Medicare Payment and Reimbursement

Hospital care at home signifies an important innovation in acute care delivery

Although the CMS Acute Hospital Care at Home program is still early in its development in the U.S., early adopters show evidence of the program’s exciting promise, including positive impacts on health outcomes, an improved patient and provider experience, reduced cost of care and overall healthcare savings.

Shawn Stack July 23, 2021

In 2022 OPPS rule, CMS plans to reinstate policies pertaining to the inpatient-only and ASC covered-procedures lists

The 2022 proposed rule for the Outpatient Prospective Payment System would reverse 2021 policies that began to phase out the inpatient-only list of procedures and expand the covered-procedures list for ambulatory surgical centers.

Nick Hut July 21, 2021

CMS is preparing to make noncompliance with price transparency requirements much more expensive

A hospital with at least 550 beds would owe more than $2 million in penalties for a year of noncompliance with new price transparency requirements, according to a proposed rule.

Nick Hut July 20, 2021

CMS’s 2022 Medicare Physician Fee Schedule proposed rule: A look at telehealth provisions and overall payment rate changes

Clinicians will be able to seek payment for providing mental health visits to Medicare beneficiaries via audio-only telehealth, according to newly proposed regulations from CMS.

Nick Hut July 15, 2021

Newer payment models should be part of holistic transformation efforts, CMS deputy administrator says

Healthcare industry stakeholders can expect a new approach to how federal payment models are formulated, as a newly released rule for Medicare coverage of kidney care illustrates.

Nick Hut July 9, 2021

Healthcare leaders offer direction on key CMS inpatient proposals for FY 2022

HFMA offers direction to CMS on several of its key inpatient proposals for 2021 as many healthcare leaders have expressed concern about these proposals.

Shawn Stack June 30, 2021

Hospital groups raise red flags about spending offsets in bipartisan infrastructure bill

The bill would be paid for in part by extending the duration of the 2% reduction in Medicare payments and by tapping into the Provider Relief Fund.

Nick Hut June 29, 2021

Medicare should update its policies for separately payable drugs in the Outpatient Prospective Payment System, MedPAC says

Worthwhile changes include requiring drugs to be proven clinically superior before granting them pass-through payment status, according to a new report.

Nick Hut June 27, 2021

Healthcare News of Note: Struggling rural hospitals have option to become stand-alone EDs to receive more funding

Healthcare News of Note for healthcare finance professionals is a roundup of recent news articles: An upcoming option for rural hospitals to receive more funding, a key factor in outcomes of Black patients who receive COVID-19 care, and predictions about the hospital room of the future.

Deborah Filipek June 25, 2021

Medicare indirect medical education payments to teaching hospitals should be overhauled, MedPAC says

Although the proposals represent a significant change, most hospitals wouldn’t be projected to experience a large impact on their payments.

Nick Hut June 21, 2021
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );