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CMS

The five-year demonstration project, beginning Jan. 1, 2018, aims to strengthen substance use disorder care for state Medicaid beneficiaries.

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CMS

The Centers for Medicare & Medicaid Services' frequently asked questions document clarifies aspects of the Mental Health and Substance Use Disorder Parity final rule for Medicaid and the Children’s Health Insurance Program.

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CMS

The document explains hospital payment adjustments under the Medicare Electronic Health Record Incentive Program; adjustments are applied as a reduction to the hospital Inpatient Prospective Payment System percentage increase for FY 2018.

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CMS

America's Essential Hospitals opposed the proposed payment model, which would have reduced Medicare payments to providers for Part B drugs.

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CMS

Hospitals have until Oct. 31 to preview their quality data; CMS hospital-specific preview reports for overall quality star ratings will be available to hospitals in mid-October.

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CMS

Hospitals use the worksheet S-10 to submit uncompensated care data to the Centers for Medicare & Medicaid Services; the agency will begin using the worksheet to calculate Medicare disproportionate share hospital payments in fiscal year 2018.

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CMS

The Centers for Medicare & Medicaid Services did not receive any letters of intent for the 2018 start date of the Medicare-Medicaid accountable care organization model.

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CMS

The Centers for Medicare & Medicaid Services will conduct field testing from Oct. 16 to Nov. 15 of eight episode-based cost measures for the Merit-based Incentive Payment System.

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CMS

The harmful payment reduction was included in the 2018 Outpatient Prospective Payment System proposed rule, expected to be finalized this fall.

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CMS

Clinicians can participate in the first year of the Merit-based Incentive Payment System and avoid a negative payment adjustment if they begin collecting data by Dec. 31.

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CMS

America's Essential Hospitals was among those urging the agency to suspend overall star ratings and examine concerns with the methodology.

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CMS

CMS is seeking broad feedback on a new direction for the Centers for Medicare & Medicaid Innovation, with increased emphasis on patient-centered care and market-based reforms.

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CMS

Affected providers will be exempt from reporting provisions of the Medicare Hospital Outpatient Quality Reporting Program, Hospital Inpatient Quality Reporting Program, and Ambulatory Surgical Center Quality Reporting Program.

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CMS

A push is underway on Capitol Hill to delay Medicaid disproportionate share hospital cuts and withdraw proposed 340B policy. Please urge your member of Congress to sign both letters.

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CMS

The proposed rule would further cut payments to non-excepted provider-based departments to 25 percent of the Medicare Outpatient Prospective Payment System rate and change certain quality reporting requirements.

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CMS

The Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, and other federal agencies have released several resources to help health care providers prepare for and respond to disasters.

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CMS

The online course provides an overview of disaster preparedness and skills to gauge compliance with emergency preparedness requirements that go into effect on Nov. 15.

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CMS

By cutting reimbursement rates for Part B drugs to 340B hospitals, the Centers for Medicare & Medicaid Services would harm essential hospitals, which care for the nation’s poorest, most complex, and costliest patients.

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CMS

The Centers for Medicare & Medicaid Services is granting exceptions under certain Medicare quality reporting and value-based purchasing programs to hospitals and health care facilities in Federal Emergency Management Agency–designated major disaster counties.

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CMS

The changes include optimizing the assignment of star categories, eliminating the removal of outliers, and ensuring only hospitals meeting public reporting thresholds are assigned star ratings.

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CMS

The proposed reductions are set to take effect Oct. 1; the association recommended the Centers for Medicare & Medicaid Services protect state disproportionate share hospital payment allotments from total elimination, among other suggestions.

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CMS

In response to a proposed annual update to the Quality Payment Program, America’s Essential Hospitals offered recommendations related to the merit-based incentive payment system.

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CMS

The newly released set of frequently asked questions relates to potential payment issues for Medicaid managed care patients in institutions for mental disease.

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CMS

The first performance year was set to begin Jan. 1, 2018; America’s Essential Hospitals previously expressed concern about the scope and pace of the models.

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CMS

The association says providers selected for the Comprehensive Care for Joint Replacement (CJR) demonstration are only just now adapting to the new payment and delivery approaches and need more time before facing another demonstration.

