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.
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.
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 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.
Successfully Negotiating Managed Care Contracts
“The more an organization solidifies its own expectations for contract negotiation and appreciates the needs of the payer, the more likely it is to reach an acceptable agreement,” says Paula Dillon, director of managed care for Rockford Health System.
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.
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.
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).
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’s Comment Letter to CMS on Hospital Value-Based Purchasing
HFMA submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the weighting of the HCAHPS domain within the CMS Hospital Value-Based Purchasing Program.