Medicare outpatient payments Archives - Safety-Net Association of Pennsylvania

CMS Proposes 2017 Medicare Outpatient Payment Policies

The Centers for Medicare & Medicaid Services has revealed how it proposes paying hospitals for Medicare-covered outpatient services in 2017.
Bookshelf with law books Among other matters, the 764-page proposed regulation addresses:

proposed rate increases for outpatient and ambulatory surgery center services;
new site-neutral outpatient payment policies;
changes in the value-based purchasing program;
changes in hospital outpatient quality reporting requirements;
electronic health record policies; and
changes in ambulatory surgical center quality reporting requirements.

Interested parties have until September 6 to submit written comments to CMS. The final rule will be published later this year and take effect on January 1, 2017. To learn more about what CMS has proposed for Medicare outpatient payments go here to see a CMS fact sheet and here to see the proposed regulation itself.

PA Safety Net Admin2016-07-08T06:00:26+00:00July 8th, 2016|Medicare|Comments Off

Members of Congress Seek Increased Medicare Rates

Members of Congress have written to Centers for Medicare & Medicaid Services (CMS) acting administrator Andrew Slavitt asking him to reconsider his agency’s proposal to reduce the rates Medicare will pay providers for outpatient services.
In July, CMS proposed reducing those outpatient rates 0.2 percent in calendar year 2016.
The letter notes that

According to MedPAC, Medicare already pays hospitals less than 88 cents on the dollar for outpatient services and this rule will make that situation worse for our constituents – both hospitals and patients alike.

The letter also states that

Medicare already pays providers less than the cost of care. Prescribing a negative update to OPPS [note: outpatient prospective payment system] payment rates will only make it more difficult for hospitals to serve their patients and their communities, particularly as they move to adopt delivery system reforms.

To see the letter, including the names of the 95 Democrats and Republicans who signed it, go here.

PA Safety Net Admin2015-10-13T06:00:53+00:00October 13th, 2015|Medicare|Comments Off

OIG Reiterates Medicare, Medicaid Recommendations

Every year the U.S. Department of Health and Human Services’ Office of the Inspector General (OIG) examines the operations of various department offices, programs, and policies and offers recommendations for changes and improvements. Some of those recommendations are adopted and others are not.
The OIG annually publishes a document reiterating what it believes to be its most important and potentially useful recommendations that were not adopted, and that publication was just released.
Among the Medicare and Medicaid recommendations it has presented again are:

Establish accurate and reasonable Medicare payment rates for hospital inpatient services.
Establish accurate and reasonable Medicare payment rates for hospital transfers.
Reduce hospital outpatient department payment rates for ambulatory surgical center-approved procedures.
Prevent inappropriate payments to Medicare home health agencies.
Reduce inappropriate payments to skilled nursing facilities.
Prevent payments for ineligible Medicare beneficiaries.
Reconcile Medicare outlier payments in accordance with federal guidance and regulations.
Ensure that states calculate accurate costs for Medicaid services provided by local providers.
Ensure the collection of identified Medicare overpayments.
Improve oversight of management of Medicaid personal services.
Improve the Medicare appeals process at the administrative law judge level.
Enhance efforts to identify adverse events to ensure quality of care and safety.
Ensure that Medicare children receive all required preventive screening services.
Strengthen oversight of state access standards for Medicaid managed care.

In its Compendium of Unimplemented Recommendations/March 2015, the OIG presents the issues and its rationale for its recommendation and describes the status of implementation, including, in some cases, why CMS has chosen not to implement its recommendations.
Find the report here.

PA Safety Net Admin2015-03-25T06:00:00+00:00March 25th, 2015|Medicare|Comments Off

MedPAC Considers FY 2016 Pay Boost for Inpatient, Outpatient Payments

Medicare payments to hospitals for inpatient and outpatient care could rise 3.25 percent in the coming fiscal year.
At least that is what members of the Medicare Payment Advisory Commission (MedPAC) discussed recommending to Congress when they met last week in Washington.
During MedPAC’s two-day public meeting, members discussed recommending to Congress a 3.25 percent increase in Medicare inpatient and outpatient payments in FY 2016. They will vote on their recommendation at their next meeting.
A presentation to MedPAC members by their staff also offered a number of observations about Medicare services:

Demand for hospital services is stable.
With hospital occupancy down to 60 percent, it appears hospitals have excess capacity.
The quality of care hospitals provide is improving according to several metrics.
Hospital cost growth is down.
Hospitals’ Medicare margins are steady, although they remain negative, especially for outpatient services.
MedPAC should consider recommending policies to reduce or eliminate differences between payments to hospitals and doctors’ offices for selected outpatient services.

For a closer look at the Medicare inpatient and outpatient issues MedPAC examined at its December meeting, see the presentation on this subject here, on MedPAC’s web site.

PA Safety Net Admin2014-12-23T06:00:27+00:00December 23rd, 2014|Uncategorized|Comments Off

SNAPShots

SNAPShots

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us