Medicare Payment and Reimbursement

Providers should prepare for a possible expansion of Medicare site-neutral policies

HFMA’s Chad Mulvany says if the CY2021 OPPS rule is finalized as proposed without significant modifications to CMS's MS-DRG weight-setting process, it heightens the need for hospitals to expand outpatient/ASC capacity and continue aggressive cost management.

Chad Mulvany, FHFMA October 22, 2020

Medicare readmissions reduction program penalizes hospitals inaccurately, study finds

The hospital readmissions reduction program incorrectly penalizes hundreds of hospitals, according to new research.

Rich Daly October 22, 2020

Latest HHS provider relief fund FAQs offer insight into what’s permissible under the Sept. 19 reporting requirements

HFMA's Chad Mulvany says due to HHS's whipsaw approach to the provider relief fund FAQs and guidance, any clarity to be derived from the Phase 3 application instructions and FAQs needs to be considered with a measure of caution.

Chad Mulvany, FHFMA October 22, 2020

Changes coming to bundled payments and Direct Contracting, CMMI chief says

Coming changes will affect both Medicare bundled payment programs and the looming Direct Contracting program, said the director of the Center for Medicare and Medicaid Innovation.

Rich Daly October 19, 2020

CMS to add COVID-19-related waivers to value-based payment models, Verma says

Medicare plans to add pandemic-era waivers to its value-based payment models as a way to incentivize provider participation.

Rich Daly October 14, 2020

340B cuts, inpatient-only elimination lead hospitals’ OPPS concerns

Proposed OPPS cuts for 340B hospitals and outpatient payment changes drew the most concerns from hospitals and advocates.

Rich Daly October 13, 2020

Q&A: Humana expands value-based payment push

One MA health plan discusses how it’s pushing further into value-based payment and what that means for providers.

Rich Daly October 12, 2020

Proposed change to Medicare E/M payment leads to disagreement among both providers and health plans

Medicare physician payment changes for evaluation and management could have dire financial repercussions for some practices, providers warn.

Rich Daly October 12, 2020

Hospitals get relaxed Medicare repayment terms, short delay of DSH cut in federal funding bill

Hospitals will get some flexibility in the repayment of Medicare advance payment loans and a delay in uncompensated-care payment cuts under a new federal funding law.

Rich Daly October 7, 2020

Major insurers roll back no-cost sharing telehealth services

HFMA's Chad Mulvany says patients who received a surprise bill for a telehealth visit will likely blame the provider.

Chad Mulvany, FHFMA October 7, 2020
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