Posts Tagged Medicare

OIG Report Says Vulnerabilities Exist in Hospital Wage Index System

The US Department of Health and Human Services’ Office of Inspector General recently issued a report identifying vulnerabilities in the hospital wage index system for Medicare payments. “As a result of these vulnerabilities, wage indexes may not always accurately reflect local labor prices and, therefore,

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CMS Finalizes Calendar Year 2019 Payments and 2020 Policy Changes for Home Health Agencies and Home Infusion Therapy Suppliers

CMS issued a final calendar year 2019 update to the home health prospective payment system (HH PPS). The rule will update both the payment rates and case-mix weights for home health agencies (HHAs) for CY 2019. For home health services beginning on or after

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CMS Proposes International Pricing Index Model for Medicare Part B Drugs

CMS has issued an Advance Notice of proposed rulemaking regarding the development of a potential model that seeks payment prices comparable for Part B drugs relative to other economically-similar countries. CMS says that a proposed rule would be issued, based on comments, in the spring

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Register Now for NCHA’s Government Payors Summit Oct. 30

Register by Oct. 23 to attend NCHA’s Government Payors Summit on Tuesday, Oct. 30 at the Embassy Suites by Hilton Raleigh-Durham/Research Triangle in Cary. This program, in partnership with the he North Carolina Chapter of the Healthcare Financial Management Association, will: Update providers on the latest

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Study: Hospital Outpatient Departments Treat Sicker, Poorer Patients

Medicare patients who receive care in a hospital outpatient department are likely to be poorer and have more severe chronic conditions than Medicare patients treated in an independent physician office, according to a study prepared for the American Hospital Association. “America’s hospitals and health systems are

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Hospital Groups Refile Lawsuit to Reverse 340B Payment Cuts

The American Hospital Association, Association of American Medical Colleges, America’s Essential Hospitals, and three hospital plaintiffs (includes Park Ridge Health in Hendersonville) refiled a lawsuit in federal district court seeking expedited relief from Medicare payment cuts for many hospitals in the 340B Drug Pricing Program.

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Joint Letter to CMS Addresses Medicare Bad Debt Policy Changes

In recent months, many hospitals in North Carolina, South Carolina, Virginia, and West Virginia have experienced increased focus and scrutiny of their Medicare bad debts by Palmetto GBA (Jurisdiction M Medicare Administrator Contractor) and its subcontractors. These reviews are applying new documentation requirements

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Deadlines Approaching for Low-Volume Hospital Payment Adjustment, Hospital Reclassifications

Hospitals wishing to qualify for the payment adjustment for low-volume hospitals in fiscal year 2019 must make a written request for low-volume status to their Medicare Administrative Contractor no later than Sept. 1, per the instructions outlined in the CMS’ inpatient prospective payment

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Can I Get Paid for Telehealth?

The Health Resources and Services Administration provides a Medicare Telehealth Payment Eligibility Analyzer tool through its Data Warehouse, allowing providers to check if an address is eligible for Medicare payment for telehealth services. Further information about the types of services, eligible providers and

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Ways and Means Committee Reports on Efforts to Reduce Medicare Burdens

The US House Ways and Means Committee recently released a report reviewing the committee’s year-long initiative to reduce legislative and regulatory burdens on Medicare providers and potential next steps. According to the report, the committee is sending letters to the Centers for Medicare & Medicaid

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