Medicare Payment and Reimbursement

HFMA Comment Letter to CMS: FY14 Hospital Outpatient Prospective Payment Systems for Acute Care Hospitals

HFMA prepared a comment letter on key issues contained in CMS's 2014 Hospital Outpatient Prospective Payment Systems for Acute Care Hospitals.

HFMA September 6, 2013

FY14 IPPS Final Rule Overview

This fact sheet contains information on the updates to hospital payment rates under the inpatient prospective payment system for fiscal year 2014.

HFMA September 6, 2013

CY14 OPPS Proposed Rule Fact Sheet

This fact sheet contains information on the proposed rule released by CMS updating payments to outpatient hospitals paid under the Medicare OPPS, and ambulatory surgical centers for CY14. The Centers for Medicare & Medicaid Services (CMS) released a proposed rule with comment period that updates payment policies and rates for services furnished to Medicare beneficiaries in hospital outpatient departments and establishes payments for services furnished in ambulatory surgical centers (ASCs) beginning January 1, 2014. In addition, CMS proposes to update and refine the requirements for the Hospital Outpatient Quality Reporting Program, the ASC Quality Reporting Program, and the Hospital Value-Based Purchasing Program.

HFMA July 26, 2013

Overview of Medicaid Disproportionate Share Hospital Allotment Reductions

This document summarizes the proposed rule requiring reductions to state Medicaid disproportionate share hospital allotments required under the ACA from FY14 through FY20. CMS released a proposed rule requiring aggregate reductions to state Medicaid disproportionate share hospital (DSH) allotments. The rule, required by the Affordable Care Act (ACA), sets forth aggregate reductions to state Medicaid DSH allotments annually from FY14 through FY20. The proposed rule also delineates the DSH health reform methodology (DHRM) to implement the annual reductions for FY14 and FY15, and proposes to add additional DSH reporting requirements for use in implementing the DHRM.

HFMA June 27, 2013

Medicare Disproportionate Share Hospital Payment Adjustment Fact Sheet

This document summarizes the major changes to the disproportionate share (DSH) payment adjustment that hospitals serving a significantly disproportionate number of low-income patients can qualify for, as outlined in the FY14 IPPS proposed rule.

HFMA June 20, 2013

HFMA Comments on Medicare Part B Inpatient Hospital Billing and the RAC Program

HFMA is concerned with aspects of the RAC program that violate many of HFMA’s principles of a reformed payment system. Comments focused on rebilling for medically necessary services and the timeframe.

HFMA May 20, 2013

HFMA Comment Letter: Second Draft of Sustainable Growth Rate Repeal & Reform Proposal

Read HFMA's comments to the chairs of the House of Representatives' Ways and Means and Energy and Commerce Committees and their respective Health Subcommittees on their drafted framework for legislation to replace the SGR.

HFMA April 15, 2013

Medicare Part B Inpatient Billing in Hospitals Proposed Rule Fact Sheet ;reasonable and necessary;Medicare Part A claim denial;inpatient admission

This fact sheet highlights the CMS's proposed rule, Medicare Program; Part B Inpatient Billing in Hospitals, which would revise the current billing policy under Medicare Part B following a denial of a Medicare Part A inpatient claim for services not reasonable and necessary.

HFMA April 5, 2013

CY13 Medicare Physician Fee Schedule Final Rule Fact Sheet

CMS has issued a final rule regarding revisions to payment policies under the Medicare Physician Fee Schedule for calendar year 2013 (CY13).

HFMA January 11, 2013

CY13 OPPS Final Rule Fact Sheet

This fact sheet provides information on the updates to Medicare payment rates for hospital outpatient services paid under the outpatient prospective payment system and the ambulatory surgical center payment system for calendar year 2013.

HFMA December 19, 2012
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