Medicare Payment and Reimbursement

Looming changes to quality reporting in the Medicare Shared Savings Program draw strong pushback from healthcare providers

Healthcare provider organizations are petitioning the Biden administration to slow recently finalized quality-related changes to the Medicare Shared Savings Program.

Nick Hut May 18, 2021

CMS increases the payment rate for administering authorized monoclonal antibody treatments to patients with COVID-19

CMS has provided a nearly 50% boost in payment to providers that administer monoclonal antibodies to beneficiaries with COVID-19.

Nick Hut May 17, 2021

Proposed FY 2022 IPPS Rule: Hospital finance and revenue cycle teams, clinicians and payers are assessing the rule impacts and preparing their responses

HFMA’s Shawn Stack summarizes the Proposed FY 2022 IPPS Rule, and says health systems, payers and providers have until June 28 to provide CMS with input.

Shawn Stack May 11, 2021

CMS is curtailing voluntary participation in the Comprehensive Care for Joint Replacement bundled payment model

Hospitals that participated in the Comprehensive Care for Joint Replacement model on a voluntary basis over the last three years will be excluded after Sept. 30.

Nick Hut May 3, 2021

In a win for hospitals, CMS removes a rate-reporting requirement from the Medicare FY22 Inpatient Prospective Payment System

An FY22 requirement for hospitals to disclose privately negotiated MA rates on their Medicare cost reports has been rescinded in the proposed rule for the Inpatient Prospective Payment System.

Nick Hut April 29, 2021

Key payment details in the Medicare FY22 Inpatient Prospective Payment System proposed rule

CMS’s FY22 proposed rule for the Inpatient Prospective Payment System includes a 2.8% payment increase for general acute care hospitals.

Nick Hut April 28, 2021

News briefs: CMS reduces Medicare payments by 25% for many providers as part of loan recoupment

News briefs for May include recoupment of Medicare advance payments, a potential issue with hospitals' 340B eligibility, and more.

Nick Hut April 26, 2021

Why the federal agency that oversees healthcare payment innovation is rethinking its approach

The director of the Center for Medicare & Medicaid Innovation is conducting a “strategic refresh” of the agency to consider how the healthcare industry’s transition to value can be improved.

Nick Hut April 25, 2021

Prospective CMS administrator’s confirmation hearing highlights Congress’s desire to expand telehealth coverage

In a confirmation hearing for prospective CMS Administrator Chiquita Brooks-LaSure, various members of the Senate Finance Committee expressed their hope to implement a permanent expansion of Medicare telehealth coverage.

Nick Hut April 21, 2021

Update on Medicare payment policy for treatments involving bamlanivimab

Medicare no longer will pay healthcare providers for administering the COVID-19 treatment bamlanivimab now that the FDA has revoked the Emergency Use Authorization for treatments in which the drug is administered alone.

Nick Hut April 20, 2021
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