Medicare

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|

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week to discuss various Medicare payment issues. Among the issues discussed at MedPAC’s March meeting were: Medicare beneficiary access to care in rural areas skilled nursing facility value-based purchasing program and proposed replacement streamlining CMS’s portfolio of alternative payment models balancing efficiency with equity in Medicare Advantage benchmark policy relationship between clinician services and other Medicare services revising Medicare’s indirect medical education payments to better reflect teaching hospitals’ costs Medicare’s vaccine coverage and payment separately payable drugs in the hospital outpatient prospective payment system MedPAC is an independent congressional agency [...]

iqtsupport2021-03-10T06:00:08-05:00March 10, 2021|Medicare, MedPAC|

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|

Medicare Pays Far More Than Medicaid for Brand-Name Drugs

Medicare pays three times as much for brand-name drugs at retail pharmacies as Medicaid and two-and-a-half times more for specialty drugs, according to a new analysis by the Congressional Budget Office. The vast difference occurs because of how drug prices are established for the two programs. Under Medicare Part D, individual payers and manufacturers negotiate prices based on commercial market conditions while for Medicaid, federal law requires manufacturers to provide rebates. Learn more about the differences between Medicare and Medicaid prescription drug prices, how and why those differences occur, and their implications in the CBO report “A Comparison of Brand-Name [...]

iqtsupport2021-02-26T06:00:54-05:00February 26, 2021|Medicaid, Medicare|

Congress Approves New GME Slots

The year-end federal COVID-19 relief bill brought changes to Medicare’s graduate medical education program. Among those changes: 200 new GME slots over the next five years additional federal funding for residency training – the first new funding for the program in nearly a quarter of a century new opportunities for some hospitals to establish new (and higher) resident caps new flexibilities for rural hospitals to participate in physician training programs Learn more in the National Law Review article “COVID-19: Reimbursement Corner: Graduate Medical Education Gets Major Boost From Congressional Appropriations Bill.”

iqtsupport2021-01-06T06:00:33-05:00January 6, 2021|Medicare|

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|

HHS Webinar Thursday

The Department of Health and Human Services will hold a webinar on Thursday, October 22 at 1:00 (eastern) about the Centers for Medicare & Medicaid Services’ recent guidance explaining how it will implement an interim final rule that makes the collection and reporting of COVID-19 data a condition of participation in Medicare for hospitals. On August 24 CMS published an interim final rule establishing new requirements in the hospital conditions of participation in Medicare and on October 6 HHS published the updated document “COVID-19 Guidance for Hospital Reporting and FAQs For Hospitals, Hospital Laboratory, and Acute Care Facility Reporting.” Among [...]

iqtsupport2020-10-22T06:00:34-04:00October 22, 2020|Coronavirus, COVID-19, Medicare, Medicare regulations|

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|