MedPAC

MedPAC Weighs in on Proposed Medicare Payment Changes

The Medicare Payment Advisory Commission has submitted formal comments to the Centers for Medicare & Medicaid Services in response to the latter’s publication of a proposed regulation that would govern how Medicare will pay for acute-care hospital inpatient services and long-term hospital care in the coming 2020 fiscal year. The 14-page MedPAC report addresses four aspects of the proposed Medicare payment regulation: inpatient- and outpatient drug- and device related payment proposals proposed changes in the hospital area wage index the reporting of hospitals’ uncompensated care on the Medicare cost report’s S-10 worksheet the long-term hospital prospective payment system MedPAC is [...]

MedPAC Issues Annual Report to Congress

The Medicare Payment Advisory Commission has sent its mandatory annual report to Congress. Included in the report are sections on: Beneficiary enrollment in Medicare: eligibility notification, enrollment process, and Part B late enrollment penalties. Restructuring Medicare Part D for the era of specialty drugs. Medicare payment strategies to improve price competition and value for Part B drugs. MedPAC’s mandated report to Congress on clinician payments. Issues in Medicare beneficiaries’ access to primary care. Assessment of the Medicare Shared Savings Program’s effect on Medicare spending. Ensuring the accuracy and completeness of Medicare Advantage encounter data. Redesigning the Medicare Advantage quality bonus [...]

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 April agenda were: Expanding the use of value-based payment in Medicare Medicare Shared Savings Program performance Redesigning the Medicare Advantage quality bonus program Increasing the accuracy and completeness of Medicare Advantage encounter data Evaluating patient functional assessment data reported by post-acute-care providers Options for slowing the growth of Medicare fee-for-service spending for emergency department services Options to increase the affordability of specialty drugs and biologics in Medicare Part D Improving payment for low-volume and isolated outpatient dialysis [...]

MedPAC Offers Recommendations on FY 2020 Rates, More

Last week the Medicare Payment Advisory Commission released its annual report to Congress.  Included in this report are MedPAC’s Medicare rate recommendations for the coming year.  They are: hospital inpatient rates – a two percent increase hospital outpatient rates – a two percent increase physician and other health professional services rates – no update skilled nursing facilities – no 2020 increase home health agencies – a five percent rate reduction inpatient rehabilitation facilities – a five percent rate reduction long-term-care hospital services – a two percent increase hospice services – a two percent rate reduction MedPAC also recommended that the [...]

MedPAC Discusses ED Coding Changes

Members of the Medicare Payment Advisory Commission discussed the possibility of recommending to Congress that it call for national guidelines for how hospitals code emergency department services. The change may be needed, the commissioners suggested at their March meeting, because hospitals have gravitated toward coding for higher intensity services as time passes. Such a change, if implemented, could result in less emergency department revenue for some hospitals. Learn more in the Healthcare Dive article “MedPAC eyes changes to ED coding, Part B drug pricing.”

2019-03-15T06:00:51-04:00March 15, 2019|Medicare, MedPAC|

MedPAC Debates Post-Acute Payments

As the Centers for Medicare & Medicaid Services continues to develop a unified payment system for all post-acute-care providers, Congress’s advisors on Medicare payment policy appear ready to weigh in on an important aspect of such a system: Whether payments should be based on entire episodes of care or individual stays in post-acute-care facilities. And at least for now, the Medicare Payment Advisory Commission is leaning toward recommending that post-acute-care payments be based on individual stays. At their March public meeting, MedPAC commissioners expressed concern that post-acute-care payments based on entire episodes of care might create financial incentives for providers [...]

2019-03-13T14:55:27-04:00March 13, 2019|Medicare post-acute care, 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 March agenda were: two Medicare payment strategies to improve price competition and value for Part B drugs: reference pricing and binding arbitration options for slowing the growth of Medicare fee-for-service spending for emergency department service. Medicare’s role in the supply of primary care physicians evaluating an episode-based payment system for post-acute care mandated report: changes in post-acute and hospice care following the implementation of the long-term care hospital dual payment rate structure MedPAC is an independent congressional [...]

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: The Medicare prescription drug program (Part D) Opioids and alternatives in hospital settings: payments, incentives, and Medicare data Hospital inpatient and outpatient services payments Redesigning Medicare’s hospital quality incentive programs Physicians and other health professional services payments Medicare payment policies for advanced practice registered nurses and physician assistants Ambulatory surgical centers and hospice payments Skilled nursing facilities, home health agency, and inpatient rehabilitation facilities payments Long-term care hospital services payments Outpatient dialysis payments Future [...]

MedPAC Mulls Billing Change for Nurse Practitioners, Physician Assistants

Medicare would permit nurse practitioners and physician assistants to bill directly for their services under a proposal being considered by the Medicare Payment Advisory Commission. Currently such services are billed as “incident to” physician services, but according to a report in Becker’s Hospital Review, MedPAC staff told commissioners there are problems with “incident to” billing because it “obscures policymakers’ knowledge of who is providing care for beneficiaries,” “inhibits accurate valuation of fee schedule services,” and “increases Medicare beneficiary spending.”  Staff also said that physician assistants and nurse practitioners increasingly practice outside of primary care. MedPAC is an independent congressional agency [...]

2018-12-13T06:00:59-05:00December 13, 2018|Medicare, 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: Medicare payments for physician and other health professionals services payments for ambulatory surgical centers payments for hospital inpatient and outpatient care Medicare’s hospital quality incentive program payments for skilled nursing facilities payments for long-term care hospitals payments for inpatient rehabilitation facilities payments for outpatient dialysis services payments for hospice care payments for home health services the Medicare Advantage program MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  [...]

2018-12-11T06:00:45-05:00December 11, 2018|hospitals, Medicare, Medicare reimbursement policy, MedPAC|
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