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 November agenda were: MedPAC’s mandated report on long-term care hospitals patient functional assessment data used in Medicare payment and quality measurement modifying advanced alternative payment model (A-APM) payments modifying the Medicare-dependent hospital program promoting greater Medicare-Medicaid integration in dual-eligible special-needs plans the Medicare Advantage quality bonus program Medicare Advantage encounter data 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 [...]

iqtsupport2018-11-06T06:00:50-05:00November 6, 2018|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

CMS Proposes Increasing Use of Telehealth by Medicare Advantage Plans

Medicare Advantage plans would be authorized to make greater use of telehealth services under a new regulation to be proposed by the Centers for Medicare & Medicaid Services. The proposal, part of a broader regulation addressing a variety of Medicare programs, would authorize wider use of telehealth services in caring for Medicare Advantage enrollees while improving provider payments for those services. According to a CMS fact sheet about the proposed regulation, The Bipartisan Budget Act of 2018 allows MA plans to offer “additional telehealth benefits” not otherwise available in Original Medicare to enrollees starting in plan year 2020. Under this [...]

iqtsupport2018-10-31T06:00:06-04:00October 31, 2018|Medicare, Medicare regulations, Medicare reimbursement policy|

CMS to Watch the Watchdogs

The Centers for Medicare & Medicaid Services intends to pay closer attention to the work performed by accrediting organizations for different types of health care providers. With all providers and suppliers participating in Medicare subject to some kind of accreditation and inspection process, CMS intends to monitor more closely the work of those accreditors and inspectors after a 2018 Wall Street Journal investigation discovered facilities with continuing problems that continued to serve patients and keep their accreditation. With this in mind, CMS will redesign how accrediting organizations do their work, publicly post performance data on those accrediting organizations, and submit [...]

iqtsupport2018-10-12T06:00:19-04:00October 12, 2018|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 October agenda were: managing prescription opioid use in Medicare Part D opioids and alternatives in hospital settings: payments, incentives, and Medicare data Medicare payment policies for advanced practice registered nurses and physicians Medicare’s role in the supply of primary care physicians Medicare payments for services provided in inpatient psychiatric facilities episode-based payments and outcome measures under a unified payment system for post-acute care Medicare policy issues related to non-urgent and emergency care MedPAC is an independent congressional [...]

iqtsupport2018-10-11T06:00:51-04:00October 11, 2018|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care|

CMS: More Medicare Site-Neutral Payments Coming

The federal government is unlikely to stop with outpatient visits in its drive to make more Medicare payments on a site-neutral basis. That was the message Centers for Medicare & Medicaid Services administrator Seema Verma delivered at a public event last week. We are taking a look at [site-neutral payments] across the board and looking at our authority and where we can weigh in on it. But I think the post-acute space is something where there are a lot of differentials in payments and something we’re very interested in exploring. CMS recently proposed extending its use of site-neutral payments for [...]

iqtsupport2018-10-10T06:00:53-04:00October 10, 2018|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

OIG: Medicare Advantage Plans May be Denying Access to Save Money

The Office of the Inspector General of the U.S. Department of Health and Human Services is concerned that Medicare Advantage plans may be denying their members access to services to save money and increase profits. According to the OIG, those Medicare Advantage plans overturn 75 percent of their own denials of service upon appeal and independent reviewers are overturning still more denials. In the OIG’s view, this high rate of service denials raises concerns that Medicare Advantage plans, which today serve more than 20 million seniors, are denying their members access to needed medical services so they can cut costs [...]

iqtsupport2018-10-02T06:00:41-04:00October 2, 2018|Medicare|

New Approach to Readmissions Program to Take Effect October 1

Medicare’s hospital readmissions reduction program will move in a new direction beginning in FY 2019 after Congress directed the Centers of Medicare & Medicaid Services to compare hospitals’ performance on readmissions to similar hospitals instead of to all hospitals. The policy change, driven by a belief that safety-net hospitals were harmed by the program and excessive penalties because their patients are more challenging to serve, results in all hospitals being divided into peer groups based on the proportion of low-income patients they serve. The readmissions performance of hospitals is then compared only to other hospitals within each peer group. As [...]

iqtsupport2018-10-01T06:00:29-04:00October 1, 2018|Medicare, Medicare regulations|

CMS Proposes Easing Regulatory Requirements

In a newly proposed rule, the Centers for Medicare & Medicaid Services proposes easing the regulatory burden on health care providers. The proposed regulation, which weighs in at 285 pages, covers a broad range of government regulation of health care providers and would, CMS projects, save hospitals more than $1 billion a year while cutting millions of hours of administrative work. Learn more about what CMS proposes by reading its fact sheet on the proposed regulation or going here to see the proposed regulation itself.

iqtsupport2018-09-24T06:00:42-04:00September 24, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations|

Medicare Joint Replacement Program Produces Savings

The first reporting period for Medicare’s Comprehensive Care for Joint Replacement Model found that participating providers cut costs for episodes of care by more than $900, or 3.3 percent. Most of the savings, the Centers for Medicare & Medicaid Services reports, were achieved by sending patients to less-expensive post-acute-care settings or by reducing patients’ length of stay in such facilities. CMS also found that the program’s mandatory participants, located in 67 metropolitan statistical areas, achieved these savings without compromising quality of care as measured by post-discharge emergency room visits, hospital readmissions, and deaths. Learn more about CJR’s early results in [...]

iqtsupport2018-09-14T06:00:50-04:00September 14, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare|

MedPAC Meets

The Medicare Payment Advisory Commission met last week in Washington, D.C. to address a number of Medicare reimbursement-related issues. Among the subjects on MedPAC’s agenda were: a unified payment system for post-acute care long-term-care hospitals physician payments next steps in redesigning Medicare’s hospital quality and value programs While MedPAC’s policy and payment recommendations are not binding on Congress or the administration, its views are respected and influential and often become the basis for new public policy. Go here to see the policy briefs and presentations offered to help guide MedPAC commissioners’ discussions about these and other issues.

iqtsupport2018-09-13T06:00:56-04:00September 13, 2018|Medicare, Medicare post-acute care, MedPAC|