According to CMS, some of the changes implement certain statutory provisions contained in the Affordable Care Act and other legislation. These changes are applicable to discharges occurring on or after October 1, 2014, unless otherwise specified in this final rule. There are updates to the rate of increase limits for certain hospitals excluded from the IPPS that are […]
CMS issued a proposed rule on April 20, 2014 that would update fiscal year (FY) 2015 Medicare payment policies and rates for inpatient stays at general acute care and long-term care hospitals (LTCHs). This rule builds on the Obama administration’s efforts through the Affordable Care Act to promote improvements in hospital care that will lead […]
This proposed rule would establish methodology and payment rates for a prospective payment system (PPS) for federally qualified health center (FQHC) services under Medicare Part B beginning on October 1, 2014, in compliance with the statutory requirement of the Affordable Care Act. This proposed rule would also establish a policy which would allow rural health […]
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 […]
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, […]
This proposed rule would lay out a structure and options for coordinating Medicaid, CHIP, and Exchange eligibility notices and appeals; provide additional benefits and cost-sharing flexibility for state Medicaid programs; and codify several provisions included in the Affordable Care Act and Children’s Health Insurance Program Reauthorization Act (CHIPRA). Key Provisions Process for Appeals of Eligibility […]
CMS has issued a proposed rule that would update Medicare policies and payment rates for End-Stage Renal Disease (ESRD) facilities paid under the ESRD Prospective Payment System (PPS) for calendar year (CY) 2013. The proposed rule would also strengthen incentives for improved quality of care and better outcomes for patients through improvements to the ESRD […]