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CMS

The new rule would affect inpatient operating payments, Medicare disproportionate share hospital payments, and the Hospital Readmissions Reduction Program.

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CMS

An in-depth discussion on proposed Medicaid DSH reduction methodology and the association’s efforts to combat the impending cuts.

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cms, dsh
CMS

The decision extends by five years the state's demonstration of a capitated Medicaid managed care program and a low-income pool to provide support for the safety net.

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CMS

The announcement to allow revisions to fiscal year (FY) 2014 worksheets is important because the agency will use FY 2014 data to calculate FY 2018 Medicare disproportionate share hospital compensation.

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CMS

The Hospital Compare refresh includes data on new measures; hospitals can preview their overall star ratings through Aug. 13.

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CMS

In the rule, the Centers for Medicare & Medicaid Services proposes a disproportionate share hospital (DSH) health reform methodology to determine each state’s DSH allotment reduction for each fiscal year.

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CMS

The latest from experts on the CMS proposed policy rules that cut 340B savings and support for outpatient services in underserved areas.

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CMS

A publicly released set of slides describes dramatic restrictions to CMS' budget neutrality policy for Section 1115 waivers.

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CMS

The Centers for Medicare & Medicaid Services will allow hospitals to submit revisions to Worksheet S-10 of their Medicare cost report for fiscal year 2015 by Sept. 30.

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CMS

Proposed rules would affect outpatient payment rates, reduce Medicare Part B payments to hospitals in the 340B Program, and revise site-neutral policies.

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CMS

Aids provided by the Centers for Medicare & Medicaid Services include fact sheets and overview documents, lists of alternative payment models, webinars and other educational tools, and support contacts.

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CMS

The proposed rule would increase outpatient payment rates by 1.75 percent and drastically reduce Medicare Part B reimbursement for drugs purchased through the 340B Drug Pricing Program.

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CMS

Courts in Minnesota, Tennessee, and Virginia have ruled in favor of hospitals challenging the Center for Medicare & Medicaid Services' inclusion of Medicare and commercial payments in the calculation of disproportionate-share hospital payment limits.

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CMS

This is the second Section 1332 State Innovation Waiver to receive approval; Alaska is pursuing the waiver to stabilize the state's individual health care market.

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CMS

Attendees gained a comprehensive view of legislative and regulatory action in Washington, D.C, a preview of action in the fall, and our recommendations for messaging and strategy during Congress’ August recess.

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CMS

In the bulletin on the Medicaid managed care final rule, the Centers for Medicare & Medicaid Services said it will use enforcement discretion based on state-specific facts.

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CMS

America's Essential Hospitals provides a detailed analysis of the Quality Payment Program proposed rule for calendar year 2018.

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CMS

CMS proposes changes related to participation in the merit-based incentive payment system or Advanced Alternative Payment Models tracks.

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CMS

New Medicare cards will include a randomly generated Medicare beneficiary identifier instead of the Social Security-based health insurance claim number.

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CMS

The fact sheet gives a general overview of the Medicare Shared Savings Program and Quality Payment Program and explains how the programs work together.

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CMS

America’s Essential Hospitals encourages CMS to improve transparency, risk adjust, and reduce regulatory burden for essential hospitals.

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CMS

CMS aims to eliminate or change outdated, costly, or inconsistent regulations for marketplaces established under the Affordable Care Act.

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CMS

The webinar on June 28 will focus on the Medicaid Innovation Accelerator Program's Reducing Substance Use Disorders program area.

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CMS

States have until June 12 to complete an expression of interest form for the Medicaid Innovation Accelerator Program track.

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CMS

The Vital Signs report notes ways to prevent the bacterial lung infection, which is fatal in 25 percent of people who contract it at a health care facility.

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CMS

The deadline for Medicare- and Medicaid-providers and suppliers to meet applicable requirements of the rule, including training and testing, is Nov. 15.

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CMS

Overall star ratings now will be released in October because of issues with data on three measures; hospitals can preview the ratings in July.

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CMS

CMS predicts nearly all clinicians in advanced alternative payment models in 2016 would qualify for a 2019 incentive payment for participating in 2017.

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CMS

A new Centers for Medicare & Medicaid Services guide highlights technical resources for clinicians participating in the Quality Payment Program under MACRA.

