CMS published a notice on March 13, 2013 correcting previous technical errors to the Medicare inpatient prospective payment systems (IPPS) final rulemaking for FY 2013. Among other things, CMS is correcting statistics on the Hospital Readmissions Reduction Program with regard to (1) the amount by which payments to hospitals would be reduced; and (2)

On February 5, 2013, CMS is holding a town hall meeting on FY 2014 applications for new medical services and technology add-on payments under the hospital inpatient prospective payment system (IPPS). Interested parties are invited to present their recommendations and data regarding whether the FY 2014 new medical services and technologies applications meet the substantial

On October 29, 2012, CMS published additional corrections to its August 31, 2012 final FY 2013 Medicare inpatient prospective payment system (IPPS) rule. The corrections address the achievement thresholds and benchmark values presented in the Clinical Process of Care measures section of the final performance standards for the FY 2015 Hospital Value-Based Purchasing Program table. 

On October 4, 2012, CMS published technical corrections to the agency’s September 5, 2012 final administrative transactions rule that adopted a unique health plan identifier standard and delayed the implementation date for the International Classification of Diseases, 10th Revision (ICD-10) coding update from October 1, 2013 to October 1, 2014. CMS also published a rule

On August 31, 2012, the Centers for Medicare & Medicaid Services (CMS) is publishing its final rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for FY 2013. Overall, CMS estimates that FY 2013 payments to general acute care hospitals for operating expenses will increase by $2 billion under the rule considering all policy changes, the expiration of certain temporary payment increases, and projected utilization. CMS addresses a wide variety of policies in the extensive rule, including the following:
Continue Reading CMS Issues Final Medicare Inpatient Hospital Rates/Policies for FY 2013

On June 11, 2012, CMS published corrections to the May 11, 2012 proposed rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for fiscal year (FY) 2013. Among other things, CMS is decreasing the national capital standard federal payment rate, which in

The OIG has issued a report entitled “Medicare Continues To Pay Twice for Nonphysician Outpatient Services Provided Shortly Before or During an Inpatient Stay.” The OIG estimates that Medicare contractors made approximately $6.4 million in overpayments to hospital outpatient providers in 2008 and 2009 for services provided to beneficiaries within 3 days prior

The Government Accountability Office (GAO) has issued a report entitled “Medicare: Trends in Beneficiaries Served and Hospital Resources Used in Implantable Medical Device Procedures.”  The report discusses trends in the use of IMD procedures – particularly orthopedic and cardiac implants — among Medicare beneficiaries from the period of 2003 to 2009. The report includes

On May 11, 2012, the Centers for Medicare & Medicaid Services (CMS) published its proposed rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for FY 2013. Overall, CMS estimates that FY 2013 payments to general acute care hospitals for operating expenses would increase by $175 million under the proposed rule considering all policy changes, the expiration of certain temporary payment increases, and projected utilization. CMS addresses a wide variety of policies in the sweeping rule, which are summarized below.
Continue Reading CMS Proposes Medicare Inpatient Hospital Rates/Policies for FY 2013

On April 20, 2012, CMS published a notice making changes to special exception wage indices and geographic reclassifications for Medicare inpatient and outpatient hospital payments in conformance with the Temporary Payroll Tax Cut Continuation Act of 2011 as amended by the Middle Class Tax Relief and Job Creation Act of 2012.

CMS has announced a February 14, 2012 town hall meeting to discuss FY 2013 applications for add-on payments for new medical services and technologies under the hospital inpatient prospective payment system (IPPS). The meeting provides an opportunity for interested parties to present recommendations and data regarding whether FY 2013 new medical services and technologies

On September 26, 2011, CMS published notices correcting technical errors in the following rules: (1) the August 18, 2011 final Medicare hospital inpatient prospective payment system (PPS) and long-term care hospital PPS rule for FY 2012; (2) the August 5, 2011 final Medicare inpatient rehabilitation facility PPS final rule for FY 2012; and the August 8

On July 13, 2011, CMS published a document correcting technical errors that occurred in its May 5, 2011 proposed rule to update the Medicare hospital inpatient prospective payment system and the long-term care hospital prospective payment system for fiscal year (FY 2012). The corrections address the calculation of the outmigration adjustment and the listing of

On May 5, 2011, the Centers for Medicare & Medicaid Services (CMS) is publishing its proposed rule to update Medicare inpatient prospective payment system (IPPS) hospital and long-term care hospital prospective payment system (LTCH-PPS) payment and other policies for FY 2012. Overall, CMS estimates that FY 2012 payments to general acute care hospitals for operating expenses would decrease by $498 million (0.5%) under the proposed rule, while Medicare payments to LTCHs are projected to increase by $95 million (1.9%). CMS addresses a wide variety of policies in the more than 1000-page advance version of the rule. 

Highlights of the proposal are available after the jump.Continue Reading CMS Proposes Medicare Inpatient Hospital/LTCH Payment Policies for FY 2012

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

On February 2, 2011, CMS is hosting a Town Hall meeting to discuss FY 2012 applications for new medical services and technologies add-on payments under the hospital inpatient prospective payment system (IPPS).  Interested parties are invited to present recommendations and data regarding whether FY 2012 new medical services and technologies applications meet the substantial clinical

On August 16, 2010, CMS is publishing its final rule updating Medicare hospital inpatient prospective payment systems (IPPS) and long term care hospital (LTCH) prospective payment system (PPS) rates for 2011. The rule, which responds to comments that CMS received on its May 4, 2010 proposed rule and a June 2, 2010 supplemental proposed rule, also makes numerous changes to Medicare policies affecting hospitals and other providers. The rule generally is effective October 1, 2010, with certain exceptions. Highlights of the lengthy rule are available after the jump.Continue Reading Final FY 2011 Medicare Inpatient Hospital, LTCH Rates

On June 17, 2010, CMS published a notice correcting technical and typographical errors in its June 2, 2010 “supplementary” proposed rule updating the Medicare hospital inpatient prospective payment system (IPPS) and the long-term care hospital prospective payment system (LTCH) for 2011. CMS also corrected technical errors in its June 2, 2010 notice on IPPS and