News & Analysis as of

Inpatient Prospective Payment System (IPPS)

CMS request for information presents rare opportunity for medicare stakeholder engagement

by Hogan Lovells on

On 14 April 2017, the Centers for Medicare & Medicaid Services (CMS) published the fiscal year (FY) 2018 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective...more

Coming Soon: Proposed 2018 Medicare Payment Rules

by Reed Smith on

CMS has sent several major proposed Medicare 2018 payment rules to the White House Office of Management and Budget (OMB) for regulatory clearance before publication in the Federal Register. OMB has already cleared the...more

Regulatory “Freeze” Thaws for HHS: Medicare FY 2018 IPPS/LTCH Rulemaking Process Gets Underway

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) is moving ahead on its annual Medicare hospital payment update rule – and it actually is ahead of last year’s pace. Specifically, on March 8, 2017 CMS sent to Office of...more

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

by King & Spalding on

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

CMS Issues Final Mandatory Episode Payment Models for Cardiac and Orthopedic Cases, Plus New Cardiac Rehabilitation Incentive...

by Reed Smith on

In the waning days of the Obama Administration, the Centers for Medicare & Medicaid Services (CMS) has unveiled a lengthy and complex final rule to establish mandatory Medicare bundled payment programs for acute myocardial...more

Meaningful Use Changes in 2017 OPPS Final Rule

by Faegre Baker Daniels on

On November 14, 2016, the Centers for Medicare and Medicaid Services (CMS) published the 2017 Outpatient Prospective Payment System (OPPS) final rule in the Federal Register. The rule finalizes changes to the Electronic...more

CMS Schedules Meeting on FY 2018 IPPS New Technology Applications

by Reed Smith on

CMS has announced a February 14, 2017 town hall meeting to discuss FY 2018 applications for add-on payments for new medical services and technologies under the Medicare hospital inpatient prospective payment system (IPPS)....more

D.C. District Court Bucks the Trend and Rules for Hospital in Provider Tax Case

by Baker Ober Health Law on

Many states assess taxes against hospitals and other providers as a means of funding their Medicaid and other healthcare-related programs. The revenue generated by the taxes is used, with CMS’s approval, to fund Medicaid...more

CMS Corrects FY 2017 Medicare IPPS/LTCH Final Rule

by Reed Smith on

CMS has corrected a series of technical and typographical errors in its final rule updating the Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system...more

CMS Releases 2017 Medicare Hospital Payment Rates, Penalties for Poor Performers

Earlier this month, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (Final Rule) modifying the Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective...more

GME in the IPPS Final Rule: Medicare GME slots now up for grabs from three closed hospitals

by Dentons on

In the Fiscal Year 2017 inpatient prospective payment system (IPPS) Final Rule published in the Federal Register on August 22, 2016, the Centers for Medicare & Medicaid Services (CMS) announced the next open round of GME...more

CMS Releases the 2017 IPPS and LTCH PPS Final Rule, Including MOON Requirements

by Baker Ober Health Law on

On August 2, 2016, CMS issued its final rule addressing new payment rates and policies under both the Hospital Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System...more

Final FY 2017 Inpatient Psychiatric Facilities Payment and Policies Rule, Payment Matters

by Baker Ober Health Law on

On August 1, 2016, CMS published the FY 2017 Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS) – Rate Update notice. Some of the key changes are highlighted below....more

CMS Re-proposes Ban on Per-Click Fees for Space and Equipment Leases under Stark

by Baker Ober Health Law on

In the CY 2017 Medicare Physician Fee Schedule (CY 2017 MPFS), the Centers for Medicare & Medicaid Services (CMS) issued proposed updates to the physician self-referral law (Stark law). The primary Stark law update focused on...more

CMS Finalizes FY 2017 Update to Medicare IPPS, LTCH PPS Rates and Policies

by Reed Smith on

The Centers for Medicare & Medicaid Services (CMS) has released its final rule to update Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS)...more

CMS Releases FY 2017 Hospital Inpatient Prospective Payment System and Long-Term Care Hospital Prospective Payment System Final...

by King & Spalding on

On August 2, 2016, CMS released a final rule (Final Rule) with updates to the Hospital Inpatient Prospective Payment System (Hospital IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) affecting...more

CMS Finalizes Medicare IRF PPS Update for FY 2017

by Reed Smith on

On August 5, 2016, CMS is publishing its final rule to update Medicare prospective payment system (PPS) rates for inpatient rehabilitation facilities (IRFs) for FY 2017, which begins October 1, 2016. CMS estimates that...more

CMS Issues Pay Increase for Inpatient Psychiatric Facilities

by King & Spalding on

On July 28, 2016, CMS issued a notice updating the prospective rates for Medicare inpatient hospital services provided by inpatient psychiatric facilities. Beginning in fiscal year 2017, inpatient psychiatric facilities will...more

Two-Midnight Rule Update

by Carlton Fields on

Medicare and Medicaid Services (CMS) on August 19, 2013, the two-midnight rule provided that an inpatient admission generally would only be payable under Medicare Part A if: (1) the admitting practitioner had an expectation,...more

MedPAC Releases Comment Letters on Fiscal Year 2017 Inpatient Hospital, Hospice, Skilled Nursing, and Inpatient Rehabilitation...

by King & Spalding on

In late May, the Medicare Payment Advisory Commission (MedPAC) issued comment letters in response to multiple CMS payment proposals in which MedPAC encouraged refinements to the hospital star rating system to emphasize...more

Congress Considers Broader Hospital Site-Neutral Payment Exceptions and Other Payments Changes

by McDermott Will & Emery on

In Depth - The House Ways and Means Committee next week is expected to consider and approve the Helping Hospitals Improve Patient Care Act of 2016, legislation that would create broader exceptions under much maligned...more

FY 2017 IPPS Proposed Rule Results in Modest Increase for Hospitals

by BakerHostetler on

CMS recently issued a proposed rule updating fiscal year (FY) 2017 Medicare payment policies and rates under the Medicare inpatient prospective payment system (IPPS) and the long-term care hospital (LTCH) prospective payment...more

CMS Proposes FY 2017 Update for Medicare IPPS, LTCH PPS Rates and Policies

by Reed Smith on

CMS has published its proposed rule to update the Medicare acute hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) for fiscal year (FY) 2017....more

CMS Issues Rule to Implement LTCH PPS Wound Care Discharge Payment Policy, Geographic Reclassification Changes

by Reed Smith on

CMS has published an interim final rule with comment period to implement a recent statutory provision addressing Medicare payments to certain rural long-term care hospitals (LTCHs) for severe wound care discharges. By way of...more

CMS Proposes Update to Medicare IRF PPS Payments for FY 2017

by Reed Smith on

CMS has published its proposed rule to update Medicare prospective payment system (PPS) rates for inpatient rehabilitation facilities (IRFs) for FY 2017, which begins October 1, 2016. CMS estimates that rates would increase...more

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