Medicare regulations

MedPAC Comments on Proposed Medicare Outpatient Payment Rule

The Medicare Payment Advisory Commission has weighed in with the Centers for Medicare & Medicaid Services on its proposed regulation governing the 2018 hospital outpatient prospective payment system and ambulatory surgical center payment systems and quality reporting programs. Among the issues MedPAC addresses in its comment letter to CMS are the proposal to reduce Medicare reimbursement for 340B-covered prescription drugs; how to reinvest the savings such a payment cut would produce; the ability of hospitals to expand the services they offer at hospital-based outpatient departments; proposed changes in the Medicare hospital outpatient quality reporting program and ambulatory surgery center quality [...]

iqtsupport2017-09-11T09:59:57-04:00September 11, 2017|Centers for Medicare & Medicaid Services, hospitals, Medicare regulations, MedPAC|

Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs. Or so says one of CMS’s own advisory panels. The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options. The panel’s recommendation [...]

iqtsupport2017-09-01T06:00:14-04:00September 1, 2017|Medicare, Medicare regulations|

Improvements Inspired by Readmissions Reduction Program Level Off

After major improvements during the early years of Medicare’s hospital readmissions reduction program, the program is no longer showing significant new gains. While Medicare readmissions have fallen from 21.5 percent to 17.8 percent since 2007, there has been very little improvement since 2012, suggesting that most of the benefits from the program have already been achieved. And in FY 2018, Medicare will penalize almost the same number of hospitals it penalized in FY 2017: approximately 80 percent of the hospitals subject to the program. In FY 2018, the average penalty will be 0.73 percent of affected hospitals’ Medicare payments. Forty-eight [...]

iqtsupport2017-08-08T06:00:18-04:00August 8, 2017|Medicare regulations|

Ways and Means Seeks to Cut Medicare Red Tape

The House Ways and Means Committee’s Health Subcommittee has launched a new initiative to attempt to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery. The subcommittee describes its “Medicare Red Tape Relief Project” as …a new initiative to deliver relief from the regulations and mandates that impede innovation, drive up costs, and ultimately stand in the way of delivering better care for Medicare beneficiaries. In support of this initiative, the committee has announced a three-part approach in which it will seek feedback from stakeholders, host roundtables with stakeholders across the country, [...]

iqtsupport2017-07-27T13:00:59-04:00July 27, 2017|Medicare, Medicare regulations|

Congress Looks at 340B Program

Last week the House Energy and Commerce Committee took a look at the 340B prescription drug discount program, which requires pharmaceutical companies to sell discounted drugs for outpatient use to hospitals that care for especially large numbers of low-income patients. The previous week, the Centers for Medicare & Medicaid Services issued a proposed Medicare regulation calling for significant reductions in Medicare payments for such drugs. The hearing touched on the CMS proposal to reduce Medicare payments for 340B drugs, the high prices of prescription drugs, the 340B program’s growth over the years, the possibility that the program is being abused [...]

iqtsupport2017-07-24T06:00:44-04:00July 24, 2017|Medicare, Medicare regulations|

MedPAC Testifies Before Congress

Last week Mark Miller, executive director of the Medicare Payment Advisory Commission, testified before the House Ways and Means Committee’s Health Subcommittee. In his testimony, Miller summarized and explained some of the key points MedPAC made in its March report to Congress, including: why MedPAC believes most post-acute-care payments are too high; why Medicare needs to reduce the incentives for hospitals and doctors to deliver more services; why it recommended no FY 2018 payment increases for long-term acute-care hospitals, ambulatory surgical centers, and skilled nursing facilities and reductions of payments for home health care providers and inpatient rehabilitation facilities; why [...]

iqtsupport2017-05-22T06:00:12-04:00May 22, 2017|hospitals, Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

Cures Law Addresses Shortcomings in Readmissions Program

The 21st Century Cures Act passed last December includes a provision that addresses perceived inequities in Medicare’s readmissions reduction program. Those inequities centered around holding safety-net hospitals, thought to care for more medically and socially challenging patients than the typical hospital, to the same standard as those typical hospitals when assessing penalties under Medicare’s hospital readmissions reduction program. While proponents of addressing this perceived inequity focused on addressing it through socio-economic risk adjustment, the Cures Act took another approach, as a recent article on the Health Affairs Blog explained: The Cures Act changes this by instructing HHS to set different [...]

iqtsupport2017-02-13T06:00:15-05:00February 13, 2017|Medicare regulations|

MedPAC Meets

Last week the independent agency that advises Congress on Medicare payment issues met for two days in Washington, D.C. Among the issues on the agenda of the Medicare Payment Advisory Commission were: payments for hospital inpatient and outpatient services, ambulatory surgery centers, dialysis facilities, and hospice care payments for post-acute-care providers a unified payment system for post-acute-care services Medicare Advantage Medicare Part B and Part D payments Medicare-covered primary care services implementation of the Medicare Access and CHIP Reauthorization Act of 2015 Go here for links to the issue briefs and presentations used at the MedPAC meeting and for a [...]

iqtsupport2017-01-19T06:00:38-05:00January 19, 2017|hospitals, Medicare, Medicare regulations, MedPAC|

Bundled Payments Reduce Hip, Knee Replacement Costs

Medicare’s bundled payment program for knee and hip replacements is reducing the cost of such treatments, a study has found. According to a new study in JAMA Internal Medicine, the Medicare bundled payment program, known as the Comprehensive Care for Joint Replacement program, has driven down the cost of the those joint replacements more than 20 percent or $5500 a case. Most of the savings have been derived through a significant decrease in the use of post-acute care, according to the study. This decrease occurred, moreover, at a time when Medicare spending on joint replacement rose five percent. Learn more [...]

iqtsupport2017-01-12T16:35:59-05:00January 12, 2017|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|