Medicare Payment and Reimbursement

Hospitals Hit By 340B and Site-Neutral Medicare Cuts in New Rule

Nov. 5—Medicare pay cuts included in a new payment rule will affect the federal discount drug program and off-campus provider-based departments (PBDs).

Rich Daly November 6, 2018

Providers Should Keep Watch on Payer Discount Increases

A significant uptick in payer contractual allowances and discounts in the first quarter of 2018 indicate that hospitals should remain focused on payer mix and payer category shifts.

Jeanne M. Slates November 2, 2018

Hospital Advocates Concerned About Trump Drug Price Plan

Oct. 26—Hospitals would face uncertain financial impacts under a Medicare drug payment pilot announced this week.

Rich Daly October 29, 2018

The Controversy over the Rules of the Game for the Medicare Shared Savings Program

Ken Perez examines the fundamental disagreement over how MSSP ACO savings are being measured and the potential fallout as participants consider leaving the program.

Ken Perez October 16, 2018

Medicare Shared Savings Program “Pathways to Success” Proposed Rule

This document summarizes the Medicare Shared Savings Program - Pathways to Success proposed rule, published in the August 17, 2018, Federal Register.

HFMA October 3, 2018

HFMA Comments on the CY 2019 OPPS/ASC Propsed Rule

HFMA submits comments to CMS on the CY 2019 hospital OPPS/ASC proposed rule, published in the July 31, 2018, Federal Register. 

HFMA October 1, 2018

Rural Hospitals Push Congress to Address Key Financial Issue

Sept. 26—Amid rising concern in Congress over rural hospital failures, some stakeholders are renewing their push for a long-sought Medicare payment change that was described during a recent hearing as “one of the single most important” financial fixes for those organizations.

Rich Daly September 27, 2018

Site-Neutral Payment Reduction Leads Hospital OPPS Concerns

Sept. 25—Among reactions to a range of thorny policy proposals, hospital advocates are urging Medicare to withdraw a $760 million payment cut for outpatient services.

Rich Daly September 26, 2018

CY 2019 OPPS/ASC Proposed Rule: HFMA Executive Summary|HFMA

CMS published a proposed rule updating OPPS/ASC payments for CY 2019, in the July 31, 2018, Federal Register.

HFMA September 17, 2018

Hospitals Express Opposition to E/M Code Changes

Sept. 12—A Medicare proposal to simplify evaluation and management (E/M) codes could hit hospitals’ bottom lines, hospital advocates recently warned the Trump administration.

Rich Daly September 13, 2018
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