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CMS

The nine-month program will link up to eight state Medicaid agencies with local housing systems to aid Medicaid beneficiaries.

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CMS

The first performance year for new cardiac episode payment models and the effective date of joint replacement regulation amendments now starts Jan. 1, 2018.

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CMS

The new checklist tool helps states compile the necessary documents to apply to waive ACA provisions and pursue alternative reforms.

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CMS

Clinicians enter their national provider identifier into the tool to determine whether they must submit data to the merit-based incentive payment system.

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CMS

The update for the 2018 performance year aligns electronic clinical quality measure specifications with current clinical guidelines and code systems.

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CMS

The study found that the penalty burden was greater in hospitals treating a high share of patients with socioeconomic disadvantages.

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CMS

Barriers to communication can be especially harmful for Medicare beneficiaries, who are more likely to have comorbidities and complex health needs.

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CMS

A vote on the bipartisan bill could come Wednesday in the House, followed by Senate consideration before continuing resolution appropriations expire Friday.

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CMS

CMS updated the Hospital Compare website with new data, including health care–associated infections and HCAHPS survey data.

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CMS

America’s Essential Hospitals expressed support of the delay of episode payment models to allow selected hospitals more time to prepare for participation.

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CMS

The rule would raise inpatient operating payment rates, revise Medicare DSH payment methodology, and apply a transitional methodology for HRRP penalties.

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CMS

The rule contains provisions on the Hospital Readmissions Reduction Program, Medicare DSH, the Inpatient Quality Reporting program, and more.

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CMS

Association calls the fiscal year 2018 Inpatient Prospective Payment System proposed rule a welcome first step toward broader recognition in federal health policy of challenges that affect the health of vulnerable patients.

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CMS

It requires Medicare payments for beneficiaries dually eligible for Medicaid, and other third-party payments be included in uncompensated care calculations.

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CMS

Over a five-year period, CMS will test the three-track AHC model, which aims to support health-related social needs of Medicare and Medicaid beneficiaries.

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CMS

Hospitals have until May 5 to review overall Hospital Compare star rating and until May 10 to review value-based purchasing hospital-specific reports.

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CMS

CMS finalizes the agency's interpretation that, in determining hospital-specific DSH payment limits, the total costs of care for Medicaid inpatient and outpatient services must account for all third-party payments.

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CMS

The delay, which applies to certain hospital outreach labs, comes after stakeholders expressed concerns about the March 31, 2017, deadline.

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CMS

The webinar and listening session, on April 4 and 5, will focus on MIPS' advancing care information performance category and cost measure development.

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CMS

The deadline for meeting all applicable requirements of the rule is Nov. 15; CMS will host a provider conference call on April 27 to review the rule.

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CMS

The rule affects the Advancing Care Through Episode Payment Models, the Cardiac Rehabilitation Payment model, and changes to the CJR model.

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CMS

Health care professionals who provide chronic care management services often are not aware they are eligible for separate payments under Medicare Part B.

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CMS

The letter affirms their desire to improve the Medicaid program and the vulnerable people it serves and to ensure the program provides value to taxpayers.

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CMS

The FAQs outline how hospitals should complete the form's free-text field and clarify that the form must be issued to Medicare Advantage enrollees.

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CMS

America's Essential Hospitals recognizes the new CMS administrator for her experience with health care for low-income and other vulnerable people and helping states tailor Medicaid to meet specific program and policy goals.

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CMS

America’s Essential Hospitals expressed concerns about proposed changes that could harm the integrity of qualified health plan networks.

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CMS

A series of forums will provide information on the Next Generation ACO Model; a separate CMS webinar will outline the Medicare ACO Track 1+ Model.

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CMS

The March 22 webinar will outline the agencies' roles in the expansion of the program model, next steps for organization considering offering it & more.

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CMS

Draft GOP text for legislation to repeal and replace the ACA leaks; a Senate committee is poised to vote on the administration's CMS administrator nominee.

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CMS

In a request for information, CMS seeks input on how to improve the quality and reduce the cost of care for children enrolled in Medicaid and CHIP.

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CMS

Hospitals will be required to provide the form and accompanying instructions to applicable Medicare patients starting March 8.

