Medicare physician payments

Medicaid DSH Cut In, Medicare Site-Neutral Payments Out of Health Bill?

With Congress at a stalemate on spending legislation, lawmakers are considering a narrower scope of issues to address in near-term health care legislation. According to published reports, scheduled cuts in Medicaid disproportionate share allotments to states (Medicaid DSH), already delayed several times, could be delayed once again. In addition, a proposal to require Medicare to pay for outpatient services on a site-neutral basis, rather than paying higher rates to hospital-based outpatient departments higher rates, might not be included. Also under consideration:  restoring some cuts in Medicare’s payments to physicians and additional funding for community health centers. Also in jeopardy at [...]

MedPAC Offers FY 2024 Rate Recommendations

Medicare rates would rise for some providers and fall for others based on recommendations made to Congress last week by the Medicare Payment Advisory Commission, the independent congressional agency that advises Congress on Medicare reimbursement matters. MedPAC’s rate recommendations to Congress and the administration, which it approved at its January 2023 meeting, are: Outpatient and inpatient prospective payment systems – under current law, the estimated increase would be about 2.9 percent; MedPAC proposes 2.9 percent plus one percent. Physician services – increase fees 50 percent of the projected increase in the medical economic index (MEI). Skilled nursing facilities – reduce [...]

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22.  Some of the language used below is taken directly from government documents. Congress As of this writing, Congress continues to work on an FY 2023 omnibus spending bill:  the Senate has passed it but the House has not yet addressed it.  Highlights of what negotiators have agreed to – but that have not yet been adopted – include: Preventing the additional four percent Medicare sequester for two years. Reducing by more than half the 4.5 percent cut in Medicare payments to physicians [...]

MedPAC Considers 2023 Medicare Rates at December Meeting

The government agency that advises Congress on Medicare payment matters met publicly in Washington, D.C. last week. During the virtual meeting, members of the Medicare Payment Advisory Commission discussed and debated: Assessing payment adequacy and updating payments: hospital inpatient and outpatient services and supporting Medicare safety-net hospitals – commissioners discussed a proposal to increase FY 2024 rates one percentage point more than current law prescribes.  Commissioners also discussed additional steps they might take to provide better support to safety-net hospitals, which they described as “…hospitals with high shares of low-income Medicare patients.” Status report: ambulatory surgical center services. Assessing payment [...]

117th Congress’s Waning Hours

In addition to its biggest challenge – funding the federal government, authorization for which ends on December 16 – Congress has a number of health care issues on its agenda that at least some lawmakers and health care industry stakeholders would like to see it address before the year ends. Those issues include the cut in Medicare payments to physicians scheduled to take place on January 1; the desire of many to make permanent some of the flexibilities to use telehealth that were temporarily authorized in response to the COVID-19 public health emergency; additional pandemic funding for new vaccines, new [...]

2022-11-17T06:00:49+00:00November 17, 2022|Congress, COVID-19, Medicare, Medicare reimbursement policy, Telehealth|

MedPAC Makes 2023 Medicare Payment Recommendations

The Medicare Payment Advisory Commission has released its March 2022 Report to the Congress: Medicare Payment Policy.  The report includes MedPAC’s recommendations for Medicare payments in 2023. For the coming year, MedPAC recommends the following changes in Medicare fee-for-service payments: hospital inpatient payments – increase 2.5% hospital outpatient payments – increase 2.0% long-term care hospital payments – increase approximately 2.0% outpatient dialysis payments – increase 1.2% physician, ambulatory surgical center, and hospice payments – no change skilled nursing facility, home health, and inpatient rehabilitation facility payments – reduce 5.0% The report also reviews the status of Medicare Advantage and the [...]

2022-03-21T06:00:52+00:00March 21, 2022|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. 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 [...]

CMS Proposes New Medicare Payments for 2021

Medicare will change its provider payments for two types of Medicare-covered services in 2021 and has proposed changes in payments for three other Medicare-covered services in a flurry of activity over the past week. Last week the Centers for Medicare & Medicaid Services finalized new 2021 Medicare payment rates for: skilled nursing facilities hospice services inpatient psychiatric facilities In addition, this week CMS proposed new 2021 Medicare rates for: physician services outpatient and ambulatory surgical services The proposed changes in Medicare provider payments for physician services and outpatient and ambulatory surgical services are subject to a public comment period before [...]

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 [...]

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 [...]

Go to Top