CMS

AHA’s Recommendations for Inpatient Medicare Reimbursement in FY22

by Jill McKeon

The American Hospital Association (AHA) released comments on CMS’s FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule, which would increase inpatient Medicare reimbursement rates...

CMS Proposes New Value-Based Payment for End-Stage Renal Disease

by Jacqueline LaPointe

CMS has issued a proposed rule that would create a new value-based payment pathway for end-stage renal disease (ESRD) facilities, as well as update Medicare rates for renal dialysis services next...

CMS Proposes $310M Boost, Value-Based Purchasing for Home Health

by Jacqueline LaPointe

CMS has released the proposed rule for the Home Health Prospective Payment System next year. The rule seeks to expand the Home Health Value-Based Purchasing (HHVBP) Model and address health equity...

CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

by Jill McKeon

Medicare payments will increase by $35 per dose for providers who administer at-home COVID-19 vaccinations for Medicare beneficiaries, CMS announced today. In alignment with President Biden’s...

CJR Model Linked to Increased Health Disparities, Study Reveals

by Jill McKeon

In a study of over four million Medicare beneficiaries, researchers found that the Comprehensive Care for Joint Replacement (CJR) model may be widening racial and socioeconomic health disparities in...

Chiquita Brooks-LaSure Becomes Next CMS Administrator

by Jacqueline LaPointe

The Senate has confirmed Chiquita Brooks-LaSure to lead the Centers for Medicare & Medicaid Services (CMS) by a vote of 55 to 44. Brooks-LaSure is the first Black woman to lead the agency...

CMS to Reweight MIPS Cost Performance Category for 2020

by Jill McKeon

CMS announced it will be reweighting the cost performance category under the Merit-Based Incentive Payment System (MIPS) from 15 percent to zero percent for the 2020 performance period to provide...

CMS Delays Codifying Definition of “Reasonable and Necessary”

by Jill McKeon

CMS announced that it will delay the effective date of a final rule updating the definition of “reasonable and necessary” and the guidelines surrounding the Medicare Coverage of Innovative...

Medicare Payment Bumped for COVID-19 Antibody, At-Home Infusions

by Jacqueline LaPointe

CMS has raised the Medicare payment rate for certain COVID-19 antibody infusions and included a new payment policy for at-home administration, which will have a higher payment rate compared to other...

CMS Proposes $2.5B IPPS Rate Hike, With Eye on Rural, Health Equity

by Jacqueline LaPointe

CMS is proposing to increase Medicare hospital inpatient rates by $2.5 billion next fiscal year, in addition to bolstering the rural healthcare workforce and health equity reporting. The rate increase...

How Fowler Plans to Refresh CMMI’s Value-Based Care Vision

by Jacqueline LaPointe

The healthcare system is at a critical point in its transition to value-based care a decade after implementation of the Affordable Care Act and its Center for Medicare and Medicaid Innovation (CMMI),...

2% Medicare Sequester Cuts Delayed Through End of 2021

by Jacqueline LaPointe

A two percent cut to Medicare reimbursement will be paused until the end of the year, CMS recently announced. The announcement via the MLN Connects newsletter on April 16th stated that the Medicare...

Hospital Price Transparency Rule Compliance Is Inconsistent

by Hannah Nelson

Many hospitals are not complying with the CMS price transparency rule more than four months after its passage, according to a new KFF analysis that calls for data standardization. Put into effect on...

AHA Backs Chiquita Brooks-LaSure as Next CMS Administrator

by Jacqueline LaPointe

The American Hospital Association (AHA) has announced its support of President Biden’s pick for CMS Administrator, Chiquita Brooks-LaSure, ahead of the confirmation hearing this week. The...

CMS Stops Accepting New Direct Contracting Applications

by Jacqueline LaPointe

CMS has announced that it will not be soliciting any more applications for the Global and Professional Direct Contracting Models slated to launch on January 1, 2022. Organizations that had already...

CMS Plans 1.3% Medicare Payment Hike for Skilled Nursing Facilities

by Jacqueline LaPointe

CMS has proposed a $444 million increase in Medicare payments to skilled nursing facilities (SNFs) in the federal fiscal year (FY) 2022, according to a new proposed rule. The rule released late...

CMS Proposes Medicare Payment Bump for Rehab, Psychiatric Facilities

by Jacqueline LaPointe

CMS has released the proposed rules for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the Inpatient Psychiatric Facility Prospective Payment System for fiscal year (FY)...

CMS Starts Recouping Accelerated, Advance Medicare Payments

by Jacqueline LaPointe

CMS has started recouping Medicare payments it fronted to healthcare providers last year during the COVID-19 pandemic. In a recent MLN Matters newsletter, the agency stated that it has begun...

CMS Holding Claims Until Medicare Sequester Decision

by Jacqueline LaPointe

UPDATED 04/16/2021 CMS is temporarily holding claims from providers in anticipation of legislation that will extend the suspension of the 2 percent Medicare sequester, according to a recent...

CMS Delays CHART Model’s ACO Transformation Track

by Jacqueline LaPointe

CMS has pushed back the application cycle by a year for a new rural-focused accountable care organization (ACO) model. In an email sent yesterday, CMS said it has delayed the request for applications...