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CMS published two notices on January 25, 2013 announcing the development of surveys of patient care experiences to support the Administration’s National Quality Strategy. First, CMS is designing a Hospice Survey to help CMS understand: (1) patient experiences throughout their hospice care, as reported by bereaved family members or close friends of patients who died…

The HHS Secretary has submitted a report to Congress outlining the Department’s plan to implement a value-based purchasing (VBP) program for Medicare payments to ambulatory surgical centers (ASCs), as mandated by the ACA. The report describes current efforts to improve quality and payment efficiency in ASCs, and examines steps required in designing and implementing a…

On March 15, 2011, MedPAC released its annual report to Congress on Medicare Payment Policy. The report includes MedPAC’s recommendations on payment rate updates and other policies, such as distribution of payments and program integrity, for Medicare fee-for-service payment systems. It also includes an overview of the status of the Medicare Advantage and Medicare Part…

CMS published a rule on February 2, 2011 that would require certain Medicare-certified providers and suppliers to inform their Medicare beneficiaries about their right to file written quality-of-care complaints with the local Quality Improvement Organization (QIO). The new standard would apply to: ambulatory surgical centers (ASCs); hospices; hospitals; long term care (LTC) facilities; home…

On January 13 and 14, 2011, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss Medicare payment adequacy for a number of Medicare providers, including: physicians and other health professionals, ambulatory surgical centers, hospital inpatient and outpatient services, outpatient dialysis providers, home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, long term care hospitals,…

The OIG has issued a report entitled “Payments for Ambulatory Surgical Center Services Provided to Beneficiaries in Skilled Nursing Facility Stays Covered Under Medicare Part A in Calendar Years 2006 through 2008.” Based on a sample review, the OIG estimates that Medicare contractors made at least $6.6 million in overpayments to ambulatory surgical centers (ASCs) …

On December 2-3, 2010, the Medicare Payment Advisory Commission (MedPAC) is meeting to discuss the adequacy of Medicare payment for a variety of services, including hospital (inpatient and outpatient), physician, ambulatory surgical center, outpatient dialysis, hospice, skilled nursing facility, home health, inpatient rehabilitation facility, and long-term care hospital services

On November 24, 2010, the Centers for Medicare & Medicaid Services (CMS) is publishing its final rule updating the Medicare hospital outpatient prospective payment system (HOPPS) and the ambulatory surgical center (ASC) payment system rates and policies for calendar year (CY) 2011.  Highlights of the lengthy rule are available after the jump.
Continue Reading CMS Issues Final CY 2011 HOPPS/ASC Rates

The HHS Office of Healthcare Quality is soliciting public comments on new draft components of the “HHS Action Plan to Prevent Healthcare-Associated Infections.” Specifically, HHS seeks comments on its draft strategies to prevent and reduce healthcare-associated infections in ambulatory surgical centers and in end-stage renal disease facilities, along with a draft strategy to increase influenza …

On July 2, 2010, CMS released its proposed rule updating the Medicare hospital outpatient prospective payment system (HOPPS) and the ambulatory surgical center (ASC) payment system rates and policies for calendar year (CY) 2011. The official version of the rule is scheduled to be published in the Federal Register on August 3, 2010. Comments on the proposed rule will be accepted until August 31, 2010. CMS expects to issue a final rule by November 1, 2010, which will be effective for services furnished on or after January 1, 2011. Highlights of the rule are available after the jump.Continue Reading CMS Proposes CY 2011 HOPPS/ASC Rates, Revises 2010 Rates

On April 23, 2010, CMS published a proposed rule that would revise the Medicare ambulatory surgical center (ASC) patients rights condition for coverage (CfC) that currently requires certain patient’s rights information to be provided to patients in advance of the date of the procedure. CMS observes that the current requirement has been problematic for ASCs…

On March 1, 2010, the Medicare Payment Advisory Commission (MedPAC) issued its recommendations to Congress regarding Medicare provider payment updates for 2011. Among other things, MedPAC recommends:

  • Increasing acute inpatient and outpatient prospective payment system reimbursement in 2011 by the projected rate of increase in the hospital market basket index (MBI), coupled with implementation of

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The Medicare Payment Advisory Commission (MedPAC) recently voted on recommendations it will make to Congress regarding Medicare payment updates for 2011. At the meeting, MedPAC voted to recommend increasing acute inpatient and outpatient prospective payment system reimbursement in 2011 by the projected rate of increase in the hospital market basket index (MBI). This rate increase…

CMS has published a notice correcting errors that appeared in the final CY 2010 rule updating the Medicare hospital outpatient prospective payment system (HOPPS) and the ambulatory surgical center (ASC) payment system.  Among other technical changes, the rule corrects Medicare ambulatory surgical center (ASC) payment rates that had been based on incorrect Medicare physician…

CMS has issued its final rule updating the Medicare hospital outpatient prospective payment system (HOPPS) and ambulatory surgical center (ASC) payment system for 2010.  The official version of the rule is scheduled to be published in the Federal Register on November 20, 2009. With regard to the HOPPS update, CMS estimates that the rule will increase HOPPS rates by 1.9% compared to total spending in CY 2009.  This reflects a 2.1% market basket increase (reduced by 2.0 percentage points for hospitals that do not report quality data), adjusted for changes in the pass-through estimate, outlier payments, and wage index payments. Other major HOPPS and ASC provisions are outlined after the jump.
Continue Reading Final CY 2010 Medicare HOPPS/ASC Rule Released

CMS has recently issued guidance to state survey agencies on a number of issues, including: Interpretive Guidelines for Long-Term Care Facilities (infection control programs); Surveying Facilities That Use Electronic Health Records; EMTALA Requirements and Options for Hospitals in a Disaster; Clarification of Ambulatory Surgical Center Interpretive Guidelines; Initial Surveys of CAH Distinct Part Units Changed…