Medicare reimbursement policy

Seven Apply for Rural Emergency Hospital Designation

With more than 140 rural hospitals closing since 2010 and more currently in financial trouble, a modest number of such facilities are hoping to avoid a similar fate by applying to the Centers for Medicare & Medicaid Services to become “rural emergency hospitals,” a new Medicare provider type created to preserve access to care in rural areas. Hospitals that become rural emergency hospitals will receive an annual fee of more than $3 million from Medicare and a five percent increase in their Medicare payments but must retain 24-hour emergency services while limiting their inpatient services to leave just enough time [...]

iqtsupport2023-03-08T06:00:26-05:00March 8, 2023|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|

End of PHE Spells End of Additional Money to Care for COVID Patients

When the COVID-19 public health emergency ends on May 11, the 20 percent increase in Medicare payments to hospitals caring for Medicare patients suffering from the disease will end as well. In the first two years under this payment policy, which took effect in January of 2020, the federal government paid more than $23 billion to hospitals caring for COVID patients. Of that amount, 20 percent consisted of the supplemental payment. Learn more about the end of these additional payments and what it may mean for hospitals and Medicare beneficiaries from the Becker Hospital Review article “The 20% cut coming [...]

iqtsupport2023-02-22T06:00:27-05:00February 22, 2023|COVID-19, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for February 6

The following is the latest health policy news from the federal government for the week of January 23 to February 6. Some of the language used below is taken directly from government documents. 340B Pharmaceutical companies may restrict the ability of providers to use specialty and community pharmacies to distribute 340B-covered drugs, a federal appeals court has decided. See the court’s ruling here. Centers for Medicare & Medicaid Services CMS has revised its fact sheets about COVID-19 public health emergency waivers and flexibilities for different types of providers, updating which waivers and flexibilities have already been terminated, which have been [...]

iqtsupport2023-02-06T17:03:31-05:00February 6, 2023|340b, Centers for Medicare & Medicaid Services, COVID-19, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List. The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment. Go here for a summary of the update [...]

iqtsupport2023-01-20T15:28:07-05:00January 20, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 12

The following is the latest health policy news from the federal government for January 6-12. Some of the language used below is taken directly from government documents. Renewal of COVID-19 Public Health Emergency Declaration HHS Secretary Xavier Becerra has signed an order extending the previous declaration of a COVID-19 public health emergency. This declaration extends the emergency to April 11. The administration continues to assure stakeholders it will provide 60 days’ notice prior to the end of the public health emergency. MedPAC Medicare Rate Recommendations Every year MedPAC recommends to Congress rate increases for the different kinds of health care [...]

iqtsupport2023-01-12T19:22:04-05:00January 12, 2023|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, Telehealth|

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5. Some of the language used below is taken directly from government documents. No Surprises Act HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities. Learn more about the administrative fee change here and about the certified IDR entity fee change here. Both changes took effect on January 1. HHS, the Department of Labor, and the Department of the [...]

iqtsupport2023-01-05T17:15:07-05:00January 5, 2023|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22. Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill: the Senate has passed it but the House has not yet addressed it. Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

iqtsupport2022-12-22T17:30:38-05:00December 22, 2022|Affordable Care Act, Alternative payment models, Centers for Medicare & Medicaid Services, CMMI, Congress, COVID-19, hospitals, Medicaid, Medicare, Medicare bad debt reimbursement, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans. Learn more about the plan from this White House fact sheet and go here for a transcript of the White House [...]

MedPAC Considers 2023 Medicare Rates at December Meeting

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated: Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes. Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.” Status report: ambulatory surgical center services. Assessing payment [...]

iqtsupport2022-12-14T06:00:43-05:00December 14, 2022|Congress, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 8

The following is the latest health policy news from the federal government for the week of December 4-8. Some of the language used below is taken directly from government documents. No Surprises Act CMS has published an FAQ about implementation of good faith estimates for uninsured and self-pay patients under the No Surprises Act. In the FAQ the agency explains that it will extend enforcement discretion for situations in which good faith estimates do not include expected charges from co-providers or co-facilities. This enforcement discretion was expected to end on January 1 but CMS now writes that it will remain [...]

iqtsupport2022-12-08T17:09:11-05:00December 8, 2022|Centers for Medicare & Medicaid Services, COVID-19, Medicaid, Medicaid regulations, Medicare, Medicare bad debt reimbursement, Medicare cuts, Medicare regulations, Medicare reimbursement policy, Telehealth|