March 27, 2024 - The Merit-Based Incentive Payment System (MIPS) is a mandatory quality payment system for clinicians who receive Medicare Part B payments unless they qualify for an exception or are part of an alternative payment model (APM). More than 655,000 eligible clinicians engaged with the MIPS program in 2021, according to the latest data from CMS.
The...
Congress narrowly avoided a partial government shutdown, sending a $460 billion spending bill to the President’s desk over the weekend.
The bipartisan deal, passed by the House 339-85 last...
The American Hospital Association (AHA) and five other hospital groups are calling on the Supreme Court to challenge the Department of Health and Human Services’ (HHS) interpretation of...
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was enacted by Congress to address issues related to physician payments under Medicare. The primary goal of MACRA was to move away from...
The US House of Representatives has passed a bill to improve healthcare price transparency and establish site-neutral payment policies for drug administration.
The Lower Costs, More Transparency Act...
Most surgical healthcare professionals participating in the Merit-based Incentive Payment System (MIPS) earned bonus payments in 2021, with urologists seeing the highest adjustment, a study published...
Hospital Outpatient Prospective Payment System (OPPS) providers participating in the 340B drug pricing program will receive a one-time lump-sum payment to offset losses between calendar years (CYs)...
CMS has released the Medicare Physician Fee Schedule (PFS) final rule for calendar year (CY) 2024, finalizing a 1.25 percent overall reduction for physician services next year.
The federal agency...
After initially proposing a decrease, CMS has finalized a 0.8 percent increase in Medicare payment rates for home health agencies in 2024, boosting reimbursement by $140 million compared to 2023.
The...
CMS recently released the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule for 2024, which includes a 2.1 percent Medicare rate hike for renal dialysis services furnished to...
Reducing barriers to Advanced Alternative Payment Model (APM) participation for physicians in rural areas could help promote value-based care and control rising Medicare spending, according to research...
Physician-owned hospitals treated some of the most expensive Medicare beneficiaries at lower costs compared to traditional hospitals despite seeing similar patient populations, according to a recent...
As Medicare Part A is expected to become insolvent by 2033, Congress should reduce Medicare spending on post-acute care by lowering payment rates to skilled nursing facilities (SNFs), home healthcare...
Gender pay disparities persisted for neurosurgeons between 2013 and 2020, with women receiving 44 percent less in annual payments than men, a study published in JAMA Surgery revealed.
Researchers used...
Physician and facility reimbursement for rural practices is not sustainable and is impacting patient access to rural healthcare, the Medical Group Management Association (MGMA) tells Congress in a new...
Hospital and specialty groups are urging CMS to amend aspects of the CY 2024 Outpatient Prospective Payment System (OPPS) proposed rule, including 340B Drug Pricing Program policies and price...
Provider organizations have made it clear they are not happy with the payment cuts CMS proposed in the 2024 Medicare Physician Fee Schedule (PFS). Additionally, groups have voiced concerns about...
Medicare payment incentives favor clinicians participating in fee-for-service models rather than those in advanced alternative payment models (APMs), according to the National Association of...
The American Hospital Association (AHA) is urging CMS to reconsider the payment cuts included in the CY 2024 Home Health Prospective Payment System (PPS) proposed rule.
Specifically, the trade...
CMS has increased Medicare payment rates for inpatient providers and long-term care hospitals (LTCHs) in the fiscal year (FY) 2024 Medicare hospital inpatient prospective payment system (IPPS) and LTCH...