Hospital Reimbursement

Hospital Margins, Volumes Still Falling Months into Pandemic

by Jacqueline LaPointe

October was a challenging month for hospitals, according to healthcare consulting firm Kaufman Hall. The firm’s latest National Hospital Flash Report found that hospital operating margins fell...

Most Facilities in Hospital Readmissions Reduction Program Penalized

by Jacqueline LaPointe

The majority of facilities participating in the Hospital Readmissions Reduction Program (HRRP) in fiscal year (FY) 2021 have been penalized for readmitting too many patients according to CMS...

Court Denies Requests to Revisit 340B, Site-Neutral Payment Cases

by Jacqueline LaPointe

According to the American Hospital Association (AHA), an appeals court has declined to reconsider two decisions from the summer, which upheld Medicare reimbursement cuts for 340B drugs and for...

Over 40% of Hospitals Seeing Bad Debt, Uncompensated Care Increase

by Jacqueline LaPointe

A new survey of hospital executives and finance leaders has found that bad debt, uncompensated care, and self-pay patients have all gone up since the start of the pandemic, adding to other revenue and...

Hospitals to See 10% Fewer Total Admissions Than Projected in 2020

by Jacqueline LaPointe

Hospitals could see admissions fall 10 percent below projections for 2020 even though stays and other types of services have rebounded compared to earlier this year, a new report from Kaiser Family...

CMS Finalizes FY 2021 Inpatient Prospective Payment System Rule

by Jacqueline LaPointe

UPDATE 09/03/2020: For an in-depth analysis for the FY 2021 IPPS final rule, click here. CMS recently released the final FY 2021 Medicare Hospital Inpatient Prospective Payment System (IPPS) and...

CMS Makes COVID-19 Data Reporting a Condition of Participation

by Jacqueline LaPointe

COVID-19 data reporting will no longer be voluntary for hospitals participating in Medicare and Medicaid programs, according to a new interim final rule from CMS. For more coronavirus updates, visit...

Children’s Hospitals Get $1.4B in Coronavirus Relief Funds

by Jacqueline LaPointe

Children’s hospitals are finally getting a piece of the coronavirus relief fund pie. HHS recently announced that the Health Resources and Services Administration (HRSA) has begun distributing...

FAH Asks Congress to Delay Recoupment of Advance Medicare Payments

by Jacqueline LaPointe

Hospitals need more time to repay Medicare payments advanced to them as a financial safety line at the start of the COVID-19 pandemic, the Federation of American Hospitals (FAH) recently told...

CMS Updates Medicare Billing Rules for 20% Add-On COVID-19 Payment

by Jacqueline LaPointe

Claims eligible for the 20 percent add-on payment for COVID-19 hospitalizations will now have to have a positive laboratory test documented in the patient’s medical record, according to recent...

AHA Wants More Payback Options for Accelerated Medicare Payments

by Jacqueline LaPointe

The American Hospital Association (AHA) is calling on CMS to reconsider repayment options for hospitals that accepted accelerated Medicare payments at the start of the COVID-19 pandemic. For more...

CMS Provides Medicare Wage Index Data for Reclassification

by Jacqueline LaPointe

UPDATE 08/24/2020: CMS has extended the deadline for hospitals to apply for reclassification of their Medicare wage index area for FY 2022 from Sept. 1, 2020, to 15 days after it releases the...

CMS to Boost Outpatient Reimbursement, Remove Inpatient Only List

by Jacqueline LaPointe

Medicare outpatient payments are slated to increase by 2.6 percent next year, a $7.5 billion boost compared to 2020, according the proposed 2021 Outpatient Prospective Payment System (OPPS)...

Medicare Payments Top $2.8B for COVID-19 Hospitalizations, So Far

by Jacqueline LaPointe

So far this year, Medicare payments for fee-for-service COVID-19 hospitalizations has totaled $2.8 billion, according to updated data from CMS. For more coronavirus updates, visit our resource...

AHA, AAMC Want Rehearing for Hospital Site-Neutral Payment Case

by Jacqueline LaPointe

The fight against site-neutral payments for hospital outpatient services is not over for two industry groups. The American Hospital Association (AHA) and the Association of American Medical Colleges...

HHS Provides More Details on Provider Relief Fund Reporting

by Jacqueline LaPointe

HHS recently shared additional information on Provider Relief Fund reporting requirements for healthcare organizations that received financial support under the Coronavirus Aid, Relief, and Economic...

COVID-19 Test Prices Set by Hospitals Range from $20 to $850

by Jacqueline LaPointe

COVID-19 test prices significantly varied by hospital, with some facilities charging as little as $20 for the diagnostic test, while others charged as much as $850, according to a recent Peterson-KFF...

Hospitals in COVID-19 Hot Spots to Receive $10B in Relief Funds

by Jacqueline LaPointe

Hospitals in COVID-19 hot spots will receive another $10 billion in coronavirus relief funds starting this week, HHS recently announced. For more coronavirus updates, visit our resource page,...

Appeals Court Rules in Favor of Hospital Site-Neutral Payments

by Jacqueline LaPointe

HHS acted within its statutory authority when it implemented hospital site-neutral payments to reduce rising levels of outpatient care provided at off-campus provider-based departments (PBDs),...

Value-Based Incentives Didn’t Reduce Hospital-Acquired Infections

by Jacqueline LaPointe

Two of Medicare’s value-based incentive programs did not improve the levels or trends of certain hospital-acquired infections, potentially widening the gap between safety-net and non-safety-net...