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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 booksAmong 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.

2016-07-08T06:00:26+00:00July 8th, 2016|Medicare|Comments Off on CMS Proposes 2017 Medicare Outpatient Payment Policies

Medicare Cuts May be Part of Budget Deal

The agreement between the White House and congressional negotiators on a two-year budget deal and an increase in the federal debt ceiling will be paid for in part with reductions in Medicare payments.
Under the reported agreement, negotiators agreed to increase federal spending $80 billion over two years, and that increase will almost certainly need to be offset by spending cuts. The New York Times has reported that “The Medicare savings would come from cuts in payments to doctors and other health care providers.”
US Capitol DomeThe budget agreement reportedly did not include specific spending cuts beyond extension of the current two percent Medicare sequestration cuts, although the publication The Hill reports that site-neutral Medicare outpatient payments may be part of the agreement; the additional cuts will need to be negotiated within Congress.
To learn more about the budget agreement and its possible implications for health care providers, see this New York Times article and this report from The Hill.

2015-10-27T16:31:46+00:00October 27th, 2015|Medicare|Comments Off on Medicare Cuts May be Part of Budget Deal

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.

2015-03-25T06:00:00+00:00March 25th, 2015|Medicare|Comments Off on OIG Reiterates Medicare, Medicaid Recommendations
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