Tag Archives: Inpatient hospital

CMS Correction Notices (IPPS, LTCH-PPS, MA, PDP)

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 … Continue Reading

Medicare Payments for Outpatient Services Before/During Inpatient Stay

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 to or … Continue Reading

Medicare Trends in Implantable Medical Device (IMD) Procedures

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 data regarding, … Continue Reading

CMS Proposes Medicare Inpatient Hospital Rates/Policies for FY 2013

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 … Continue Reading

Extension of Hospital Wage Index Reclassifications and Special Exceptions

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.… Continue Reading

FY 2013 IPPS New Technology Payment Town Hall Meeting (Feb. 14, 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 applications … Continue Reading

CMS Publishes Corrections to 2012 Medicare Payment Rules

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, 2011 Medicare … Continue Reading

Inpatient Hospital PPS, Value-Based Purchasing Program Correction Notices

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 hospitals … Continue Reading

CMS Proposes Medicare Inpatient Hospital/LTCH Payment Policies for FY 2012

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 … Continue Reading

MedPAC Report to Congress on 2012 Payment Recommendations

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 D prescription … Continue Reading

CMS Meeting on New Technology Add-On Payments (Feb. 2, 2011)

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 improvement … Continue Reading

Final FY 2011 Medicare Inpatient Hospital, LTCH Rates

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 … Continue Reading

IPPS/LTCH PPS Correction Notices

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 LTCH … Continue Reading

Revisions to Medicare Inpatient Hospital, LTCH Rates

CMS has issued two regulations implementing Affordable Care Act provisions impacting hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) payments. First, CMS has issued a “supplement” to its May 4, 2010 fiscal year (FY) 2011 IPPS and LTCH PPS proposed rule to implement provisions of the Affordable Care … Continue Reading

CMS Issues Proposed FY 2011 IPPS/LTCH Rule

CMS has released its proposed rule to update Medicare inpatient prospective payment system (IPPS) hospital and LTCH payment and other policies for FY 2011, which will be published in the Federal Register on May 4, 2010. Overall, CMS estimates that payments to general acute care hospitals for operating expenses under the proposed rule will decrease by … Continue Reading

MedPAC Issues 2011 Medicare Payment Recommendations

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 a … Continue Reading

MedPAC Votes on 2011 Medicare Provider Update Recommendations

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 … Continue Reading

CMS Meetings on Applications for IPPS/OPPS New Medical Service/Technology Payments (Feb. 10)

CMS is hosting a town hall meeting on February 10, 2010 to discuss FY 2011 applications for add-on payments for new medical services and technologies under the hospital inpatient prospective payment system (IPPS).  Also on February 10, CMS is hosting a workshop on the application process and criteria for new medical services and technologies under … Continue Reading

IPPS/LTCH PPS/IRF PPS Correction Notices

On October 7, 2009, CMS published a notice correcting typographical and technical errors in its August 27, 2009 final rule updating 2010 Medicare payment rates and policies for the acute hospital inpatient prospective payment system (IPPS) and the long-term care hospital (LTCH) PPS. CMS published a separate document on October 1, 2009 correcting technical errors in … Continue Reading

Medicare Final FY 2010 Inpatient PPS Proposed Rule

On July 31, 2009, the Centers for Medicare & Medicaid Services (CMS) released its final fiscal year (FY) 2010 Medicare policies and payment rates for acute inpatient prospective payment system (IPPS) hospitals. The rule reflects a 2.1% market basket update, derived using a rebased and revised market basket. In order to receive the full market … Continue Reading

Medicare Inpatient PPS Proposed Rule

On May 1, 2009, the Centers for Medicare & Medicaid Services (CMS) released its proposed FY 2010 Medicare policies and payment rates for acute inpatient prospective payment system (IPPS) hospitals. CMS proposes a 2.1% market basket update, derived using a proposed rebased and revised market basket update based on data from FY 2006 (rather than FY … Continue Reading

MedPAC Report to Congress — Medicare Payment/Transparency Provisions

On February 27, 2009, MedPAC released its March 2009 Report to the Congress: Medicare Payment Policy. The report includes a series of recommendations for Medicare payments designed to assure beneficiaries’ access to care and preserve Medicare’s long-term sustainability, particularly through reductions in payment updates for 2010. The report also includes recommendations to increase transparency of physician financial … Continue Reading
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