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CMS

CMS has pushed back by seven weeks, to June 21, the deadline for qualified health plans to apply to participate in the ACA health insurance marketplaces in 2018.

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CMS

The proposed rule aims to provide flexibility by targeting network adequacy reviews & inclusion of essential community providers in qualified health plans.

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CMS

The delay is in accordance with a “regulatory freeze” set forth in a recent White House memorandum.

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CMS

CMS has extended the deadline for submitting certain hospital quality data after receiving reports of system issues and inaccessibility with QualityNet.

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CMS

Former Rep. Tom Price was confirmed as secretary of HHS; the Senate Committee on Finance will consider the nomination of Seema Verma as CMS administrator.

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CMS

Eligible hospitals and professionals now have until March 13 to attest to the Medicare Electronic Health Record (EHR) Incentive Program.

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CMS

The new guidance outlines how and when hospitals must deliver the notice, retention requirements, and how the notices intersect with state laws.

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CMS

The 60-minute webinar on new episode payment models for cardiac care and surgical treatment for hip and femur fractures will begin at noon ET on Feb. 9.

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CMS

A memo instructs all executive departments and agencies to temporarily halt pending regulations until incoming department or agency heads can review them.

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CMS

Hospitals now have until March 13 — instead of Feb. 28 — to submit electronic clinical quality measure data from 2016 to CMS.

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CMS

Along with renewing ACOs, the 99 new organizations bring the total number of ACOs nationally to 480 in 2017.

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CMS

Jan. 18 rule finalizes additional restrictions proposed in November 2016 on the ability of states to increase or add new pass-through payments under Medicaid managed care plan contracts.

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CMS

The new Center for Medicare and Medicaid Innovation model aims to boost participation from small rural hospitals and other smaller health care practices.

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CMS

Hawaii is the first state to receive approval for a Section 1332 waiver, and will be allowed to close its Small Business Health Options Program for five years.

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CMS

CMS also expanded the Comprehensive Care for Joint Replacement (CJR) model to include surgical hip/femur fracture treatment.

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CMS

The changes, which reflect stakeholder feedback and the large volume of changes to ICD-10 in FY 2017, will be available on the National Library of Medicine’s Value Set Authority Center this month.

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CMS

New guidance describes how off-campus hospital provider-based departments can maintain their grandfathered status when relocating due to extraordinary circumstances.

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CMS

These new EPMs and the updated CJR model will give clinicians more opportunities to earn incentive payments through advanced alternative payment models.

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CMS

Of particular interest to essential hospitals, CMS revised the Worksheet S-10, which hospitals use to report uncompensated care data.

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CMS

A CMS spokesperson said the project was pulled after the agency reviewed public comments — there were more than 1,300 comments submitted, mostly negative.

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CMS

CMS will partner with up to six states on the new Medicare-Medicaid ACO Model, which was designed by the CMS Innovation Center.

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CMS

CMS on Dec. 19 refreshed its Hospital Compare site, including data on the Ambulatory Surgical Center Program, Hospital Readmission Reduction Program & more.

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CMS

The BBA’s “site neutral” policy creates serious, unintended consequences for vulnerable people, and CMS rules do not provide enough flexibility.

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CMS

All hospitals and critical access hospitals will be required to provide the MOON to applicable patients beginning March 8, 2017.

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CMS

Hospitals can request an exemption from the electronic clinical quality measure reporting requirement in the Hospital Inpatient Quality Reporting Program.

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CMS

The CMS FAQ answers questions about new regulatory requirements to ensure health care facilities are ready for disasters and public health emergencies.

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CMS

America's Essential Hospitals expressed continued concerns about qualified health plan network adequacy in federally facilitated marketplaces.

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CMS

Rep. Tom Price has been nominated to head HHS and Seema Verma, who graduated from the association's Fellows Program in 2001, has been nominated to lead CMS.

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CMS

America’s Essential Hospitals is pleased President-Elect Trump has made health care experience a priority in his choices for Secretary of Health and Human Services and administrator of the Centers for Medicare & Medicaid Services.

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CMS

The proposed rule would codify additional restrictions, first outlined in July 2016, on the ability of states to increase or add new pass-through payments under plan contracts.

