Medicare regulations

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|

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: managing prescription opioid use in Medicare Part D opioids and alternatives in hospital settings: payments, incentives, and Medicare data Medicare payment policies for advanced practice registered nurses and physicians Medicare’s role in the supply of primary care physicians Medicare payments for services provided in inpatient psychiatric facilities episode-based payments and outcome measures under a unified payment system for post-acute care Medicare policy issues related to non-urgent and emergency care MedPAC is an independent congressional [...]

iqtsupport2018-10-11T06:00:51-04:00October 11, 2018|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

CMS: More Medicare Site-Neutral Payments Coming

The federal government is unlikely to stop with outpatient visits in its drive to make more Medicare payments on a site-neutral basis. That was the message Centers for Medicare & Medicaid Services administrator Seema Verma delivered at a public event last week. We are taking a look at [site-neutral payments] across the board and looking at our authority and where we can weigh in on it. But I think the post-acute space is something where there are a lot of differentials in payments and something we’re very interested in exploring. CMS recently proposed extending its use of site-neutral payments for [...]

iqtsupport2018-10-10T06:00:53-04:00October 10, 2018|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Medicare Site-Neutral Outpatient Payment Proposal Would Have Disproportionate Impact

The Centers for Medicare & Medicaid Services’ proposal to make more Medicare outpatient payments on a site-neutral basis would significantly cut Medicare’s overall outpatient spending but most of that cut would be borne by just a few hospitals. A report prepared for the Integrated Health Care Coalition concluded that …CMS’ Off-Campus Site-Neutral Proposal in the FY 2019 CMS OPPS [note: outpatient prospective payment system] NPRM [note: notice of proposed rulemaking] will disproportionate affect about six percent of 3,333 hospitals that participate in the program. 200 hospitals will shoulder 73 percent of the proposed payment reductions….For the top 200, the average [...]

iqtsupport2018-10-05T06:00:43-04:00October 5, 2018|hospitals, Medicare regulations|

New Approach to Readmissions Program to Take Effect October 1

Medicare’s hospital readmissions reduction program will move in a new direction beginning in FY 2019 after Congress directed the Centers of Medicare & Medicaid Services to compare hospitals’ performance on readmissions to similar hospitals instead of to all hospitals. The policy change, driven by a belief that safety-net hospitals were harmed by the program and excessive penalties because their patients are more challenging to serve, results in all hospitals being divided into peer groups based on the proportion of low-income patients they serve. The readmissions performance of hospitals is then compared only to other hospitals within each peer group. As [...]

iqtsupport2018-10-01T06:00:29-04:00October 1, 2018|Medicare, 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|

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|