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 March agenda were: Addressing Medicare Shared Savings Program vulnerabilities The role of specialists in alternative payment models and accountable care organizations Realigning incentives in Medicare Part D Redesigning the Medicare Advantage quality bonus program Mandated report: Impact of changes in the 21st Century Cures Act to risk adjustment for Medicare Advantage enrollees Improving Medicare’s end-stage renal disease prospective payment system Separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency that advises [...]

iqtsupport2020-03-09T09:40:54-04:00March 9, 2020|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Number of Medicare-Dependent Hospitals Declines

The number of Medicare-dependent hospitals in the U.S. fell 28 percent between 2011 and 2017, the U.S. Government Accountability Office reports. Medicare-dependent hospitals receive additional payments from Medicare if at least 60 percent of their discharges or inpatient days are associated with Medicare patients, if they have 100 or fewer beds, and if their historic costs in one of three base years are greater than what they would have been paid through Medicare’s inpatient prospective payment system. The Medicare-dependent program was created in 1989 to protect vulnerable small, mostly rural hospitals, and in any given year not all eligible hospitals [...]

iqtsupport2020-03-03T06:00:53-05:00March 3, 2020|Medicare, Medicare reimbursement policy|

Hundreds of Hospitals Penalized for Medical Mistakes

786 hospitals will see their Medicare payments slashed one percent for a year because of their performance under Medicare’s hospital-acquired conditions reduction program. That program penalizes the 25 percent of hospitals with the highest rate of patient safety problems, such as infections and injuries. Among the more interesting aspects of this year’s program results: Among those being penalized are seven of the 21 hospitals on the S. News “best hospitals” list. Three hospitals also on that list have never been penalized. 145 hospitals will be penalized for the first time. 16 hospitals that have been penalized every year since the [...]

iqtsupport2020-02-05T06:00:24-05:00February 5, 2020|Medicare, Medicare regulations, 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 January agenda were: The Medicare prescription drug program (Part D): status report and options for restructuring Redesigning the Medicare Advantage quality program: initial modeling of a value incentive program Hospital inpatient and outpatient payments Physician payments Outpatient dialysis payments Skilled nursing facility, home health, inpatient rehabilitation facility, and long-term-care hospital payments Hospice and ambulatory surgery center payments The 340B program ACO beneficiary assignment MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. [...]

iqtsupport2020-01-22T06:00:06-05:00January 22, 2020|Accountable Care Organization, ACO, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Good News and Bad for Hospitals on Outpatient Payments

A federal court has provided relief to hospitals that saw reduced Medicare payments for some outpatient services in 2019. But that relief is only partial. In response to a suit filed by several hospital groups, a federal court ruled that the Centers for Medicare & Medicaid services had illegally reduced Medicare payments for services provided in some hospital off-campus outpatient departments beginning on January 1, 2019 and ordered the federal government to repay the hospitals for the Medicare revenue they lost. The reduced payments were part of a new Medicare site-neutral payment policy for outpatient services, and CMS has announced [...]

iqtsupport2019-12-17T09:40:07-05:00December 17, 2019|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare reimbursement policy|

MedPAC Meeting Transcript Now Available

Last week the Medicare Payment Advisory Commission met in Washington, D.C. The Medicare payment issues on its agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment adequacy and updating payments: Long-term care [...]

iqtsupport2019-12-13T06:00:56-05:00December 13, 2019|hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

MedPAC Considers No Pay Raise for Ambulatory Surgical Centers

Next month MedPAC will likely vote to recommend that ambulatory surgical centers receive no increase in their Medicare payments in 2021. Meeting last week in Washington, D.C., members of the Medicare Payment Advisory Commission appeared to support strongly a staff recommendation to keep Medicare ambulatory surgical center payments where they are now – enough so to expedite resolution of the issue by voting on it at MedPAC’s next meeting, in mid-January. MedPAC also will vote on a proposal to require ambulatory surgical centers to provide annual cost reports to the Centers for Medicare & Medicaid Services. CMS would use those [...]

iqtsupport2019-12-12T06:00:31-05:00December 12, 2019|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. The issues on MedPAC’s December agenda were: Assessing payment adequacy and updating payments: Physician and other health professional services Assessing payment adequacy and updating payments: Ambulatory surgical center services Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services; Mandated report: Expanding the post-acute care transfer policy to hospice Assessing payment adequacy and updating payments: Skilled nursing facility services Assessing payment adequacy and updating payments: Home health care services Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services Assessing payment [...]

iqtsupport2019-12-10T06:00:07-05:00December 10, 2019|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

MedPAC to Meet Tomorrow

The Medicare Payment Advisory Commission meets this Thursday and Friday in Washington, D.C. MedPAC’s December agenda is dominated by Medicare payment issues: how much Medicare should pay for different types of services in calendar year 2021 and FY 2021. The services to be addressed during the December 5-6 meetings are physician and other health professional services, ambulatory surgical center services, hospital inpatient and outpatient services, skilling nursing facility services, home health services, inpatient rehabilitation facility services, long-term care hospital services, outpatient dialysis services, and hospice services. In addition, MedPAC commissioners will discuss their mandated report on expanding Medicare’s post-acute care [...]

iqtsupport2019-12-04T06:00:06-05:00December 4, 2019|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Hospitals Sue HHS Over Payment Cut

Medicare cut hospital payments $840 million a year more than it should have and now, hospitals are suing to get their money back. According to the lawsuit, Congress authorized Medicare to include a cut of 0.7 percent in hospital inpatient payments through FY 2017 to recoup past Medicare overpayments but Medicare continued the cut, without Congress’s approval, in FY 2018 and FY 2019. The 600 hospitals that filed the suit estimate that the allegedly illegal cut cost them about $200,000 each and now, they want their money back – with interest. Learn more in the Becker’s Hospital Review article “622 [...]

iqtsupport2019-11-26T06:00:10-05:00November 26, 2019|hospitals, Medicare cuts, Medicare reimbursement policy|