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CMS

The agency released software that will help developers build applications for clinicians and their practices and make it easier for organizations to retrieve and maintain QPP measures using the Explore Measures section of the QPP website.

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CMS

The FAQ provides clarification on managed care contracts, rating periods, and external quality reviews, among other things.

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CMS

These long-term HCBS services and supports are critical to ensure people can remain in their homes and communities as they receive treatment.

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CMS

Under the rule, CMS would increase the OPPS payment rate by 1.65 percent and provide flexibility in the meaningful use of EHRs, among other things.

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CMS

Hosted by the Financial Interest Group, this webinar will help prepare your hospital to implement provisions of the MACRA final rule.

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CMS

CMS provides more flexibility than previously proposed, ensuring non-grandfathered, off-campus hospital outpatient departments will be reimbursed in 2017.

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CMS

It outlines factors stakeholders should focus on when designing alternative payment models, including type to propose, how to measure improvements, and more.

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CMS

CMS has awarded $347 million to the 16 organizations — including Premier Inc. — to support the next phase of a patient safety initiative.

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CMS

In the rule, CMS revised its earlier position not to direct any physician fee schedule payments to non-grandfathered, off-campus hospital clinics in 2017 and, instead, established a 50 percent interim rate.

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CMS

While the final rule provides some relief from onerous proposed payment policies, it continues to put underserved communities at risk of further declines in access to care, the association says.

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CMS

With the opportunities, clinicians potentially could earn a 5 percent incentive payment for a growing list of alternative payment models in 2017 and 2018.

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CMS

The targets aim to significantly reduce central line-associated bloodstream infections, MRSA, Clostridium difficile cases, and other infections by 2020.

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CMS

An Oct. 14 final rule establishes a new approach to physician payment required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA): the Quality Payment Program.

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CMS

The rule establishes a "transition year," as well as flexibility for providers to choose their participation pace.

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CMS

CMS says it miscalculated some hospitals' uncompensated care share and provided the incorrect wage index reclassification status of four hospitals.

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CMS

CMS will use social video platform Twitch, improve the HealthCare.gov mobile interface, and use #HealthyAdulting to encourage young adults to sign up.

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CMS

The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security numbers from beneficiaries’ Medicare cards by April 2019.

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CMS

The webinar will focus on the Advancing Care Coordination through Episode Payment Models proposed rule.

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CMS

A new policy brief by America's Essential Hospitals notes that managed care pathways might be a potential complement, or alternative, to waiver-based delivery system reform.

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CMS

In the final rule, CMS sets forth national requirements for Medicare and Medicaid participating providers and suppliers to ensure health care facilities are prepared during emergencies.

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CMS

While details are still being finalized, a continuing resolution to fund the government through early December likely will include funding to combat Zika.

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CMS

CMS Acting Administrator Andrew Slavitt announced the reporting options providers have to ensure they do not face a negative payment adjustment in 2019.

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CMS

The Accountable Health Communities Model aims to close a gap in the health care delivery system between clinical care and community services.

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CMS

The grants to support marketplace navigators come as exchanges gear up for the Nov. 1 start of open enrollment for coverage beginning in 2017.

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CMS

In a FAQ document, CMS states that the required JW modifier and patient documentation policy applies to separately payable Part B drugs.

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CMS

CMS is concerned that some providers might steer Medicare- and Medicaid-eligible patients into individual market plans to get higher payments.

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CMS

Review contractors will be able to use coding specificity as the reason for an audit or a denial of a claim to the extent that they did before Oct. 1, 2015.

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CMS

CMS encourages hospitals to view overall star ratings reports with inpatient and outpatient quality reporting preview data, while both are available.

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CMS

The rule addresses the controversial two-midnight policy, Medicare DSH, the Hospital-Acquired Condition Reduction Program, Value-Based Purchasing, and more.

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CMS

The rule includes the annual payment update to inpatient payment rates and changes to the Medicare disproportionate share hospital payment methodology.

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CMS

The advanced primary care medical home model is aimed at strengthening primary care and reducing overall health care costs.

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CMS

Model will test new episode payment models for acute myocardial infarction and coronary artery bypass graft, as well as expansion of the current CJR model.

