2011 Medicare Part D Improper Payment Error Rate For fiscal year (FY) 2011 reporting, HHS will report its baseline composite Part D improper payment error rate estimate of 3.2 percent. This rate is reported in the HHS FY 2011 Agency Financial Report (AFR), and is based on Calendar Year (CY) 2009 final Part D payments. […]
2011 Medicaid Improper Payment Error Rate The 2011 Medicaid improper payment error rate is 8.1 percent. This represents a drop in the improper payment rate from 2010 (9.4 percent).[1] CMS measures Medicaid improper payments through the Payment Error Rate Measurement (PERM) program and produces state and national-level error rates for each program. The error rates […]
From the HHS News Release: Up to $1 billion dollars will be awarded to innovative projects across the country that test creative ways to deliver high quality medical care and save money. Launched by the Department of Health and Human Services, the Health Care Innovation Challenge will also give preference to projects that rapidly […]
The Diagnosis Related Groups (DRGs), Service Intensity Weights (SIWs), Trimpoints and Average Length of Stays (ALOS) are used by the Medicaid Program to make DRG payments to New York State Hospitals. They are also published in 10NYCRR Part 86-1.62 and 86-1.63 and updated as necessary. Any questions regarding the DRGs, SIWs, Trimpoints or Average Length […]
Procedures That Will be Paid Only as Inpatient for CY2012 This is a zip file for download. CPT® license agreement required. 2012 OPPS Final Addenda [ZIP, 1.54MB] (The 2012 Inpatient Only List is here as Addendum E.)
From the HHS News Release: Medicare is adding coverage for a number of preventive services to reduce cardiovascular disease. This new coverage policy will add to the existing portfolio of free preventive services that are now available for people with Medicare, thanks to the Affordable Care Act. It contributes to the Million Hearts initiative […]
From the CMS News Release: Under the Affordable Care Act, people with Medicare can receive many preventive services at no charge, including diabetes screening, some cancer screenings and help to quit smoking. So far this year, more than 2.2 million people with Medicare have saved more than $1.2 billion on their prescriptions, for an […]
According to CMS, this final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from continuing experience with this system. This final rule with comment period, describes the changes to the amounts and factors used to determine the payment rates for Medicare hospital […]
From the CMS News Release: On November 1, 2011 CMS issued a final rule with comment period (final rule) that will update payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning Jan. 1, 2012. In addition to establishing payment rates for […]