Medicare Payment and Reimbursement

The Time Is Now to Act on the 2019 Medicare Final OPPS Rule

Although some OPPS rule changes are being challenged by key stakeholders, hospitals and health systems should move forward with implementation and measure the financial impact.

Mike Kovar February 4, 2019

Provider Payments Among Drug Costs Targeted by Congress

Jan. 29—Two provider payment systems were highlighted by members of Congress this week as areas in which policy changes are needed to control drug costs.

Rich Daly January 30, 2019

CAHs and Cost Reports

A critical access hospital’s cost of delivering care to Medicare patients is estimated using the cost accounting data that these Medicare-certified institutions submit annually to CMS via Medicare cost reports.

HFMA January 23, 2019

Improving CAH Medicare Part-A Payment Accuracy Using Bluetooth-based RTLS

A real-time location system (RTLS) provide critical access hospitals with an effective means for accurately tracking physician availability time for delivering emergency department services, thereby potentially increasing Medicare payments.

Marc B. Westle January 23, 2019

4 Key Ways the OPPS Final Rule Affects the Revenue Cycle

Clinic visits in hospital settings and 340B payments are among the changes to be aware of in 2019.

Mike Kovar January 17, 2019

Medicare Shared Savings Program 2019 Final Rule Summary

This document provides a comprehensive summary of December 2018 Medicare Shared Savings Program final rule, published by CMS.

HFMA January 7, 2019

Medicare Shared Savings Program 2019 Final Rule: HFMA Executive Summary

This document briefly highlights noteworthy details of the 2019 Medicare Shared Savings Program final rule, published by CMS.

HFMA January 3, 2019

Judge Rejects 2018 Cut to Medicare 340B Payments

Jan. 2—A federal judge recently ruled against a year-old 30 percent cut to Medicare payments for 340B drugs. But the ruling’s implementation—including the effect on 2019 payment—remains to be decided.

Rich Daly January 3, 2019

Medicare’s Move Toward Site-Neutral Payment

A payment change in the OPPS final rule that aims to align payments made for services delivered in off-campus hospital outpatient departments with those made for services delivered in physician offices has raised considerable controversy.

Gail R Wilensky, PhD December 26, 2018

CY 2019 OPPS/ASC Final Rule: HFMA Executive Summary Presentation

This presentation briefly summarizes the CY 2019 OPPS/ASC final rule, published by CMS.

HFMA December 13, 2018
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