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CMS

CMS will issue future rulemaking to further restrict new or increased pass-through payments under Medicaid managed care plan contracts.

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CMS

Several members of America’s Essential Hospitals are among the participants selected for the Million Hearts Cardiovascular Disease Risk Reduction Model.

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CMS

The release comes after America’s Essential Hospitals and other hospital groups urged CMS to delay the ratings due to serious concerns with the methodology.

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CMS

We are disappointed the Centers for Medicare & Medicaid Services (CMS) chose to publicly release overall hospital star ratings today, when so many questions remain about the data behind the ratings and their value to consumers.

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CMS

Under the models, hospitals would be financially accountable beginning July 1, 2017, for meeting quality and cost measures for the entire episode of care.

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CMS

The agency analyzed how subsets of hospitals, including those defined as a safety net, performed in the overall hospital star rating system.

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CMS

The actions build on the National Pain Strategy, a federally coordinated plan for reducing and better treating chronic pain.

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CMS

The proposed rule updates the payment rate for services provided in hospital outpatient departments and provisions relating to quality reporting.

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CMS

The proposed rule would implement Section 603 of the Bipartisan Budget Act, which reduced payments for new, off-campus hospital outpatient departments.

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CMS

Join us to hear CMS’ perspective on the finalized rule to modernize Medicaid and the Children’s Health Insurance Program managed care regulations.

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CMS

America’s Essential Hospitals and other hospital groups urge CMS to continue to delay the public release of overall hospital quality star ratings, arguing that the rating methodology is opaque and flawed.

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CMS

America's Essential Hospitals denounces the Centers for Medicare & Medicaid Services decision to limit flexibility and withhold hospital payments for new, off-campus hospital outpatient departments.

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CMS

Centers for Medicare & Medicaid Services' narrow interpretation of Section 603 of the Bipartisan Budget Act of 2015 threatens to reduce access to badly needed health care services in the nation's most underserved communities.

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CMS

Agency will use measure to calculate the proportion of adult patients with active, concurrent prescriptions for opioids or for an opioid and benzodiazepine at discharge.

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CMS

The agency says the proposed changes are intended to reduce a backlog of Medicare payment and coverage determination appeals.

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CMS

The new CMS rate development guide outlines various provisions of the recent Medicaid managed care final rule that affect the rate-setting process.

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CMS

This year’s release includes some changes in both the information released and its classification.

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CMS

Failure to follow the public notice and process for Medicaid payment changes can result in delay or disapproval of state plan amendments.

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CMS

The Senate rejected a $1.1 billion Zika funding package, and Patrick Conway, with CMS, testified about the proposed Medicare Part B demonstration project.

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CMS

The overall star rating hospital-specific reports will be available to hospitals for 30 days, starting from the June 22 reload date.

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CMS

By forming strategic partnerships and using social media, CMS aims to “reach young adults where they are” to facilitate engagement during open enrollment.

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CMS

The HAC reports might have contained the incorrect hospital name in one table. CMS will distribute new reports to affected hospitals.

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CMS

Providers have until July 1 to apply for a hardship exception to avoid a penalty for the Medicare EHR Incentive Program.

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CMS

CMS has delayed the effective date of a new claims coding and patient documentation policy for unused Medicare Part B drugs from July 1 to Jan. 1, 2017.

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CMS

The new rule aims to help more accountable care organizations successfully participate in the Medicare Shared Savings Program.

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CMS

CMS has released a no-cost resource to help patients access care after signing up for coverage on the health insurance marketplaces.

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Hospitals have until June 4 to preview reports on overall Medicare star ratings, which will be publicly posted to Hospital Compare in July.

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CMS

Association supports bill, which would add needed risk adjustment to the Medicare Hospital Readmissions Reduction Program and provide some relief for recent cuts to off-campus hospital outpatient department payments.

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CMS

Delay of patient status reviews will continue until further notice. The agency will work with Quality Improvement Organizations to ensure the two-midnight policy is enforced consistently for all hospitals.

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CMS

The proposed rule includes key provisions for carrying out a new physician payment system to replace Medicare's sustainable growth rate updates.

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CMS

The new provisions include updated sprinkler requirements and increased flexibility to allow for facility modernization. Hospitals and other health care facilities must comply with the regulations by July 3.

