Medicare

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|

Home Health Agencies Expanding Scope of Endeavor

In the coming years, home health agencies will be providing a broader scope of services. With many such agencies already offering medication management technology, remote patient monitoring, image-sharing technology, and mobile apps for e-visits, many are planning to do more. More than a quarter of home health providers plan to move into or expand their telehealth offerings in the coding years and many already provide chronic care services, with more planning to do so in the coming years. Home health providers also are moving into palliative care, veteran-specific services, and mental health services. Behind some of this expansion of scope [...]

iqtsupport2019-12-09T06:00:21-05:00December 9, 2019|Medicare, Telehealth|

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|

Administration Reveals Regulatory Priorities for 2020

The Trump administration’s health care regulatory priorities for 2020 have been outlined by the Office of Management and Budget in a newly released “Statement of Regulatory Priorities for Fiscal Year 2020.” The statement, an annual OMB document, organizes the priorities as follows: Facilitating patient-centered markets Fixing health care financing through protecting private insurance and Medicare Fixing health care financing through reforming the individual market Fixing health care financing through making the ACA and Medicaid fiscally sustainable Bringing value to health care through price and quality transparency Bringing value to health care through patient-centered health IT Bringing value to health care [...]

iqtsupport2019-11-22T06:00:34-05:00November 22, 2019|Affordable Care Act, Centers for Medicare & Medicaid Services, Medicaid, Medicaid regulations, Medicare, Medicare regulations|

Improper Medicare Payments Down in FY 2019

The amount of improper Medicare payments made by the federal government fell $7 billion in federal fiscal year 2019, the Centers for Medicare & Medicaid Services reports. FY 2019 marked the third consecutive year that improper fee-for-service payments have fallen. In FY 2018, improper payments accounted for 8.12 percent of Medicare fee-for-service spending but in FY 2019 that portion fell to 7.25 percent. In FY 2019, CMS estimates that it made $28.9 billion in improper fee-for-service payments. $5.32 billion of the $7 billion reduction came through corrective actions in Medicare home health payments. Other Medicare Part B services accounted for [...]

iqtsupport2019-11-19T14:00:06-05:00November 19, 2019|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 November agenda were: congressional request on health care provider consolidation increasing the supply of primary care physicians redesigning the Medicare Advantage quality bonus program reforming the benchmarks in the Medicare Advantage payment system considerations for plans serving low-income beneficiaries in the restructuring of Medicare Part D post-acute care spending under the Medicare Shared Savings Program MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program. While its recommendations are not binding on [...]

iqtsupport2019-11-12T06:00:16-05:00November 12, 2019|Alternative payment models, hospitals, Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Azar: More Value-Based Care Coming

Medicare may add more value-based care initiatives and alternative payment models to those it already operates, Health and Human Services Secretary Alex Azar suggested at a recent event in Washington, D.C. During his remarks, Azar spoke about population health benefits, global budgeting for Medicare patients, more primary care programs, and new models that address kidney care and opioid use and hinted at future efforts that address social determinants of health. Learn more about Azar’s remarks about Medicare value-based purchasing and alternative payment models and other current federal health policy matters in the Healthcare Dive article “HHS chief keeps focus on [...]

iqtsupport2019-10-31T13:00:29-04:00October 31, 2019|Alternative payment models, Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy|

More Hospitals Gain Than Lose in FY 2020 Value-Based Purchasing Program

Medicare’s value-based purchasing program will reward more hospitals than it will penalize in FY 2020 through its value-based purchasing program. The program, in which 2700 hospitals are scored in four domains – clinical outcomes, safety, person and community engagement, and efficiency and cost reduction – will distribute $1.9 billion in bonus payments to 1500 hospitals. Bonus payment average 0.6 percent, with a high of 2.93 percent. Penalties average -0.39 percent, with a high of -1.72 percent. Overall, rural hospitals performed better in the safety, person and community engagement, and efficiency and cost reduction categories and had a higher average score [...]

iqtsupport2019-10-30T15:15:04-04:00October 30, 2019|hospitals, Medicare, Medicare reimbursement policy|

Hospitals Advocate Losing Chargemaster

Hospitals would no longer need to post their chargemaster prices under a new approach to Medicare payments being advocated by a new hospital lobbying group. The small group, calling itself the Chargemaster Alternatives for Medicare Payment Alliance, wants Medicare to eliminate payment formulas based on chargemaster prices and base them instead on actual costs. Acting in response to a new proposal that hospitals be required to post their chargemaster prices, the group argues that chargemaster prices are irrelevant for all but a few consumers. Learn more about the group, its members, and its argument for ending use of chargemaster prices [...]

iqtsupport2019-10-28T06:00:54-04:00October 28, 2019|Medicare, Medicare reimbursement policy|

Court Upholds Delay of Site-Neutral Payment Cut

Medicare cannot proceed with its plan to pay for outpatient care on a site-neutral basis while it appeals a court ruling rejecting that policy, a federal court has ruled. A federal judge found that Medicare has not articulated an adequate reason to delay the $380 million a year in site-neutral payment cuts while the Centers for Medicare & Medicaid Services appeals the September decision rejecting the payment policy change. The court also found that, contrary to CMS’s claim, Medicare still has an appropriate methodology for making payments that are not site-neutral and that the agency has not proved that it [...]

iqtsupport2019-10-22T06:00:38-04:00October 22, 2019|Centers for Medicare & Medicaid Services, Medicare, Medicare reimbursement policy|