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|

Expand Use of Telehealth, Group Recommends

The federal government should encourage greater use of telehealth, a task force has recommended. Among the changes recommended by the task force, it called on the federal government to make permanent some of the temporary extensions of the use of telehealth authorized for Medicare in response to COVID-19, including: Lifting geographic restrictions and limitations on originating sites. Allowing telehealth for various types of clinicians and conditions. Acknowledging, as many states now do, that telehealth visits can meet requirements for establishing a clinician/patient relationship if the encounter meets appropriate care standards or unless careful analysis demonstrates that, in specific situations, a [...]

iqtsupport2020-09-28T06:00:26-04:00September 28, 2020|Medicare|

Private Insurer Payments Far Exceed Medicare Payments, Study Finds

“…employers and private insurers … paid 247 percent of what Medicare would have paid for the same services at the same facilities,” according to a new study by the Rand Corporation, which also notes that “This difference increased from 224 percent of Medicare in 2016 and 230 percent in 2017.” The study also found that: From 2016 to 2018, the overall relative price for hospitals (including inpatient and outpatient care) increased from 224 to 247 percent, a compounded annual rate of increase of 5.1 percent. Some states (Arkansas, Michigan, Rhode Island) had relative prices under 200 percent of Medicare; others [...]

iqtsupport2020-09-23T13:39:09-04:00September 23, 2020|Medicare, Medicare reimbursement policy|

MedPAC Talks Telehealth

Expanded telehealth is here to stay, members of the Medicare Payment Advisory Commission agreed at their September public meeting. What they do not yet know is in what form. Among the issues that need to be addressed in any post-COVID-19 expansion of Medicare-covered telehealth services are: Whether affording access to telehealth services would exacerbate the digital divide and leave some Medicare beneficiaries with less access to care than others. Whether audio-only coverage, temporarily permitted during the pandemic, should be continued. Whether greater use of telehealth might foster greater use of low-value services. Whether use of non-HIPAA-compliant video technology should continue [...]

iqtsupport2020-09-11T06:00:46-04:00September 11, 2020|Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

Feds Delay Stark Rule, Anti-Kickback Update

An update of regulations that limit the ability of doctors to refer patients for care to sources in which those doctors have a financial interest will wait as long as another year, according to the Centers for Medicare & Medicaid Services. CMS had previously proposed regulations updating current guidelines, essentially easing them, but provider comment was so great – often, saying that the easing of the guidelines did not go far enough – that the agency decided to step back and review the situation. In a public inspection version of a notice to be published in the Federal Register, CMS [...]

iqtsupport2020-08-29T06:00:59-04:00August 29, 2020|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

OIG Cites Medicare, Medicaid Among Top Unimplemented Recommendations

CMS has failed to implement many of the policy changes recommended to it by HHS’s Office of the Inspector General, according to a new OIG report. Every year the Department of Health and Human Services’ OIG offers recommendations for policy changes designed to reduce fraud, waste, and abuse in HHS programs. This week, the OIG published “OIG’s Top Unimplemented Recommendations: Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs.” Among the top 25 unimplemented recommendations to the Centers for Medicare & Medicaid Services are 14 involving Medicare and Medicaid. Its top 10 unimplemented Medicare recommendations are: CMS should take [...]

iqtsupport2020-08-11T10:33:28-04:00August 11, 2020|Centers for Medicare & Medicaid Services, Medicaid, Medicare, Medicare post-acute care, Medicare reimbursement policy|