Physicians and related stakeholder groups have rallied against the 2024 physician fee schedule proposed rule, which was issued in July. The rule is expected to be finalized shortly, but providers are saying that any cuts could jeopardize access to...
Last week, the Southern District Court of Ohio heard the first oral arguments from the U.S. Chamber of Commerce (CoC, the Chamber) and the U.S. Department of Justice (DOJ). The Chamber requested an injunction of the Medicare negotiation program before October 1, which is the deadline for companies to sign an agreement to participate in...
Last Friday, the White House and the Centers for Medicare and Medicaid Services (CMS) released their long-awaited proposal for a federal minimum staffing mandate in nursing homes.
The proposal would require Medicare and Medicaid nursing homes to provide a baseline minimum 0.55 hours of care from a registered nurse per resident per day...
The Biden administration released its list of 10 drugs for direct price negotiations with manufacturers. The highly anticipated list is the most recent step in enacting a part of the Inflation Reduction Act (IRA) of 2022. The drugs listed are largely treatments related to Type 2 diabetes, blood thinning, arthritis and cancer...
States will now be required to report health quality measures for Medicaid beneficiaries including children's health, adult behavioral health and health home data to the Centers for Medicare and Medicaid Services (CMS).
The Core Set of Children's Health Care Quality Measures for Medicaid and the Children's Health Insurance Program...CMS Rules
The FY 2024 Hospital Inpatient Prospective Payment System (IPPS) and Long-term Care Hospital Prospective Payment System (LTCH PPS) rule was finalized by the Centers for Medicare and Medicaid Services (CMS) on August 1 and contains a shocking projected cut to disproportionate share hospitals (DSH).
For all hospitals, the rule provides...
The Centers for Medicare and Medicaid Services (CMS) published a final rule on Friday that will give skilled nursing facilities (SNFs) a much needed 4% pay increase in 2024.
The proposed rule contained a 3.7% increase but the final policy reflects a 3% market basket update in addition to 3.6% increase to correct previous forecasting...
The Centers for Medicare and Medicaid Services (CMS) announced the creation of a new payment model for people diagnosed with dementia.
The Guiding an Improved Dementia Experience (GUIDE) Model is an alternative payment model focused on preserving quality of life for diagnosed dementia patients while keeping them at home and providing...
The Centers for Medicare and Medicaid Services (CMS) finalized the 2024 Inpatient Prospective Payment System (IPPS), which included a 3.1% pay bump. Continuing the trend set early on in the PPS season, hospitals and other inpatient facility groups responded negatively to the raise, claiming that it's not enough due to inflation, labor...
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...
