CMS Releases Guidance on Independent Dispute Resolution Process
CMS has launched a webpage containing resources and guidance regarding the federal independent dispute resolution (IDR) process under the No Surprises Act. The process helps determine reimbursement...Biden Administration Releases Final Surprise Billing Rules
The Biden Administration has released final surprise billing rules implementing the No Surprises Act, a federal law enacted in January 2021 that protects patients from out-of-network medical bills when...Federal Judge Rejects Surgeon’s Challenge of No Surprises Act
A surgeon from New York has lost a challenge of the No Surprises Act, a federal law enacted earlier this year that bans providers from surprise billing their patients for out-of-network...Hospital Price Transparency Compliance Lags Nearly 20 Months Later
Just 16 percent of 2,000 hospitals reviewed as part of PatientsRightsAdvocate.org’s Semi-Annual Hospital Price Transparency Report are complying with the regulation requiring all hospitals...CMS Nixes MIPS Facility-Based Scoring for 2022 Performance Year
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,...CMS Releases FY23 IPPS Rule, Boosts Hospital Reimbursement by 4.3%
CMS has released the Inpatient Prospective Payment System (IPPS) rule for fiscal year (FY) 2023, increasing hospital reimbursement by 4.3 percent and making good on promises to advance health equity....Hospitals Press CMS to Rethink Proposed FY23 Medicare IPPS Rates
Medicare inpatient reimbursement cuts slated to take effect in the 2023 fiscal year would threaten access to care at hospitals, which are already facing substantially higher costs because of the...Providers Face Cuts in Medicare Physician Fee Schedule Proposed Rule
CMS has proposed a decrease to the Medicare Physician Fee Schedule conversion factor, which would lead to significant cuts to physician reimbursement next year. The federal agency released the...New Medicare Provider Designation to Prevent Rural Hospital Closures
CMS has proposed a rule to establish a new rural hospital designation that would enable small rural hospitals and critical access hospitals (CAHs) to expand access to care and receive Medicare payment...Medicare, Medicaid to Take Closer Look at Nursing Home Staffing
CMS has updated guidance on minimum health and safety standards that long-term care facilities must meet to participate in Medicare and Medicaid. The guidance specifically addresses nursing home...Safety-Net Hospitals Lose Challenge of Medicare DSH Payment Rule
In a narrow ruling, the Supreme Court recently sided with HHS in a case challenging a multi-billion dollar cut to Medicare payments to safety-net hospitals. The Court ruled 5 to 4 that HHS did have...CMS Rule to Update ESRD Medicare Reimbursement, New Care Model
CMS recently proposed the Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, which would boost Medicare reimbursement for ESRD facilities and refine a new...CMS Proposes New Medicare Payment Adjustment for Home Health
CMS is looking to apply a permanent prospective payment adjustment to the home health 30-day period payment rate to account for changes resulting from the implementation of the Patient-Driven Groupings...Sponsored by Cloudmed
