Medicare regulations

MedPAC Meets

Earlier this week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. Among the issues on MedPAC’s November agenda were: expansion of telehealth in Medicare report on Medicare beneficiaries’ access to care in rural areas effects of pharmaceutical rebates on Part D’s risk adjustment improving competition among Medicare Part D’s benchmark plans separately payable drugs in the hospital outpatient prospective payment system Medicare Advantage payment and access for enrollees with end-stage renal disease MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are [...]

iqtsupport2020-11-12T06:00:40-05:00November 12, 2020|Medicare, Medicare regulations, Medicare reimbursement policy|

Most Hospitals Fined by Medicare Over Readmissions

More than 80 percent of all hospitals subject to Medicare’s hospital readmissions reduction program, and half of all of hospitals in the country, will be penalized in FY 2021 under that program because they have what Medicare considers to be too many avoidable readmissions. In all, 2556 of the 3080 hospitals subject to the program will be penalized. More than 600 will see their inpatient payments cut one percent as a result and the average cut will be 0.69 percent. The penalties are based on hospital performance with patients experiencing congestive heart failure, heart attacks, chronic obstructive pulmonary disease, coronary [...]

iqtsupport2020-11-06T06:00:25-05:00November 6, 2020|Medicare regulations, Medicare reimbursement policy|

HHS Webinar Thursday

The Department of Health and Human Services will hold a webinar on Thursday, October 22 at 1:00 (eastern) about the Centers for Medicare & Medicaid Services’ recent guidance explaining how it will implement an interim final rule that makes the collection and reporting of COVID-19 data a condition of participation in Medicare for hospitals. On August 24 CMS published an interim final rule establishing new requirements in the hospital conditions of participation in Medicare and on October 6 HHS published the updated document “COVID-19 Guidance for Hospital Reporting and FAQs For Hospitals, Hospital Laboratory, and Acute Care Facility Reporting.” Among [...]

iqtsupport2020-10-22T06:00:34-04:00October 22, 2020|Coronavirus, COVID-19, Medicare, 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|