The rule updates Medicare fee-for-service payment rates and policies for inpatient hospitals and long-term care hospitals (LTCH) and builds on key priorities to advance health equity, including better measurements for healthcare quality disparities...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) published a set of quality metrics for home and community-based services (HCBS) to assess patient health outcomes. According to CMS, the ratings will provide insight into HCBS programs and will enable states to determine the success of long-term services and support programs offered...CMS Rules
In 2023 hospice payments will increase by 3.8% and the most Medicare will pay per hospice patient in FY 2023 will be $32,486.92, this year the cap amount is $31,297.61. Hospices that don't meet quality reporting requirements get a 2% point reduction to the annual hospice payment update percentage increase for the year. The rule also...
No new changes yet to the Inpatient Psychiatric Facility (IPF) Quality Reporting Program, but payments to facilities are expected to increase 2.5% ($90 million) over FY 2022. The Centers for Medicare & Medicaid Services (CMS) said the IPF prospective payment system (PPS) rates in FY 2023 will be updated by 3.8%. The agency also...
The agency had proposed a more modest 2% increase ($170 million) but the FY 2023 Inpatient Rehabilitation Facility (IRF) payments will increase by 3.2% ($275 million) relative to payments in FY 2022. The IRF Quality Reporting Program (QRP) is a pay-for-reporting program. IRFs that do not meet reporting requirements are subject to a 2%...
In 2020, the Centers for Medicare and Medicaid Services (CMS) reevaluated and revised the Hospital Overall Star Ratings methodology to streamline the ratings process and improve equitable ratings throughout a highly-varied industry. The American Hospital Association (AHA) reviewed the changes and found that they provide some stability...
Last Thursday, the Centers for Medicare and Medicaid Services (CMS) published the proposed 2023 physician fee schedule (PFS) which included an overhaul to the agency's strategies on accountable care organizations (ACOs) through the Medicare Shared Savings Program (MSSP).
In February, CMS pulled the Accountable Care Organizations...
It's no secret that the Biden administration is planning to implement mandatory staffing levels in nursing facilities that are reimbursed through Medicare and Medicaid. In the most recent step to announcing this measure last Thursday, the Centers for Medicare and Medicaid Services (CMS) published new guidance on staffing measures tied to...CMS Rules
On June 29, the Centers for Medicare and Medicaid Services (CMS) updated its guidance on requirements for long-term care facilities on staffing levels, arbitration, infection prevention and the administration of certain medications. The agency attributed the guidance to President Joe Biden's efforts to improve nursing home safety and is...
A new final rule is in effect as of July 1, 2022. CMS says that the Transparency in Coverage Final Rule is the first of several rules that will be met with stronger compliance enforcement in accordance with the No Surprises Act of 2021 and instead of targeting hospitals for the clear publication of potential prices for a range of...
The Centers for Medicare and Medicaid Services (CMS) has approved Colorado's plan to create a public insurance option through a Section 1332 innovation waiver. The "Colorado Option" will be offered in the Colorado Affordable Care Act Health Insurance Exchange beginning in 2023.
According to Healthcare Dive, the Colorado Option is the...CMS Rules
Earlier this year, President Joe Biden relaunched his Cancer Moonshot Initiative, which was initially established under the Obama administration to accelerate research into cancer prevention and cures. As part of the initiative, the Biden administration announced a new alternative payment model (APM) from the Center for Medicare and...CMS Rules
The rule includes proposals and routine updates to the Medicare Home Health Prospective Payment System (HHPPS) and the home infusion therapy services’ payment rates for CY 2023.
This rule proposes a permanent, budget-neutral approach to smooth year-to-year changes in the pre-floor/pre-reclassified hospital wage index as critics...
As nursing homes across the country are grappling with staff shortages exacerbated by the COVID-19 pandemic, the Biden administration is considering a rule that nursing homes spend most of their Medicaid payments on direct care for residents rather than operations or capital improvements.
According to Modern Healthcare, the rule would...
The hospital price transparency rule, which was issued by the Centers for Medicare and Medicaid Services and went into effect on January 1, 2021, is largely being ignored by hospitals who would prefer to absorb any financial penalty than comply. CMS has only started to impose fines as of last Wednesday, according to an agency email, but...
Last Friday, the Centers for Medicare and Medicaid Services (CMS) published a report that reviewed the Medicare Supplementary Medical Insurance (SMI) Trust Fund for 2023 and determined that cost-savings from unexpectedly low Medicare Part B spending in 2022 could be recommended to drive premium cuts for Part B coverage next year.
The...CMS Rules
The Leapfrog Group, a healthcare consumer safety watchdog group, has asked the Centers for Medicare and Medicaid Services (CMS) to revoke plans to end reporting on serious medical and surgical complications that occur in hospitals.
The 2023 Hospital Inpatient Prospective Payment System (IPPS) proposed rule contains within it a measure...
Last Friday, the Centers for Medicare and Medicaid Services (CMS) published a long-awaited final rule for Medicare Advantage (MA) that increases the agency's efforts to provide oversight to participating plans.
The rule includes new reasons for denying contracts or expanding contracts based on past performance. Modern Healthcare...
The No Surprises Act, a law that aims to protect Americans covered by private health plans from receiving surprise medical bills relating to emergency services or non-emergency services from out-of-network providers at in-network facilities, has been met with trouble since its implementation at the beginning of the year.
In February,...
Last Friday, April 22, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a proposal to rectify a few of the issues many Americans face with Medicare enrollment.
The CMS press release says the proposed rule will implement provisions from the Consolidated Appropriations Act of 2021 and President Joe Biden's executive...