Medicare Payment and Reimbursement

HFMA Comments on Interim Final Rule on Third Party Payment of Qualified Health Plan Premiums

HFMA comments on CMS's IFR to codify the guidance related to third party premium payment for individuals enrolling in QHPs. However, the IFR does not resolve the ambiguity created by CMS’s conflicting statements on the issue.

HFMA May 12, 2014

HFMA Comments on Medicare DSH Payment Reductions

With weeks remaining in the open enrollment period it appears highly unlikely that the CBO's May 2013 estimate of a reduction in the uninsured by 14 million individuals in 2014 will be achieved. 

HFMA March 13, 2014

Comment Letter to CMS: FY14 IPPS Proposed Rule

Read HFMA's comments to Centers for Medicare & Medicaid Services regarding its FY2014 proposed rule for Hospital Inpatient Prospective Payment Systems.

HFMA February 6, 2014

HFMA Supports the Two-Midnight Rule Delay Act (H.R. 3698)

HFMA believes a workable approach is to delay enforcement of the two-midnight rule until October 1, 2014. During this delay, CMS will work with stakeholders to develop alternate policy solutions.

HFMA January 30, 2014

CY14 OPPS Final Rule Fact Sheet

This document summarizes the updates to the OPPS final rule for CY14. 

HFMA December 20, 2013

The Physician Value-Based Payment Modifier: Summary of National Provider Call

Beginning in 2015, physicians will be financially rewarded by Medicare for providing higher-quality, more efficient care. Here’s what CMS told providers about the payment adjustment during a Dec. 3 call.

HFMA December 16, 2013

FY14 IPPS Changes to Certain Cost Reporting Procedures Related to DSH Uncompensated Care Payments

This fact sheet summarizes the changes to the operational procedures for reconciling Medicare disproportionate care payments for hospitals with cost reporting periods spanning more than one federal fiscal year.

HFMA November 14, 2013

HFMA’s Regulatory Sound Bites: An Overview of the Final 2014 Inpatient Prospective Payment Rule

This presentation outlines FY14 updates to the IPPS payment rates, CMS's quality-promoting programs, and other policy changes.

HFMA October 30, 2013

HFMA Comments on the Medicare Recovery Audit Contractor Program

HFMA addresses the Centers for Medicare & Medicaid Services (CMS) in a proactive comment on issues related to the Medicare Recovery Audit Contractor (RAC) program.

HFMA October 18, 2013

CMS Open Door Forum: 2-Midnight Rule

On Tuesday, Sept. 26, 2013, CMS hosted a second, much anticipated, follow-up call to allow providers and other interested parties to ask questions pertaining to those areas of the two-midnight provision contained in the FY14 inpatient PPS final rule, which pertains to physician order and certification, inpatient hospital admission, and medical review criteria.

HFMA October 2, 2013
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