Updates by Reed Smith on U.S. legislative & regulatory developments affecting the health care industry
On November 30, 2011, CMS is publishing its final rule updating the Medicare hospital outpatient prospective payment system (OPPS) and the ASC payment system rates and policies for CY 2012. The following are highlights of the lengthy rule:
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A new GAO report, “Value in Health Care: Key Information for Policymakers to Assess Efforts to Improve Quality While Reducing Costs,” examines the availability of evidence that various health care interventions (e.g., provider payment restructuring, chronic care management, patient safety initiatives, care transitions management, and prevention programs, and care coordination activities) impact the…
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 July 27, 2011, CMS will host a Special Open Door Forum on the 2013 Hospital Value-Based Purchasing Program, under which quality of care factor into hospital Medicare reimbursement. Note that the period of performance for the FY 2013 program began on July 1, 2011. The call will cover, among other things, hospital eligible for…
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 April 29, 2011, CMS released its final rule to implement a Hospital Value-Based Purchasing (VBP) program, as mandated by the ACA. The VBP program will build on the current pay-for-reporting program by tying Medicare payments to the quality of hospital services. Specifically, under the rule, starting in FY 2013 (which begins October 1, 2012)…
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 10, 2011, CMS is hosting a public call on implementation of an ACA requirement that HHS develop a plan to implement a value-based purchasing program for Medicare SNF services. On the call, CMS is seeking stakeholder input on such issues as: the development, selection, and modification process for measures of quality and…
On February 24, 2011, CMS is hosting a Special Open Door Forum on “Designing A Home Health Value-Based Purchasing Program.” The event is designed to solicit input from interested parties regarding the development of the plan for implementing a value-based purchasing program for home health agencies as mandated by the Affordable Care Act.
On February 10, 2011, CMS is holding a Special Open Door Forum to discuss its January 13, 2011 proposed rule to establish the Hospital Inpatient Value-Based Purchasing (VBP) Program.
On January 13, 2011, the Centers for Medicare & Medicaid Services (CMS) is publishing a proposed rule that would implement the Hospital Value-Based Purchasing (VBP) program, as mandated by the Affordable Care Act (ACA). The VBP program will build on the current pay-for-reporting program by tying Medicare payments to the quality of hospital services. Specifically,…
On October 26, 2010, CMS is hosting a “Special Forum” on development of the Medicare hospital value-based purchasing (VBP) program, as required by Section 3001 of the ACA. Under Section 3001, an inpatient hospital quality incentive payment program must be established effective with the FY 2013 inpatient prospective payment system (IPPS) payment determination for Medicare…
On October 14, 2010, CMS is hosting a Special Open Door Forum on its ACA-mandated report to Congress on Ambulatory Surgery Center (ASC) Value Based Purchasing. The purpose of the call is to receive comments from ASCs, hospitals, physicians, physician associations, consumer groups, and others interested in the development of CMS’s plan for implementing…
On June 15, 2010, the Medicare Payment Advisory Commission (MedPAC) issued a report to Congress on “Aligning Incentives in Medicare.” Among other things, the report addresses: Medicare payment accuracy and moving away from volume incentives in fee-for-service Medicare; the Stark law in-office ancillary exception policy and options to change incentives that induce physicians to provide…
On June 24, 2010, CMS is holding a Special Open Door Forum provider call on the Medicare Shared Savings Program/Accountable Care Organizations (ACOs). The call will focus on the formation and use of ACOs to enhance the quality and efficiency of physician services. CMS will solicit comments from physicians, physician associations, hospitals, consumer groups…
