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|

Proposal Would Equalize Medicare Physician Payments

All physicians would be paid equally for Medicare-covered office visits under a new proposal published recently by the Centers for Medicare & Medicaid Services. Under the proposed regulation, Medicare would collapse four levels of patient evaluation and management office visits, eliminate the extensive documentation required to justify the payments physicians seek, and pay one simple rate for office visits. CMS estimates that reducing the documentation requirements would save every doctor 51 hours a year. Some critics are concerned that specialists and those caring for especially ill or especially complex patients would be shortchanged by the proposed policy while others fear [...]

iqtsupport2018-07-24T06:00:47-04:00July 24, 2018|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

CMS Proposes Changes in Medicare Physician Payments

The Centers for Medicare & Medicaid Services has published a proposed regulation that it says …proposed historic changes that would increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare. The proposed rules would fundamentally improve the nation’s healthcare system and help restore the doctor-patient relationship by empowering clinicians to use their electronic health records (EHRs) to document clinically meaningful information instead of information that is only for billing purposes. Among the policy changes offered in the proposed 1743-page regulation governing Medicare physician [...]

iqtsupport2018-07-16T06:00:47-04:00July 16, 2018|Centers for Medicare & Medicaid Services, Medicare regulations|

MedPAC Issues 2018 Report to Congress

The non-partisan legislative branch agency that advises Congress and the administration on Medicare payment policies has submitted its mandatory annual report to Congress. Among the findings included in the report by the Medicare Payment Advisory Commission are: Medicare’s hospital readmissions reduction program has not resulted in increases in emergency room visits or hospital observation stays. Many Medicare accountable care organizations, while maintaining or improving quality, are producing more modest savings than predicted. MedPAC approves of Medicare’s proposals to redesign the case-mix classification system for skilled nursing facilities. MedPAC supports changes Medicare has proposed for patient assessment and therapy requirements for [...]

iqtsupport2018-06-21T10:33:14-04:00June 21, 2018|Accountable Care Organization, ACO, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, MedPAC, post-acute care|

HHS Unveils Spring Regulatory Agenda

The U.S. Department of Health and Human Services has published a comprehensive list of the regulatory actions it plans to take in the coming months. Included on the list are regulations that have been proposed, that are being finalized, and that are currently under development. They address Medicare, Medicaid, Food and Drug Administration endeavors, medical devices, the 340B prescription drug discount program, and more. Among the policy changes contemplated through future regulations are measures to reduce regulatory burdens for hospitals, address the opioid problem, facilitate the use of non-Affordable Care Act-compliant health insurance plans, and more. Go here to see [...]

iqtsupport2018-05-14T06:00:28-04:00May 14, 2018|340b, Affordable Care Act, Medicaid, Medicaid regulations, Medicare, Medicare regulations|

Time to Raise the Bar on Preventable Hospital Readmissions?

A new report suggests that hospitals can have the greatest impact on reducing preventable readmissions within seven days of discharge and not through the 30-day mark at which they are currently judged by Medicare. According to a study published in the Annals of Internal Medicine, Early readmissions were more likely to be preventable and amenable to hospital-based interventions. Late readmissions were less likely to be preventable and were more amenable to ambulatory and home-based interventions. The study, conducted at 10 academic medical centers and involving more than 800 of their patients who had been readmitted to the hospital, concludes that [...]

iqtsupport2018-05-03T06:00:37-04:00May 3, 2018|Medicare, Medicare regulations|

MedPAC Mulls Uniform Outcome Measures to Complement Unified Post-Acute Payments

In support of its proposal that Medicare adopt a unified payment system for post-acute-care services, the Medicare Payment Advisory Commission is exploring how to develop uniform outcome measures to support such a new payment system. Under the MedPAC vision, articulated at its early April public meeting, skilled nursing facilities, home health agencies, long-term-care hospitals, and inpatient rehabilitation facilities would see their outcomes quantified based on their performance on a series of quality measures. Meanwhile, there has been little congressional interest in the unified post-acute payment proposal so far. While some aspects of such a proposal could be implemented administratively, the [...]

iqtsupport2018-04-18T06:00:59-04:00April 18, 2018|Medicare, Medicare regulations, MedPAC, post-acute care|