Hospitals Medicare

News & Analysis as of

Judge Denies HHS’s Request to Rescind Timeline to Eliminate the Medicare Appeals Backlog

On January 4, 2017, the court in the American Hospital Association (AHA) v. Burwell litigation denied HHS’s motion to reconsider, which means that HHS must comply with the court’s timeline to eliminate the Medicare appeals...more

Urban hospitals that established GME caps after 1996: Be careful with this compliance issue

If a teaching hospital meets certain regulatory requirements, the hospital is generally permitted to loan its cap slots to other hospitals through a Medicare GME affiliated group agreement. (See Sharing FTE Caps: Threshold...more

CMS Corrects Final 2017 OPPS/ASC Rule, Results in Slight Payment Increase

CMS has published a notice correcting technical errors in its November 14, 2016 final rule with comment period updating the Medicare hospital outpatient prospective payment system (OPPS) and ambulatory surgical center payment...more

The AHA’s Letter to Santa Claus

The American Hospital Association, after having been “nice” all year, penned its letter to Santa Claus with its wish list for Christmas. Its four page letter (actually addressed to President-Elect Donald Trump at 1717...more

Researchers see ways Obamacare helped to cut costs, improve patient care

As the already known complications to its demise have increased by the minute, there may be some detectable pauses in the partisan zeal to give the Affordable Care Act, aka Obamacare, the bum’s rush. That’s because the...more

A Condition of Participation for Medicare Providers in 2017

This year, Medicare providers and suppliers — including hospitals, ambulatory surgical centers (ASCs) and end-stage renal disease (ESRD) facilities — will need to develop emergency preparedness plans for both natural and...more

HHS OIG Issues Report on Medicare’s 2-Midnight Rule

On December 19, 2016, the HHS OIG issued a report on Medicare’s 2-midnight rule titled “Vulnerabilities Remain Under Medicare 2-Midnight Hospital Policy.” The report reviews data from 2013 and 2014 and reaches several...more

Final Rule Implements Quality Payment Program under MACRA

If you are a physician, mid-level provider, or work with those providers, then you have been bombarded with new acronyms for new programs and promises to remove older acronyms from your Medicare vocabulary. Medicare...more

HHS Claims it is Unable to Meet Court-Ordered Targets to Resolve Medicare Appeals Backlog

The U.S. District Court for the District of Columbia issued an order on December 5, 2016 compelling HHS to meet certain annual targets to resolve its backlog of hundreds of thousands of pending Medicare claim appeals. HHS...more

OIG Issues Report on Medicare’s ‘2-Midnight Hospital Rule’

On December 19, 2016, the US Department of Health and Human Services Office of Inspector General (OIG) posted a report examining the Centers for Medicare & Medicaid Services’ (CMS’s) “2-Midnight Rule.” The OIG concluded that...more

CMS Issues Final Rule for New Cardiac, Orthopedic Bundled Payment Models

On December 20, 2016, CMS issued its final rule implementing three new Medicare Parts A and B episode payment models for patients admitted for treatment for heart attack, bypass surgery, or hip/femur fracture under its...more

CMS Publishes the Medicare Outpatient Observation Notice Form and Instructions

On December 8, 2016, CMS published the final version of the Medicare Outpatient Observation Notice (MOON) that hospitals and critical access hospitals (referred collectively as "hospitals" herein) must use to provide notice...more

CMS Releases Medicare Outpatient Observation Notice Form

On December 8, 2016, the Centers for Medicare and Medicaid Services (CMS) published the Medicare Outpatient Observation Notice (MOON), which educates Medicare beneficiaries on the effect of outpatient status, particularly as...more

HHS-OIG reports on impact and vulnerabilities of Medicare's Two-Midnight Rule

On December 19, 2016, the US Department of Health and Human Services, Office of Inspector General (HHS-OIG) issued a report, "Vulnerabilities Remain Under Medicare 2-Midnight Hospital Policy" (OEI-02-15-00020). The report is...more

Also In The News - Health Headlines - December 2016

CMS Releases the Finalized Medicare Outpatient Observation Notice Form – On December 9, 2016, CMS released the final Medicare Outpatient Observation Notice (MOON) form. The MOON form is a standardized form developed by CMS...more

CMS Releases Standardized Hospital Medicare Outpatient Observation Notice Form

Hospitals are facing a March 8, 2017 deadline to begin using the new Medicare Outpatient Observation Notice (MOON) to inform Medicare beneficiaries when they are outpatients receiving observation services and not inpatients...more

CMS Final Rule and 21st Century Cures Act Include Good and Bad News for Provider-Based Sites

CMS recently published its final outpatient prospective payment system (OPPS) rule, which includes its new policies governing payment related to services furnished at off-campus provider-based departments (OPBDs). 81 Fed....more

It Ain't Over 'Till It's Over – First Circuit Rejects Settlement Agreements Between Providers and Intermediary and Upholds Cost...

On October 27, 2016, a three-judge panel for the United States Court of Appeals for the First Circuit issued an opinion concluding that a Medicare fiscal intermediary (Intermediary) does not have the authority to enter into a...more

21st Century Cures Act to provide modest relief from site-neutral provider-based department payment policy

The 21st Century Cures Act (H.R. 34) was recently overwhelmingly approved by both houses of Congress and reportedly will be signed into law by President Obama on December 13, 2016. Section 16001 of the Act modifies a...more

2016 Health Care Year in Review

Since I began writing this year-end review in 2013, there have been some common themes – a shift to pay for quality and away from fee-for service, much of which has been brought about by the Affordable Care Act (ACA): efforts...more

21st Century Cures: Congress Approves Legislation Expanding Hospital Site-Neutral Payment Exceptions and Making Other Payments...

The 21st Century Cures Act encourages biomedical research investment and facilitates innovation review and approval processes, but also serves as a vehicle for a wide variety of other health-related measures, including...more

CMS Issues Final Rule on Off-Campus Hospital Department Reimbursement

As of January 1, 2017, hospitals will receive lower Medicare reimbursement for items and services provided at certain off-campus provider-based facilities. This Alert provides an overview of the new reimbursement framework...more

OPPS Provider-Based Final Rule — A More Practical Approach From CMS

CMS recently finalized sweeping changes to the way Medicare pays hospitals for services furnished in “new” off-campus provider-based departments (referred to as “off-campus PBDs”). CMS revealed the changes on November 1...more

OIG Releases 2017 Work Plan

On November 10, 2016, the Office of Inspector General (“the OIG”) of the U.S. Department of Health and Human Services (“DHHS”) is charged with ensuring the integrity of more than 100 programs administered by DHHS, including...more

The Wait is Over: CMS Delivers Post-BBA Provider-Based Policies in Final 2017 OPPS

Now that the rule is out, work to implement the BBA changes begins in earnest. CMS commemorated the one-year anniversary of the Bipartisan Budget Act of 2015 (BBA) with the traditional gift of paper, offering...more

591 Results
|
View per page
Page: of 24
Popular Topics

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.
×