Medicare Reimbursement

More Articles

$460B spending bill averts shutdown, some physician pay cuts

by Jacqueline LaPointe

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...

Hospital Groups Rally Against HHS’ Interpretation of DSH Payments Formula

by Victoria Bailey

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...

House Bill Addresses Price Transparency, Site-Neutral Payment Policies

by Victoria Bailey

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 Surgeons Earned MIPS Bonus Payments in 2021, Study Finds

by Victoria Bailey

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...

CMS Will Issue OPPS Providers Lump-Sum Payments to Remedy 340B Losses

by Victoria Bailey

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 Finalizes 1.25% Cut To Medicare Physician Fee Schedule

by Jacqueline LaPointe

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...

CMS Finalizes a $140M Increase to Medicare Home Health Payment Rates

by Victoria Bailey

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 Boosts End-Stage Renal Disease Medicare Rates by 2.1%

by Jacqueline LaPointe

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 MIPS, Advanced APMs Could Promote Participation

by Victoria Bailey

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 Could Save Medicare Over $1B

by Jacqueline LaPointe

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...

Lower Payment Rates May Help Curb Medicare Spending on Post-Acute Care

by Victoria Bailey

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 in Medicare Reimbursement Impact Neurosurgeons

by Victoria Bailey

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...

MGMA: Sustainable Financing Needed to Protect Rural Healthcare

by Jacqueline LaPointe

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...

Healthcare Orgs Address Price Transparency, 340B Policies in OPPS

by Victoria Bailey

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 Groups Oppose Proposed Payment Cuts in Physician Fee Schedule

by Victoria Bailey

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...

NAACOS: Medicare Payment Incentives Favor Clinicians in Fee-For-Service

by Victoria Bailey

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...

AHA Opposes Proposed Payment Cuts for Home Health Providers

by Victoria Bailey

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...

Inpatient Providers Will Receive 3.1% Reimbursement Increase in FY24

by Victoria Bailey

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...