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.
HHS Notice of Benefit and Payment Parameters for 2020 Proposed Rule Summary
Summary of the Notice of Benefit and Payment Parameters for 2020 proposed rule, published by CMS.
Medicare Physician Fee Schedule Final Rule: 3 Must-Do Steps for Physicians
The Medicare Physician Fee Schedule for 2019 includes a variety of new policies—and revenue opportunities for providers if they take a few key steps in relation to areas such as payment rates, documentation requirements, and new services.
Medicare Expands Value Pay in MA and Part D Plans
Jan. 21—Medicare is expanding its value-based insurance design (VBID) model and creating a new drug plan model.
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.
The Texas Federal District Court’s Ruling on the Constitutionality of the ACA
The 2018 ruling in by the Texas District Court declaring Affordable Care Act unconstitutional is expected to be overturned, but the decision still could have an adverse effect on the future of value-based payment.
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.
Henry Ford Health System Joins Direct-Contracting Trend
Henry Ford Health System expects to succeed in its direct-contracting initiative with General Motors, thanks in large part to its capabilities in areas such as analytics, case management, and patient engagement.
Finding Common Ground in Health Care with a Divided Government
Ken Perez comments on the need for both parties in Congress to set aside partisan differences and find common ground in passing bipartisan legislation to solve key problems affecting the nation’s healthcare system.
Jan. 21-25: Medicaid Policies in Focus
Jan. 17—As Congress’s primary Medicaid advisory body prepares to meet next week, hospitals and insurers are clashing over changes to the program’s managed care rules.