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The Skilled Nursing Facility Utilization and Payment Public Use File (SNF PUF) contains information on utilization, payments, and submitted charges organized by provider, state, and resource utilization group (RUG). The data include information on 15,055 skilled nursing facilities, over 2.5 million stays, and almost $27 billion in Medicare payments for 2013. The data set does […]
The Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to test new models to improve how Medicare Part B pays for prescription drugs and supports physicians and other clinicians in delivering higher quality care. CMS values public input and comments as part of the rulemaking process, and looks forward to continuing to […]
The Centers for Medicare & Medicaid Services (CMS) issued the final annual Notice of Benefit and Payment Parameters for the 2017 coverage year, along with related guidance documents, as part of our ongoing efforts to promote healthy and stable markets that works for consumers and for insurers. The rule finalizes provisions to: help consumers with […]
Posting of ambulance, home health utilization data follows recent provider and supplier moratoria extension The Centers for Medicare & Medicaid Services (CMS) released two public data sets regarding the availability and use of services provided to Medicare beneficiaries by ground ambulance suppliers and home health agencies, as well as a list of Medicare fee-for-service (FFS) […]
This is a zip file for download. CPT® license agreement required. 2016 OPPS Final Rule Addenda – Opens in a new window (The 2016 Inpatient Only List is here as Addendum E.) It is available as an Excel file or as a Text file. For additional information on the OPPS Final Rule see this document. […]
The Work Plan describes the primary objectives and provides for each review its internal identification code and the year in which OIG expects one or more reports to be issued as a result of the review. Get the PDF (80 pages)
The 2016 OPPS Final Rule (effective January 1, 2016) is now available. Here’s the first paragraphs: This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience […]
This proposed rule would revise the discharge planning requirements that Hospitals, including Long-Term Care Hospitals and Inpatient Rehabilitation Facilities, Critical Access Hospitals, and Home Health Agencies must meet in order to participate in the Medicare and Medicaid programs. The proposed rule would also implement the discharge planning requirements of the Improving Medicare Post-Acute Care Transformation […]
