Last Friday, the Centers for Medicare and Medicaid Services (CMS) published the final rule for the FY 2024 Hospice Payment Rate Update.
Hospices will receive 3.1% pay bump, which will work out to roughly $780 million. According to the CMS Fact Sheet, the rule also raises the payment cap to $33,494.01.
The agency also notes that it...
The federal government issued a final rule to update FY 2024 Medicare payment policies providing a 4% bump under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and a 3.3% raise under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS).
The Center for Medicare & Medicaid Services...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) CY 2024 Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) proposed rules released this week have caught major criticism from the industry for cuts to physician pay and inadequate raises for hospitals. But the OPPS proposal also contains a number of...CMS Rules
The Centers for Medicare and Medicaid Services (CMS published its proposed physician fee schedule (PFS), which add up to a 1.25% decrease in pay for Medicare physicians for 2024. Physician groups and industry leaders met the news with frustration, with some doubling down on calls to reform the entire payment formula. CMS also posted the...CMS Rules
Hospital-based end stage renal disease (ESRD) facilities are poised to receive a 2.6% increase in the ESRD prospective payment proposed rule for 2024, but home-based dialysis care is gaining traction. Experts are also recommending earlier screening for chronic kidney disease.
Under the 2024 End Stage Renal Disease Prospective Payment...
The Biden administration released revised guidance for the Medicare drug price negotiation program late last week in response to the mounting lawsuits against the policy required by the Inflation Reduction Act (IRA) of 2022.
Drugmakers Merck and Bristol Myers Squibb, as well as industry representatives like the U.S. Chamber of...
Last Friday, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule for the 2024 Home Health Prospective Payment System. The proposal shocked the home health industry by enforcing an aggregate decrease of 2.2% for Medicare payments to home health agencies (HHAs).
The cut arises from a proposed pay bump of 2.7%...CMS Rules
On Monday, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would make changes to the end-stage renal disease (ESRD) Prospective Payment System (PPS) for dialysis services. The rule includes a slight pay increase for dialysis providers and increases payments for some dialysis drugs and biologics.
CMS is...CMS Rules
States are employing tech vendors to help facilitate communications for the Medicaid redeterminations process, but they can't curb the high volume of enrollees losing coverage.
More than 90 million Americans must undergo eligibility review over the next several months and the U.S. Department of Health and Human Services has estimated...CMS Rules
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) announced that it would reverse course on anti-amyloid treatments for Alzheimer's patients and cover Leqembi should it receive full approval from the U.S. Food and Drug Administration (FDA). June is Alzheimer's Awareness month.
Leqembi, produced by Biogen and Eisai,...CMS Rules
As states proceed with Medicaid redeterminations after three years of a pause on eligibility review, hundreds of thousands of Americans are losing insurance coverage, according to early data reports. The Centers for Medicare and Medicaid Services (CMS) are stressing the importance of limiting the number of lost enrollees and facilitating...CMS Rules
The Biden administration issued a proposed rule through the Centers for Medicare and Medicaid Services that aims to increase transparency of prescription drug costs and managed care plan operations for Medicaid enrollees.
It would do this by implementing a new drug price verification survey tool and requiring the inclusion of drug...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) published a memo concerning a crackdown on improper claims for skilled nursing facilities. CMS also announced that it would begin a demonstration for inpatient rehabilitation facilities in Alabama that will allow all Medicare claims to be subject to review.
As of June 5, all SNFs...CMS Rules
Last week, the Centers for Medicare and Medicaid Services released a final rule taking aim at prior authorization and its use in Medicare Advantage. The rule also makes changes to the star ratings program and marketing reforms.
The rule stipulates that once a health plan grants prior authorization for a service, the approval will...
Published Friday, the rate notice includes a 3.32% overall pay raise which was up from the 1.03% in the proposed rule.
The Centers for Medicare and Medicaid Services (CMS) appears to have ceded to the demands of the insurance industry; the new pay rates translate to a $13.8 billion increase for insurers, according to Axios, CMS will...
On Monday, the Centers for Medicare and Medicaid Services (CMS) proposed the FY 2024 Skilled Nursing Facility (SNF) Payment Prospective Systems (PPS) rates. It includes an increase of 3.7%, or $1.2 billion in Medicare Part A payments to SNFs.
The rate increase reflects a 6.1% market basket update to the payment rates comprised of a...
On Friday, the Centers for Medicare and Medicaid Services issued a proposed rule that would give hospice providers a 2.8% reimbursement increase and would institute a number of penalties for hospices that fail to meet reporting requirements. The rule signals a long-expected federal crackdown on hospice fraud, waste and...
Lawmakers and stakeholders are still very upset with the U.S. Department of Health and Human Services' (HHS) plan to cut payments to the Medicare Advantage (MA) program and to enforce regulations against MA plans that have benefitted financially from improper overpayments. This week, HHS Secretary Xavier Becerra defended the rule in two...
Last week, the Centers for Medicare and Medicaid Services (CMS) announced plans to extend the Medicare Advantage (MA) Value-Based Insurance Design Model for five more years, through 2030.
According to the American Hospital Association, 52 Medicare Advantage organizations with a collective 9.3 million enrollees are participating int he...