Medicare regulations

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: the skilled nursing facility value-based payment system future research directions in hospice payments Medicare Advantage benchmark policy indirect medical education: current Medicare policy, concerns, and principles for revising the evolution of Medicare’s advanced alternative payment models vertical integration and Medicare payment policy MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in [...]

iqtsupport2020-10-09T06:00:26-04:00October 9, 2020|Alternative payment models, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Talks Telehealth

Expanded telehealth is here to stay, members of the Medicare Payment Advisory Commission agreed at their September public meeting. What they do not yet know is in what form. Among the issues that need to be addressed in any post-COVID-19 expansion of Medicare-covered telehealth services are: Whether affording access to telehealth services would exacerbate the digital divide and leave some Medicare beneficiaries with less access to care than others. Whether audio-only coverage, temporarily permitted during the pandemic, should be continued. Whether greater use of telehealth might foster greater use of low-value services. Whether use of non-HIPAA-compliant video technology should continue [...]

iqtsupport2020-09-11T06:00:46-04:00September 11, 2020|Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

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: the coronavirus pandemic and Medicare context for Medicare payment policy report on the skilled nursing facility value-based purchasing program report on the Protecting Access to Medicare Act of 2014’s changes to the Medicare clinical laboratory fee schedule congressional request on private equity and Medicare expansion of telehealth in Medicare Medicare coverage for vaccines MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on [...]

iqtsupport2020-09-10T06:00:04-04:00September 10, 2020|Coronavirus, COVID-19, Medicare regulations, Medicare reimbursement policy, MedPAC|

Feds Delay Stark Rule, Anti-Kickback Update

An update of regulations that limit the ability of doctors to refer patients for care to sources in which those doctors have a financial interest will wait as long as another year, according to the Centers for Medicare & Medicaid Services. CMS had previously proposed regulations updating current guidelines, essentially easing them, but provider comment was so great – often, saying that the easing of the guidelines did not go far enough – that the agency decided to step back and review the situation. In a public inspection version of a notice to be published in the Federal Register, CMS [...]

iqtsupport2020-08-29T06:00:59-04:00August 29, 2020|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

Feds Propose Changing Medicare DSH Calculation

Medicare DSH payments would reflect hospitals’ Medicare Advantage inpatient days under a new regulation proposed by the Centers for Medicare & Medicaid Services. Under the newly proposed rule, the formula for calculating Medicare disproportionate share payments would incorporate hospitals’ Medicare Advantage inpatient days and not just their fee-for-service inpatient days. Medicare DSH payments are made to hospitals that serve especially high proportions of low-income and uninsured patients and are intended to help them with the cost of providing those services. Go here to see the proposed regulation.

iqtsupport2020-08-07T06:00:49-04:00August 7, 2020|Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy|

CMS Proposes New Medicare Payments for 2021

Medicare will change its provider payments for two types of Medicare-covered services in 2021 and has proposed changes in payments for three other Medicare-covered services in a flurry of activity over the past week. Last week the Centers for Medicare & Medicaid Services finalized new 2021 Medicare payment rates for: skilled nursing facilities hospice services inpatient psychiatric facilities In addition, this week CMS proposed new 2021 Medicare rates for: physician services outpatient and ambulatory surgical services The proposed changes in Medicare provider payments for physician services and outpatient and ambulatory surgical services are subject to a public comment period before [...]

iqtsupport2020-08-06T06:00:39-04:00August 6, 2020|Medicare, Medicare regulations, Medicare reimbursement policy, post-acute care|

Coronavirus Update: March 31, 2020

Coronavirus Update: March 31, 2020 Yesterday the federal Centers for Medicare & Medicaid Services (CMS) published a major update of Medicare and Medicaid regulations that included blanket waivers of a large number of Medicare and Medicaid regulations and requirements. The following is a summary of the major aspects of this new regulation. New Policies and Waivers From Medicare and Medicaid Regulations and Requirements CMS has introduced dozens of changes that involve waivers from current regulations and requirements. A comprehensive, 26-page CMS document describing these changes can be found here and below are the highlights organized into four broad categories: increasing [...]

iqtsupport2020-03-31T20:24:34-04:00March 31, 2020|Coronavirus, COVID-19, Medicaid, Medicaid regulations, Medicare, Medicare regulations, Telehealth|

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 March agenda were: Addressing Medicare Shared Savings Program vulnerabilities The role of specialists in alternative payment models and accountable care organizations Realigning incentives in Medicare Part D Redesigning the Medicare Advantage quality bonus program Mandated report: Impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees Improving Medicare’s end-stage renal disease prospective payment system Separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency that advises [...]

iqtsupport2020-03-09T09:40:54-04:00March 9, 2020|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Hundreds of Hospitals Penalized for Medical Mistakes

786 hospitals will see their Medicare payments slashed one percent for a year because of their performance under Medicare’s hospital-acquired conditions reduction program. That program penalizes the 25 percent of hospitals with the highest rate of patient safety problems, such as infections and injuries. Among the more interesting aspects of this year’s program results: Among those being penalized are seven of the 21 hospitals on the S. News “best hospitals” list. Three hospitals also on that list have never been penalized. 145 hospitals will be penalized for the first time. 16 hospitals that have been penalized every year since the [...]

iqtsupport2020-02-05T06:00:24-05:00February 5, 2020|Medicare, Medicare regulations, 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 January agenda were: The Medicare prescription drug program (Part D): status report and options for restructuring Redesigning the Medicare Advantage quality program: initial modeling of a value incentive program Hospital inpatient and outpatient payments Physician payments Outpatient dialysis payments Skilled nursing facility, home health, inpatient rehabilitation facility, and long-term-care hospital payments Hospice and ambulatory surgery center payments The 340B program ACO beneficiary assignment MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. [...]

iqtsupport2020-01-22T06:00:06-05:00January 22, 2020|Accountable Care Organization, ACO, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|