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
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Proposed Medicare Inpatient Psychiatric Facilities PPS Update
On January 27, 2011, CMS published a proposed rule that would update prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring July 1, 2011 through September 30, 2012 and make other changes to the IPF PPS. The proposed rule also would rebase and revise the Rehabilitation, Psychiatric,…
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 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
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
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Medicare Advantage Beneficiary Information Submission Requirement for Hospitals
CMS is requiring non-teaching hospitals to submit informational only bills for Medicare Advantage (MA) beneficiaries they treated in FY 2007 and FY 2008 on or before August 31, 2010 and submit a related attestation or before September 15, 2010. This requirement is a follow-up to a 2007 transmittal requiring all hospitals paid under the inpatient prospective payment…
Guidance on Implementation of PPACA Medicaid Rebate, Institutional Provider, Risk Pool Provisions
CMS has issued guidance to State Medicaid Directors on the Medicaid prescription drug rebate provisions of the Patient Protection and Affordable Care Act (PPACA). Specifically, the letter addresses the increased rebate percentages for covered outpatient drugs dispensed to Medicaid patients, the extension of prescription drug rebates to covered outpatient drugs dispensed to enrollees of…
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…
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
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Senate Approves Bill to Extend Medicare Physician Payment Fix, Make Other Medicare/Medicaid Policy Changes
Last night the Senate approved a variety of Medicare and Medicaid policy extenders as part of its version of H.R. 4213, the “Tax Extenders Act.” This legislation builds on the recently-enacted “Temporary Extension Act of 2010” (H R. 4691), which extended 2009 Medicare physician fee schedule rates through the end of March 2010 (in…
Bipartisan Senate Jobs Bill Would Extend Expiring Health Provisions
On February 11, 2010, Senate Finance Committee Chairman Max Baucus (D-MT) and Ranking Member Chuck Grassley (R-IA) released their draft “Hiring Incentives to Restore Employment (HIRE) Act.” In addition to providing tax incentives to spur hiring and extending uninsurance and COBRA health insurance premium subsidies, the legislation would extend a number of Medicare provisions, some…
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…
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 …
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…
Final LTCH PPS Rule for RY 2010
On July 31, 2009, CMS released its final rule updating long-term acute care hospitals (LTCH) prospective payment system (LTCH PPS) payments and policies for rate year (RY) 2010, which begins October 1, 2009. CMS is providing a 2.5% inflation update, resulting in $153 million in additional payments compared to FY 2009. The standard federal rate…
White House proposes $313 billion in additional Medicare/Medicaid cuts
The White House has proposed $313 billion in new Medicare and Medicaid cuts over 10 years, in addition to the provisions included in the Administration’s proposed FY 2010 budget. Among other things, the Administration is endorsing: incorporating productivity adjustments into Medicare payment updates; reducing hospital subsidies for treating the uninsured as coverage increases; paying “better”…
CMS Reduces FY 2009 LTCH PPS Payments; Issues Supplemental Proposed Rule for 2010
On June 3, 2009, the Centers for Medicare & Medicaid Services (CMS) published two regulations impacting payments under the long-term care hospital (LTCH) prospective payment system (PPS). First, CMS published an interim final rule with comment period revising the Medicare severity long-term care diagnosis-related group (MS-LTC-DRG) relative weights for federal fiscal year (FY) 2009 due…
LTCH PPS Proposed Rule
This post was also written by Jason M. Healy.
In tandem with the IPPS proposed rule, CMS released its annual payment update for the FY 2010 long-term acute care hospital (LTCH) PPS. For FY 2010, CMS projects a 2.8% increase in payments under LTCH-PPS, resulting in $135 million in additional payments compared to FY…
CMS Guidance to States on Long Term Care Hospital (LTCH) Moratorium
CMS issued a letter to State Survey Agency Directors on April 17, 2009 regarding ARRA provisions that expand the exceptions to the three-year moratorium on LTCH or LTCH satellites previously enacted in the Medicare, Medicaid, and SCHIP Extension Act. The new exception permits an increase in the number of beds in an existing LTCH or LTCH …
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 relationships. A listing of key recommendations follows after the jump.
Continue Reading MedPAC Report to Congress — Medicare Payment/Transparency Provisions
MedPAC to Consider Medicare Proposals January 8-9, 2009
The Medicare Payment Advisory Commission (MedPAC) is meeting January 8-9, 2009 to discuss a variety of Medicare payment and policy issues, including payments to hospitals, physicians, ambulatory surgical centers, dialysis providers, skilled nursing facilities, home health agencies, inpatient rehabilitation facilities, long-term care hospitals, hospices, and Medicare Advantage plans.