On August 1, 2024, CMS filed a display copy of its final rule for Fiscal Year (FY) 2025 pertaining to the Inpatient Prospective Payment Systems (IPPS) for general acute care hospitals and long-term care hospitals (LTCHs) (the...more
On April 4, 2024, CMS published a final rule implementing certain policy changes to the Medicare Advantage (MA) Program (Medicare Part C) and the Medicare Prescription Drug Benefit Program (Medicare Part D). According to the...more
4/16/2024
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Medicare Part C ,
Medicare Part D ,
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Substance Abuse ,
Third-Party
On February 21, 2024, CMS published a transmittal on its website with instructions for Medicare Administrative Contractors (MACs) to implement CMS’s final rule, issued June 9, 2023, concerning the treatment of the Part C days...more
Last week, CMS released the Calendar Year (CY) 2023 Physician Fee Schedule (PFS) final rule (the Final Rule). Under the Final Rule, CMS finalized a number of updates, revisions, and changes to Medicare payment policies for...more
On August 1, 2022, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Final Rule for FY 2023 (the Final Rule). In the Final Rule, CMS...more
8/10/2022
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DSH ,
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Graduate Medical Education ,
Inpatient Prospective Payment System (IPPS) ,
Long-Term Care ,
Medicare ,
Payment Rates ,
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Value-Based Purchasing ,
Wage Index
On December 17, 2021, CMS issued a final rule implementing three changes to Medicare’s payment rules for graduate medical education that Congress enacted last year in the Consolidated Appropriations Act, 2021 (CAA). The final...more
On December 2, 2020, CMS issued a final rule updating the payment policies and rates for services to be furnished under the Medicare Physician Fee Schedule (PFS) in calendar year (CY) 2021. The final rule includes...more
On September 2, 2020, CMS issued the fiscal year (FY) 2021 final rule for the hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (the Final Rule). This article...more
9/11/2020
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Inpatient Prospective Payment System (IPPS) ,
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Medical Reimbursement ,
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Medicare Advantage ,
Patient Prospective Payment System
n November 1, 2019, CMS posted the final rule establishing the payment rates for the Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgery Center (ASC) Payment System for calendar year (CY) 2020...more
11/15/2019
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Medical Devices ,
Medicare ,
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Outpatient Prospective Payment System (OPPS) ,
Payment Rates ,
Prescription Drugs ,
Price Transparency ,
Prior Authorization ,
Provider Payments ,
Rural Health Care Providers ,
Section 340B
On August 2, 2019, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Final Rule for FY 2020 (the Final Rule). Highlights include...more
8/9/2019
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CEHRT ,
Centers for Medicare & Medicaid Services (CMS) ,
Final Rules ,
Inpatient Prospective Payment System (IPPS) ,
Inpatient Quality Reporting ,
Long Term Care Facilities ,
Medicare ,
Payment Systems ,
Psychiatric Hospitals ,
Wage Index