Psychiatric Facilities

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On December 28, 2022, the Department of Health and Human Services’ Office of Inspector General (OIG) issued a favorable advisory opinion on a proposal by a drug manufacturer to enter into an arrangement with certain hospitals to provide up to a specified number of free samples of a long-acting antipsychotic drug for inpatient use.

The OIG indicated it would not impose administrative sanctions, despite the fact that there is no safe harbor available under the federal Anti-Kickback Statute (AKS) to protect the proposed arrangement.Continue Reading OIG approves arrangement involving free drug samples for inpatient hospital use

CMS has finalized prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for FY 2014.  CMS estimates that the FY 2014 rates will increase by a total of $115 million compared to FY 2013 levels. CMS is providing a 2.6% market basket update, which is adjusted by a 0.1…

On August 7, 2012, CMS published a notice updating the FY 2013 prospective payment rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) and IPF units.  Under the notice, estimated payments to IPFs are projected to increase by 0.8%, or approximately $36 million, considering all adjustments.  CMS is applying a 2.7% market

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CMS has announced that 11 states and the District of Columbia have been selected to participate in the ACA’s Medicaid Emergency Psychiatric Demonstration. The demonstration will test whether Medicaid beneficiaries experiencing a psychiatric emergency get more immediate, appropriate care when institutions for mental diseases (IMDs) receive Medicaid reimbursement. The demonstration will provide up to…

On May 6, 2011, CMS is publishing a final rule updating PPS rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring during rate year (RY) 2012, which begins July 1, 2011. CMS estimates that the rule would increase overall IPF PPS payments by approximately $120 million, reflecting a $130…

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,…

CMS has announced a series of  “outreach listening sessions” to focus on vulnerabilities identified in previously-released OIG reports  pertaining to DME claims, chiropractic services, ultrasound billing, hospice care, nursing home stays, psychiatric facilities, and other providers.

  • The first call is scheduled for Monday, June 7, 2010 and will concentrate on pressure reducing support surfaces, wheelchairs,

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On April 30, 2010, CMS published a notice on that updates Medicare prospective payment system (PPS) payment rates for inpatient psychiatric hospital services provided by inpatient psychiatric facilities (IPFs) for discharges occurring during the rate year beginning July 1, 2010 through June 30, 2011. CMS estimates that the rule will increase Medicare payments by $91…

On August 5, 2009, CMS published a correction to its July 13, 2009 proposed rule on Medicare physician fee schedule payments and policies for calendar year (CY) 2010. The notice makes technical questions and adds quality reporting measures regarding Functional Communications. CMS also has published a notice correcting typographical errors that appeared in its May 1…