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 […]
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
IRF Coding: HIM Basics
CMS has finalized rules governing home health agencies that will improve the quality of health care services for Medicare and Medicaid patients and strengthen patients’ rights. These Medicare and Medicaid Conditions of Participation are the minimum health and safety standards a home health agency must meet in order to participate in the Medicare and Medicaid […]
Summary: In their continuing effort to improve the Medicare Program, CMS has created the Quality Payment Program (QPP), which provides two options (based on defined criteria): MIPS (Merit-based Incentive Payment System) and APMs (Advanced Alternative Payment Models). QPP ends the SGR (Sustainable Growth Rate) formula and uses reporting data to validate important metrics. More details […]
CMS today issued this Final Rule (with comment period). SUMMARY: The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of […]
CMS announced an extension and statewide expansion of fraud-fighting temporary provider enrollment moratoria efforts in six states, along with a new related demonstration project to allow for certain exceptions to the moratoria and heightened screening requirements for new providers. CMS also announced it is immediately lifting the current temporary moratoria on all Medicare Part B, […]
This Final Rule addresses the Skilled Nursing Facility Prospective Payment System and Consolidated Billing as well as the SNF Value-Based Purchasing Program, the SNF Quality Reporting Program, and SNF Payment Models Research. Read the Final Rule in the Federal Register for August 5, 2016
CMS projects that Medicare payments to home health agencies in CY 2017 would be reduced by 1.0 percent, or $180 million based on the proposed policies. The proposed decrease reflects the effects of the 2.3 percent home health payment update percentage ($420 million increase); the rebasing adjustments to the national, standardized 60-day episode payment rate, […]