In this final rule, CMS is increasing the amount of uncompensated care payments made to acute care hospitals by $800 million to approximately $6.8 billion for fiscal year 2018. Uncompensated care represents healthcare services provided by hospitals or providers for which they don’t get reimbursed. Often uncompensated care arises when people don’t have insurance and […]
The FY 2018 final policies are summarized below. Update to the payment rates under the IRF PPS. For FY 2018, CMS is finalizing an update to the IRF PPS payments to reflect a 1.0 percent increase factor, in accordance with section 1886(j)(3)(C)(iii) of the Social Security Act, as added by section 411(b) of the Medicare […]
The proposed rule is one of several for 2018 that reflect a broader strategy to relieve regulatory burdens for providers; support the patient-doctor relationship in healthcare; and promote transparency, flexibility and innovation in the delivery of care. The OPPS and ASC payment system are updated annually to include changes to payment policies, payment rates, and […]
Measuring Compliance Program Effectiveness On January 17, 2017, a group of compliance professionals and staff from the Department of Health and Human Services, Office of Inspector General (OIG) met to discuss ways to measure the effectiveness of compliance programs. The intent of this exercise was to provide a large number of ideas for measuring the […]
OIG Provides Physician Roadmap According to the OIG’s website, “Most physicians strive to work ethically, render high-quality medical care to their patients, and submit proper claims for payment. Society places enormous trust in physicians, and rightly so. Trust is at the core of the physician-patient relationship. When our health is at its most vulnerable, we […]
This proposed rule would update the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2018 as required by the statute. As required by section 1886(j)(5) of the Act, this rule includes the classification and weighting factors for the IRF prospective payment system’s (IRF PPS) case-mix groups and a description of […]
From the OIG, an interactive map containing data by state. 2016 Data Interactive Map 2015 Data Interactive Map 2014 Data Interactive Map 2013 Data Interactive Map 2012 Data Interactive Map 2011 Data Interactive Map 2010 Data Interactive Map
On April 14, 2017, the Centers for Medicare & Medicaid Services issued a proposed rule that would update 2018 Medicare payment and polices when patients are admitted into hospitals. The proposed rule aims to relieve regulatory burdens for providers; supports the patient-doctor relationship in health care; and promotes transparency, flexibility, and innovation in the delivery […]
CMS today released final updates to the Medicare Advantage and Part D Prescription Drug Programs for 2018. Through these changes, CMS seeks to support benefit flexibility and efficiency that allows Medicare enrollees to choose the care that best fits their health needs. The final policies are similar to those proposed and discussed in the Advance […]