Policy Updates

CMS Finalizes FY 2021 Payments to Hospitals

Medicare has announced how it will pay hospitals for inpatient care in FY 2021 with publication of its annual inpatient prospective payment system regulation last week. Among the changes announced by the Centers for Medicare & Medicaid Services: A 2.9 percent increase in fee-for-service inpatient rates. A compromise on its proposal to require hospitals to report their payer-specific negotiated rates with Medicare Advantage plans. Changes in how Medicare will calculate Medicare disproportionate share (Medicare DSH) uncompensated care payments. A much smaller cut than originally proposed in the pool of funds for Medicare DSH uncompensated care payments. Minor adjustments in the [...]

iqtsupport2020-09-09T06:00:15-04:00September 9, 2020|hospitals, Medicaid regulations, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|

Coronavirus Update for Friday, September 4

The following is the latest COVID-19 information from the federal government as of 12:15 p.m. on Friday, September 4. Provider Relief Fund Reminder: Applications are currently open for Phase 2 general distribution funding for Medicaid, Medicaid managed care, the Children's Health Insurance Program (CHIP), dental providers, certain Medicare providers, and assisted living facilities. All groups have until September 13, 2020 to submit their tax identification number for validation and apply for funding from the phase 2 general distribution. Go here for more information. HHS announced that assisted living facilities may apply for funding under the Provider Relief Fund phase 2 general distribution allocation. [...]

iqtsupport2020-09-08T06:00:57-04:00September 8, 2020|Coronavirus, COVID-19|

How Medicaid Managed Care Cuts Costs

Low-cost Medicaid managed care plans mostly cut their costs by reducing how much care, and how much high-quality care, their members receive. That is the conclusion of a new study published by the National Bureau of Economic Research. According to the study, Medicaid managed care plans succeed in reducing costs less by cost-sharing, negotiating lower provider rates, employing narrow networks, and doing a better job of managing their members’ high-cost chronic medical conditions than they do by leading their members to use fewer high-value, low-cost services such as cancer and diabetes screenings and fewer high-value drugs. The researchers note that [...]

iqtsupport2020-09-02T06:00:59-04:00September 2, 2020|Medicaid|

Coronavirus Update for Monday, August 31

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Monday, August 31. Provider Relief Fund The Department of Health and Human Services has updated its CARES Act Provider Relief Fund FAQ. Six questions on pages 30 and 31, marked “Modified 8/25/2020,” primarily address submitting requests for phase 2 distributions. Five questions on pages 9, 22-23, 23, 32-33, and 33 are marked “Modified 8/27/2020” or “Added 8/27/2020” and address applying for phase 2 distributions. Five questions, on pages 44 and 45, address the upcoming nursing home infection control distribution and are marked “Added 8/27/2020.” [...]

iqtsupport2020-09-01T06:00:27-04:00September 1, 2020|Coronavirus, COVID-19|

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services. In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date, CMS will enforce its own interpretation of the policy. In new guidance, CMS presents two methodologies for accounting for its mid-year policy change [...]

iqtsupport2020-08-29T13:00:57-04:00August 29, 2020|Centers for Medicare & Medicaid Services, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations|

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|

Coronavirus Update for Thursday, August 27

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Thursday, August 27. Centers for Medicare & Medicaid Services CMS has provided new guidance on completing Medicare reports: specifically, how providers should report Provider Relief Fund payments, uninsured charges reimbursed through the uninsured program administered by HHS’s Health Resources and Services Administration, and Small Business Administration loan forgiveness amounts. The new information can be found in CMS’s updated COVID-19 FAQ on Medicare fee-for-service billing, in questions 2 through 8 on pages 99-102. The Families First Coronavirus Response Act waives cost-sharing under Medicare Part B [...]

iqtsupport2020-08-28T06:00:39-04:00August 28, 2020|Coronavirus, COVID-19|

Coronavirus Update for Wednesday, August 26

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Wednesday, August 26. Provider Relief Fund The deadline to apply for General Distribution Phase 2 Provider Relief Funds for Medicaid, CHIP, dental, and certain Medicare providers, previously this Friday, August 28, has been extended to September 13. Entities that received payments from the initial $30 million distribution and the subsequent $20 million distribution are eligible to apply for additional funding if those payments do not equal at least two percent of their annual net patient revenue. Go here for information about the extension of the application deadline and [...]

iqtsupport2020-08-27T06:00:23-04:00August 27, 2020|Coronavirus, COVID-19|

Coronavirus Update for Monday, August 24

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Monday, August 24. Provider Relief Fund: A Reminder The deadline to apply for General Distribution Phase 2 Provider Relief Funds for Medicaid, CHIP, dental, and certain Medicare providers is this Friday, August 28. Entities that received payments from the initial $30 million distribution and the subsequent $20 million distribution are eligible to apply for additional funding if those payments do not equal at least two percent of their annual net patient revenue. Go here for information about eligibility and how to apply. Department of Health and Human Services [...]

iqtsupport2020-08-25T06:00:14-04:00August 25, 2020|Coronavirus, COVID-19|

Coronavirus Update for Friday, August 21

The following is the latest COVID-19 information from the federal government as of 3:00 p.m. on Friday, August 21. Centers for Medicare & Medicaid Services CMS had updated its COVID-19 emergency declaration blanket waivers and flexibilities for health care providers. Among those flexibilities, CMS has postponed the September 1, 2020 deadline to submit wage index reclassification applications to the Medicare geographic classification review board due to COVID-19. The deadline has been pushed back until 15 days after the public display date of the FY 2021 IPPS/LTCH final rule by the Office of the Federal Register. See page 10 for details. [...]

iqtsupport2020-08-24T06:00:11-04:00August 24, 2020|Coronavirus, COVID-19|