act, which was intended to protect consumers from surprise medical bills, especially from providers not in their health insurers’ provider networks. Under the law’s implementing regulations, providers are often responsible for delivering good-faith estimates to their patients within 24 hours of scheduling a procedure. Eventually, the “convening provider” also will need to anticipate patients’ potential costs beyond the procedure itself and collect estimates for those [...]

iqtsupport2022-04-11T06:00:59-04:00April 11, 2022|hospitals|

Federal Health Policy Update for Wednesday, March 16

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, March 16. Some of the language used below is taken directly from government documents. Provider Relief Fund On March 22, 2022 at 11:59 p.m. (eastern), the HRSA COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds. On April 5, 2022 at 11:59 p.m. (eastern), the HRSA COVID-19 Uninsured Program and COVID-19 Coverage Assistance Fund will stop accepting vaccination claims due to a lack of funds. See the announcement of these changes. Providers that received Provider [...]

iqtsupport2022-03-16T17:41:14-04:00March 16, 2022|Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid upper-payment limit, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Hospitals Question Feds’ Plan for Doling Out New GME Slots

Last year Congress created 1000 new Medicare-supported graduate medical education residency slots. This year hospitals are unhappy about how regulators propose assigning those new slots. At issue, according to those who responded to CMS’s proposal for apportioning the slots, is the Centers for Medicare & Medicaid Services’ heavy reliance on assigning those slots to providers in Health Professional Shortage Areas (HPSAs). While the legislation calls for incorporating HPSAs into the distribution methodology, provider interests point out, it did not call for the degree of reliance on HPSAs that regulators propose. Doing so, they insist, is contrary to congressional intent. Learn [...]

iqtsupport2022-03-02T06:00:29-05:00March 2, 2022|hospitals, Medicare|

Congress May Tackle Hospital Staffing Challenges

Members of Congress are talking about looking into the staffing challenges hospitals currently face. Those challenges include staff – especially but not exclusively nurses – leaving their jobs, citing burnout or difficult working conditions; staff shortages caused by illnesses, often COVID-related; and the fast-rising costs of temporary or travel nurses needed to replace missing staff and the financial burden that is placing on some hospitals. Some members of Congress are considering acting on these challenges; others want the administration to do so. Learn more about the staffing challenges facing hospitals today and possible public policy tools for addressing those challenges [...]

iqtsupport2022-02-16T06:00:48-05:00February 16, 2022|COVID-19, hospitals|

Medicare Sending Mixed Signals on Hospital Quality

764 hospitals were recently penalized by Medicare for having too many patient infections and potentially avoidable medical complications. As a result, they will see their Medicare payments reduced one percent over the next year – a standard penalty under the agency’s Hospital-Acquired Condition Reduction Program. Thirty-eight of those hospitals cited for this problem, however, were awarded five stars – the highest rating – on Medicare’s Care Compare web site. Another 134 penalized hospitals received four-star ratings. Why the seeming contradiction? Kaiser Health News explores this question, and offers some answers, in the article “Health Care Paradox: Medicare Penalizes Dozens of [...]

iqtsupport2022-02-08T11:53:31-05:00February 8, 2022|hospitals, Medicare reimbursement policy|

Federal Health Policy Update for Thursday, February 3

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, February 3. Some of the language used below is taken directly from government documents. Provider Relief Fund The reconsideration window for Provider Relief Fund Phase 4 payments and American Rescue Plan rural hospital payments is now open for providers to request reconsideration of their payments. This process is intended only for providers that believe their payment was not calculated correctly. They will not have an opportunity to submit an application if they missed a deadline; will not be able to revise or [...]

iqtsupport2022-02-03T17:46:52-05:00February 3, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for Thursday, January 13

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, January 13. Some of the language used below is taken directly from government documents. Supreme Court The Supreme Court has ruled that the administration’s vaccine mandate for health care workers will remain in effect while the mandate is challenged in the lower courts. See the court’s ruling here. White House The White House has announced new efforts to protect children from COVID-19 and keep schools open. The new measures include: Sending more point-of-care and lab-based PCR tests to schools. Deploying federal surge [...]

iqtsupport2022-01-13T17:31:49-05:00January 13, 2022|Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Coronavirus, COVID-19, hospitals, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicare reimbursement policy, MedPAC, post-acute care|

Federal Health Policy Update for Thursday, January 6

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, January 6. Some of the language used below is taken directly from government documents. Provider Relief Fund The Provider Relief Fund reporting portal is now open for reporting period 2 and will remain open through March 31, 2022. Go here for more information about what organizations do and do not need to report and how to do so. The Provider Relief Fund web page offers updated information about what constitutes an allowable expense when reporting on the use of Provider Relief Fund [...]

iqtsupport2022-01-06T17:30:52-05:00January 6, 2022|Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for Wednesday, October 6

The following is the latest health policy news from the federal government as of 2:15 p.m. on Wednesday, October 6. Some of the language used below is taken directly from government documents. Provider Relief Fund: Reminder That Applications Are Now Being Accepted The Health Resources and Services Administration (HRSA) has opened its portal for providers to apply for $25.5 billion in health care relief funds, including $8.5 billion in American Rescue Plan resources for providers that serve rural patients covered by Medicare, Medicaid, or the Children’s Health Insurance Program and $17 billion for Provider Relief Fund Phase 4 grants for [...]

iqtsupport2021-10-06T19:24:30-04:00October 6, 2021|340b, Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, MedPAC|

Federal Health Policy Update for Friday, July 30

The following is the latest health policy news from the federal government as of 2:45 p.m. on Friday, July 30. Some of the language used below is taken directly from government documents. Final Medicare Payment Regulations for FY 2022 CMS has published four final rules for Medicare payments in FY 2022: FY 2022 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice and Home Health Quality Reporting Program Requirements. (See also CMS’s fact sheet) FY 2022 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2021 (FY 2022) (See [...]

iqtsupport2021-07-30T16:33:45-04:00July 30, 2021|Centers for Medicare & Medicaid Services, Coronavirus, COVID-19, hospitals, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care|