Medicare reimbursement policy

MedPAC: Go Slow on Expanding Medicare Telehealth

MedPAC wants Medicare to test the impact of telehealth on health care under non-COVID-19 conditions before moving forward with expanding the tool’s use in the Medicare population. In a news release accompanying its recently released annual report to Congress on Medicare payment policy, the Medicare Payment Advisory Commission writes that In the report, we present a policy option for expanded coverage for Medicare telehealth policy after the PHE is over. Under the policy option, policymakers should temporarily continue some of the telehealth expansions for a limited duration of time (e.g., one to two years after the PHE) to gather more [...]

iqtsupport2021-03-19T13:00:08-04:00March 19, 2021|Medicare, Medicare reimbursement policy, Telehealth|

MedPAC Offers 2022 Rate Recommendations

MedPAC has recommended modest pay increases for some health care providers and no increases for others in its annual report on Medicare payment policy to Congress. In the report, the Medicare Payment Advisory Commission recommends the following changes in Medicare rates for 2022: 2% increase for Medicare inpatient and outpatient services 2% increase for long-term-care hospitals no increase for doctors and other medical professionals no increases for ambulatory surgical centers, outpatient dialysis facilities, skilled nursing facilities, and hospices 5% reductions for home health agencies and inpatient rehabilitation facilities While MedPAC’s recommendations to Congress are not binding on the administration, its [...]

iqtsupport2021-03-18T13:00:08-04:00March 18, 2021|Medicare, Medicare reimbursement policy, MedPAC|

House to Consider Extending Medicare Sequester Delay

The moratorium on the two percent sequestration of Medicare payments could be extended under a bill the House may consider this week. If adopted, the bill would extend the sequester delay for nine months, providing financial relief that many health care providers seek as they continue to deal with the financial challenges posed by COVID-19. The sequester delay was implemented early in the pandemic as a means of providing additional Medicare revenue to hospitals and other health care providers at a time when many people were delaying seeking medical attention out of fear of contracting COVID-19. Without action by Congress, [...]

iqtsupport2021-03-18T06:00:49-04:00March 18, 2021|Medicare, Medicare cuts, Medicare reimbursement policy|

Analysts Look at Medicare Wage System

The Congressional Research Service has published a new report on the Medicare hospital wage index system. The agency undertook its analysis because Some Members of Congress, hospitals, and independent analysts have expressed interest in the differences in Medicare hospital payments by geographic area, based on the wage index. Some of these stakeholders have recommended changes to the wage index to more accurately reflect labor market forces faced by hospitals. Although some modifications to the wage index have been implemented, there is no consensus about systematic reforms. In the report the CRS describes how the geographic wage system works and what [...]

iqtsupport2021-03-09T06:00:24-05:00March 9, 2021|Medicare, Medicare reimbursement policy|

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. recently to discuss various Medicare payment issues. Among the issues discussed at MedPAC’s January meeting were: hospital inpatient and outpatient payments physician and health professionals payments the possible expansion of the post-acute transfer policy to hospice ambulatory surgical center, outpatient dialysis, and hospice payments Medicare payments for skilled nursing facilities, long-term hospitals, inpatient rehabilitation facilities, and home health services the Center for Medicare and Medicaid Innovation’s development and implementation of alternative payment models the future of telehealth after the COVID-19 public health emergency ends a status report on the Medicare Part [...]

iqtsupport2021-01-25T06:00:58-05:00January 25, 2021|Alternative payment models, Center for Medicare and Medicaid Innovation, CMMI, Medicare post-acute care, 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. MedPAC’s proposed Medicare 2021 payment recommendations dominated the December agenda, including: hospital inpatient and outpatient payments ambulatory surgical center payments physician and health professional payments hospice payments home health care payments inpatient rehabilitation facility payments long-term care hospital payments In addition, MedPAC discussed Medicare’s policy for transfers between post-acute-care facilities and hospice and received a staff update on the Medicare Advantage program. MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding [...]

iqtsupport2020-12-10T06:00:36-05:00December 10, 2020|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

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|

Feds Penalizing Wrong Hospitals for Readmissions, Study Finds

Medicare’s hospital readmissions reduction program often penalizes the wrong hospitals for excessive readmissions. Or so concludes a new study published in the journal JAMA Cardiology. According to the study, …the percentage of hospitals that were incorrectly penalized was 10.1% for acute myocardial infarction, 10.9% for heart failure, and 12.3 percent for pneumonia. The study also found that the readmissions reduction program is failing to penalize some hospitals that do deserve penalties based on the program’s standards, writing that …in fiscal year 2019, the percentage of hospitals that should have been penalized by the program, but were not, was 20.9% for [...]

iqtsupport2020-10-20T06:00:30-04:00October 20, 2020|Medicare, Medicare reimbursement policy|

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|