On August 1, 2023, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) Final Rule for FY 2024 (the Final Rule). In the Final Rule, CMS,...more
8/9/2023
/ Affordable Care Act ,
Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Department of Health and Human Services (HHS) ,
DSH ,
Final Rules ,
Food and Drug Administration (FDA) ,
Inpatient Prospective Payment System (IPPS) ,
Long-Term Care ,
Medicaid ,
Medicare ,
Rural Health Care Providers ,
Social Security Act ,
Stark Law ,
Waivers
On December 13, 2022, CMS is set to publish in the Federal Register a proposed rule (Proposed Rule) requiring certain Medicare, Medicaid, Children’s Health Insurance Program, and Qualified Health Plan fee-for-service and...more
12/21/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Children's Health Insurance Program (CHIP) ,
Fee-for-Service ,
Healthcare ,
Managed Care Contracts ,
Medicaid ,
Medicare ,
Medicare Advantage ,
Payment Systems ,
Proposed Rules ,
Qualified Health Plans
On December 28, 2021, CMS announced that it would resume enforcement of its COVID-19 vaccine mandate for healthcare providers in areas not covered by injunctions issued by federal courts. As of December 15, 2021, federal...more
1/5/2022
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Employer Mandates ,
Enforcement ,
Health Care Providers ,
Healthcare Workers ,
Injunctions ,
OSHA ,
Popular ,
Vaccinations ,
Virus Testing
On March 10, 2021, CMS revised its guidance on visitations to nursing homes in acknowledgement of the fact that millions of residents and staff in nursing facilities have received COVID-19 vaccinations in the last few months....more
On October 6, 2020, CMS announced new enforcement measures to ensure hospitals report daily COVID-19 data, with the exception of psychiatric and rehabilitation hospitals that must report weekly, to the federal government...more
10/15/2020
/ Centers for Medicare & Medicaid Services (CMS) ,
Coronavirus/COVID-19 ,
Hospitals ,
Influenza ,
Interim Final Rules (IFR) ,
Medicaid ,
Medicare ,
New Guidance ,
Public Health Emergency ,
Reporting Requirements ,
Termination
Health plans and their delegated IPAs are using a number of different tactics to deny payment for inpatient services by improperly classifying inpatient claims as observation or other types of outpatient status. Payers are...more
8/19/2019
/ Centers for Medicare & Medicaid Services (CMS) ,
Class Action ,
Constitutional Challenges ,
Department of Health and Human Services (HHS) ,
Health Insurance ,
Hospitals ,
Inpatient Billing ,
Managed Care Contracts ,
Medi-Cal ,
Medicare ,
Medicare Part A ,
Medicare Part B ,
Two-Midnight Rule ,
Underpayment
In 2016, CMS issued a proposed rule to update the requirements that hospitals and critical access hospitals must meet to participate in Medicare and Medicaid programs....more
On June 6, 2019, CMS issued a Request for Information (RFI) seeking new ideas from the public on how to decrease the administrative burden for healthcare providers, specifically the burden of “unnecessary paperwork.” The RFI...more