Access to post-acute care remains an issue in most hospitals around the country. Exacerbated by the staffing challenges that worsened during COVID-19, the ability to get a patient transferred to…
In the post-public health emergency (PHE) era, I have noticed what I think may be a glitch in the computer system at the Centers for Medicare & Medicaid Services (CMS).…
Back in June, the Centers for Medicare & Medicaid Services (CMS) released a memo titled “Requirements for Hospital Discharges to Post-Acute Care Providers,” which was sent to survey agencies that…
The AMA’s experts have analyzed the 2,000-page 2024 Medicare physician payment schedule proposed by the Centers for Medicare & Medicaid Services (CMS) and are sharing their summary of key provisions (PDF)…
While most observers of the Centers for Medicare & Medicaid Services (CMS), the release Wednesday of its final payment rule for inpatient and long-term care hospitals, caught many off-guard, expecting…
Medicare improperly paid practitioners at a higher non-facility rate for services provided to skilled nursing facility (SNF) or hospital inpatients, leading to over $22 million in over-payments, a report from…
Hierarchical Condition Categories (HCCs) and value-based care have been a major focus for healthcare organizations during recent years. As many of you may know, the Centers for Medicare & Medicaid…
There are no new MS-DRGs in the Final Rule. The fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) Final Rule, released by the Centers for Medicare & Medicaid Services…
The proposed rule includes expansions to the Physician Payment Schedule as well as a focus on access to high-quality care. The Calendar Year 2023 Physician Fee Schedule (PFS) proposed rule,…
CMS has released its Hospital Inpatient Prospective Payment System (IPPS) proposed rule for fiscal year 2023, which includes a payment rate boost for general acute care hospitals and new measures…
Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with…
The changes will become effective in about three months, giving providers time to modify processes. The staff at the Centers for Medicare & Medicaid Services (CMS) have been working overtime…
Changes to the MPFS, OPPS, and HHPPS were announced on the same day. Rather than a “news dump” late on a Friday afternoon, federal healthcare officials instead served up a…
CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment…
Various approvals, exceptions, and new PCS codes that may potentially lead to additional payments. The Centers for Medicare & Medicaid Services (CMS) desires to use the best data available when…
The CMS budget for fraud, waste and abuse has doubled in size from 2021 to 2022. Two years ago, the federal government created a plan to audit Medicare Advantage (MA) insurers more…