The improper payment rate for the federally facilitated exchange (FFE) program was less than 1 percent in 2020, according to the annual 2022 Agency Financial Report from CMS and HHS.
Improper payments...
Disproportionate share hospital (DSH) payments from Medicare and Medicaid may further racial disparities by basing allocations on patient healthcare use, a study published in JAMA Network Open...
UPDATED 11/02/2022: CMS has released the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) final rule, which will reduce the conversion factor while expanding access to behavioral health and...
UPDATED 11/02/2022 at 10:00 AM EST: The Calendar Year (CY) 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule from CMS has...
CMS has finalized a 3.1 percent increase in Medicare reimbursement for end-stage renal disease (ESRD) facilities in the Calendar Year (CY) 2023 ESRD Prospective Payment System (PPS) final...
Home health agencies will receive a 0.7 percent Medicare payment boost under the calendar year (CY) 2023 Home Health Prospective Payment System (HH PPS) Rate Update final rule, translating to an extra...
Poor alignment in the Medicare and Medicaid programs leads to higher spending and worse outcomes for dual eligible beneficiaries. Thus, policymakers should develop payment policies that offer a more...
As the 117th Congress nears the end of its session, the Federation of American Hospitals (FAH) has called upon congressional leaders to pass legislation that will reduce financial challenges for...
Following a court order, CMS is revising its methodology for paying 340B hospitals for outpatient drugs and reprocessing claims paid on or before the Sept. 28th ruling.
CMS will reimburse hospitals...
Adjunct urethral suspension use with laparoscopic radical prostatectomy did not change after CMS implemented Medicare payment policy changes that decreased reimbursement for prostatectomies, according...
The End-Stage Renal Disease Treatment Choice (ETC) model did not increase home dialysis rates, despite the financial incentives it provides clinicians to offer this type of care, according to a study...
CMS system edits helped reduce Medicare overpayments to acute care hospitals for outpatient services provided to beneficiaries who were inpatients of other facilities, a report from the Office of...
As medical groups expect to see Medicare payment cuts in 2023, practices are considering limiting the number of new Medicare patients and reducing clinical staff to ensure financial stability,...
When commenting on the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, the American...
Using social risk adjustment in Medicare’s Hospital Readmissions Reduction Program (HRRP) helped reduce differences in risk-adjusted readmissions and penalties between safety-net hospitals and...
The American Medical Association (AMA) and other physician advocacy groups are calling on CMS to reverse proposed Medicare Physician Fee Schedule updates, which would slash Medicare payment for...
The American Hospital Association (AHA) has urged CMS to reconsider the Medicare reimbursement update for home health agencies proposed in the Calendar Year 2023 Home Health Prospective Payment System...
Dialysis facilities required to participate in Medicare’s End-Stage Renal Disease Treatment Choices (ETC) model had a lower prevalence of transplantation waitlisting, living donor...
Facility-based scoring in the Merit-Based Incentive Payment System (MIPS) will not be available for the 2022 performance year after recent changes to the Hospital Value-Based Purchasing (VBP) Program,...
The American Hospital Association (AHA) has asked the US District Court for the District of Columbia to order HHS to immediately halt underpayments to hospitals participating in the 340B Drug Pricing...
