Breaking Down Common CMS Value-Based Payment Programs
Value-based payment programs tie healthcare reimbursement rates to quality care by offering providers incentive payments to meet specified quality measures during and after healthcare delivery. As the industry moves away from...CMS Proposes $1.6B Increase in IPPS Payment Rates for FY23
CMS has released its Hospital Inpatient Prospective Payment System (IPPS) proposed rule for fiscal year 2023, which includes a payment rate boost for general acute care hospitals and new measures...DOJ Alleges Methodist Violated False Claims Act, Anti-Kickback Laws
The US Department of Justice (DOJ) has filed a lawsuit against Methodist Le Bonheur Healthcare and Methodist Healthcare Memphis Hospitals, alleging that the health systems violated the False Claims Act...CMS Releases Skilled Nursing Facility PPS Proposed Rule for FY23
CMS has released its proposed Skilled Nursing Facility (SNF) Prospective Payment System (PPS) rule for fiscal year 2023, which includes a reduction in Medicare payments for SNFs. The proposed payment...AHA Asks Congress Again for More COVID-19 Financial Relief
The American Hospital Association (AHA) has penned a letter to Congressional leaders, asking once again for additional COVID-19 financial relief for hospitals and health systems. The trade...CMS Proposes 2.7% Payment Boost for Inpatient Psychiatric Facilities
CMS has issued a proposed Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) rule for FY 2023, which introduced an update to IPF Medicare payments and included comment requests on...CMS Releases FY23 Inpatient Rehabilitation Facility PPS Proposed Rule
CMS has released its proposed Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) rule for FY 2023, which included an increase in IRF payment rates and updates on the IRF Quality...CMS Increases Hospice Payment Rate in Proposed Rule for FY 2023
CMS has introduced a proposed rule for fiscal year 2023 that includes an increase in hospice payments and an aggregate cap on negative wage index changes. Under the rule, hospices would see a 2.7...HHS Reduced Medicare Appeals Backlog by 88% During FY 2022 Q1
HHS ended the first quarter of fiscal year 2022 by reducing nearly 88 percent of the Medicare appeals backlog at the Administrative Law Judge level. According to the Department’s status report...Psychiatrists See Low Merit-Based Incentive Payment System Scores
Psychiatrists had significantly lower performance scores, received more penalties, and earned fewer bonuses in the 2020 Medicare Merit-Based Incentive Payment System (MIPS) compared to other outpatient...AHA Requests Additional COVID-19 Financial Support from Congress
The American Hospital Association (AHA) has urged Congress to provide hospitals and health systems with additional COVID-19 financial support, including more Provider Relief Funds and an extension on...Stratifying Hospital Readmissions Reduction Program Improved Equity
Implementing stratification within the Medicare Hospital Readmissions Reduction Program (HRRP) helped improve health equity by decreasing penalty rates for safety-net hospitals, rural hospitals, and...AMA Urges Congress to Update Medicare Physician Payment System
Following a recent Medicare Payment Advisory Commission (MedPAC) report, the American Medical Association (AMA) has asked Congress to update the Medicare physician payment system to include a stable...Hospitals Saw Substantial Underbilling for Medicare Telestroke Services
Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial...AHA to Congress: Hospitals Need More Resources Amid Financial Struggles
The American Hospital Association (AHA) and seven other hospital organizations have penned a letter urging Congress to provide additional resources to help hospitals address ongoing operational and...764 Hospitals Face Value-Based Penalties Under HAC Reduction Program
More than 700 hospitals will face value-based penalties in fiscal year 2022 after underperforming in Medicare’s Hospital-Acquired Condition (HAC) Reduction Program, according to an Advisory Board...States with More Uninsured Received Greater COVID-19 Treatment Funding
An analysis published in JAMA Health Forum linked uninsured population size to federal reimbursement for uninsured COVID-19 treatment. The Health Resources and Services...Sponsored by Brault
