The FY2014 proposals are summarized below. Changes to payment rates under the SNF Prospective Payment System (PPS) Based on proposed changes contained within this rule, CMS estimates that aggregate payments to SNFs will increase by $500 million, or 1.4 percent, from payments in FY 2013. This estimated increase is attributable to the 2.3 percent […]
Proposed Rule Details BNAF phase-out. This proposed rule would implement the fifth year of the seven-year BNAF phase-out, reducing the BNAF by 15 percent, for a total reduction of 70 percent since FY 2010. The BNAF was implemented in 1997, when the former Health Care Financing Administration (HCFA), now CMS, moved from an outdated […]
FY 2014 Payment Update The proposed rule would increase IPPS operating rates by 0.8 percent after accounting for inflation and other adjustments required by the law. This proposed increase also reflects a proposed temporary reduction of 0.8 percent to implement the American Taxpayer Relief Act’s requirement to recoup overpayments from prior years as a result […]
According to an email from CMS dated April 25, 2013: Due to technical issues, implementation of the Phase 2 ordering and referring denial edits is being delayed. These edits would have checked the following claims for an approved or validly opted-out physician or non-physician who is an eligible specialty type with a valid individual National […]
The proposed rule updates hospital Part B inpatient billing policy consistent with the statute and payment regulations: When the Medicare review contractor denies a Part A claim because a hospital inpatient admission is not reasonable and necessary, Medicare would accept new, timely filed Part B inpatient claims and provide payment for all reasonable and […]
This proposed rule would reform Medicare regulations that CMS has identified as unnecessary, obsolete, or excessively burdensome on health care providers and suppliers, as well as certain regulations under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). The comment period for this rule ends 4/8/2013. Read the text from the Federal Register for February 7, […]
On January 31, 2013, the Centers for Medicare & Medicaid Services released a call for applications to participate in the testing of the new Comprehensive End-Stage Renal Disease (ESRD) Care model. Through this new initiative, CMS will partner with groups of health care providers and suppliers – ESRD Seamless Care Organizations (ESCOs) – to test […]