News & Analysis as of

Payment Plans Medicare

Mintz

Government Shutdown Aftermath: CMS Under Pressure to Finalize Medicare Payment Rules

Mintz on

..Because of the prolonged government shutdown, the Centers for Medicare & Medicaid Services (CMS) may encounter delays in promulgating final payment rules that would otherwise be effective January 1, 2014. ..It is...more

King & Spalding

CMS Issues FQHC Proposed PPS Rule

King & Spalding on

On September 23, CMS published a proposed rule that would establish a prospective payment system (PPS) for federally qualified health center (FQHC) services under Medicare Part B beginning on October 1, 2014. CMS has...more

Baker Donelson

IPPS Final Rule: CMS Addresses Allina Decision and Addresses New Medicare DSH Payment Calculations

Baker Donelson on

In the fiscal year 2014 Inpatient Prospective Payment System (IPPS) rule published in the Federal Register on August 19, 2013, CMS took two steps of note regarding the Medicare disproportionate share hospital (DSH)...more

King & Spalding

CMS Releases FY 2011 SSI Ratios

King & Spalding on

CMS has released the FY 2011 SSI data for IPPS hospitals, LTCHs, and IRFs. This data will be used to determine the disproportionate share adjustment for hospitals and the low-income payment adjustment for IRFs for cost...more

Baker Donelson

CMS Releases Final FFY 2014 IPPS Rule

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CMS has released its final federal fiscal year (FFY) 2014 prospective payment system (PPS) rule for inpatient stays in acute care and long-term care hospitals (LTCHs). The rule projects a net increase in operating payments to...more

Mintz - Health Care Viewpoints

Proposed Medicare Cuts Would Significantly Impact Independent Laboratories

Last week, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule setting forth revisions to payment policies under the Medicare Physician Fee Schedule (MPFS) and other revisions to Medicare Part B for...more

King & Spalding

DC Circuit Issues Latest DSH Decision, Reducing Reimbursements

King & Spalding on

On June 11, 2013, the D.C. Circuit Court issued the latest ruling relating to the proper calculation of hospitals’ disproportionate share hospital (DSH) payment, leading to potentially lower Medicare reimbursements related to...more

King & Spalding

MedPAC Recommends “Site-Neutral” Payment Policy

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The Medicare Payment Advisory Commission’s (MedPAC) June report to Congress contained several cost-cutting recommendations but one of the more significant ones was its proposal to move “immediately” to “site-neutral payment”...more

King & Spalding

OIG Recommends that CMS Establish a Hospital Transfer Payment Policy for Early Discharges to Hospice Care

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The OIG recently issued a report (A-01-12-00507) concerning the potential financial impact to Medicare Part A if CMS established a hospital transfer payment policy for early discharges to hospice care. The OIG explained that...more

Baker Donelson

CMS Proposes FY 2014 Payment Rates and Policies for Medicare Inpatient Rehabilitation Facilities

Baker Donelson on

On May 2, 2013, CMS released a proposed rule [PDF] for the Inpatient Rehabilitation Facility Prospective Payment System for fiscal year (FY) 2014. The proposed rule sets forth Medicare payment policies and rates governing...more

BakerHostetler

Bringing Sunlight to Healthcare Pricing: The CMS Release of Hospital Charge Data

BakerHostetler on

Former U.S. Supreme Court Justice Louis D. Brandeis once said that "Sunlight is the best disinfectant." The release of charges billed by some 3,337 Medicare hospitals for 100 of the most common inpatient diagnosis related...more

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