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CMS

CMS stands by its decision to prohibit states from directing payments under managed care, but responds to association concerns by adding flexibility to the policy.

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CMS

The rule maintains a prohibition against direct payments by states to providers for services delivered under managed care contracts and explicitly prohibits states from directing plan expenditures.

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CMS

America's Essential Hospitals responds to the final rule on Medicaid managed care plans, including its 10-year transition to a prohibition on states making pass-through payments to providers through health plans.

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America's Essential Hospitals statement on the Centers for Medicare & Medicaid Services' decision to delay the release of overall hospital star ratings.

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CMS

The release marks the first time CMS has provided MA beneficiary experience data stratified by race and ethnicity.

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CMS

The proposal would reverse the cut starting in FY 2017, in addition to a temporary adjustment to retroactively pay for reduced payments from fiscal years 2014 to 2016.

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CMS

Responding to hospital and other stakeholder concerns, CMS says the delay will allow a greater opportunity to fully understand the impact of the final star ratings methodology.

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CMS

Changes will more accurately reflect cost of care for dual eligibles and adjust Medicare Advantage star ratings for enrollees' socioeconomic and disability statuses.

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CMS

States now have until Oct. 1 to submit plans. Agency continues to omit hospital services from the list of core services subject to review.

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Special Innovation Project grants will be awarded to 28 partnerships with QIN-QIOs to support and scale quality improvement projects. Projects should aim to provide Medicare beneficiaries with better care, better health, and greater value.

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In letter to CMS, association raises issues of payment, definition of off-campus outpatient department of a provider, and 340B eligibility.

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In comments to CMS, America's Essential Hospitals argues for a delay to re-evaluate ratings methodology changes and the potential to disproportionately disadvantage essential hospitals.

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Under new model, providers will screen Medicare and Medicaid beneficiaries for unmet social needs and connect patients to community services. Applications are due May 18.

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CMS

Proposed Medicaid managed care regulations effectively would end supplemental payments that have been in effect for at least a generation to many essential hospitals.

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CMS

HHS finalizes 2017 Notice of Payment and Benefit Parameters rule and letter to issuers offering qualified health plans on the federally facilitated marketplace.

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CMS

Hospitals, providers can claim exclusions for public health meaningful use measures to avoid inadvertent penalties from the 2015 EHR Incentive Program final rule.

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CMS

Final rule and implementation as described in the guidance could significantly reduce Medicaid payments for 340B-covered outpatient drugs in some states.

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CMS

Agency's decision to extend deadline to July 1 gives eligible hospitals an additional three months to file for an exception.

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CMS

Guidance on the new sepsis measure (SEP-1) is now available on QualityNet, including what documentation can be used for data elements in the chart-abstracted measure.

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CMS

Eligible hospitals now have until March 11 to show meaningful use of EHR technology or face a Medicare payment adjustment in 2017.

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CMS

New clinical quality measure sets for physicians were created in collaboration with stakeholders to increase multipayer alignment, while reducing cost and administrative burden. The core measure sets will inform the implementation of MACRA.

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CMS

Providers now must report and return a Medicare Part A or B overpayment to CMS by the later date of 60 days since identification or the corresponding cost report due date. The final rule also establishes a six-year lookback period.

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CMS

The new FAQ clarify that site neutral law won't impact PO modifier requirements. PO modifiers must be included on claims as of Jan. 1 for all services and items furnished in off-campus, provider-based departments.

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CMS

Now-voluntary OAS CAHPS will measure patient experience of care in Medicare-certified hospital outpatient departments and ASCs. The first public reporting of data is not expected until 2018.

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CMS

The guide focuses on reducing readmissions for racial and ethnic minority groups and is part of the CMS Equity Plan for Improving Quality in Medicare.

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CMS

New, streamlined process requires less information from hospitals for application; deadline to apply is April 1.

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CMS

Previews of reports, to be published online in April, available now through QualityNet Secure Portal; final methodology includes 60 measures from inpatient and outpatient quality reporting programs.

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CMS

Agency collaborates with CMS to offer technical assistance to hospitals working on quality improvement projects for children in Medicaid and the Children’s Health Insurance Program.

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CMS

Educational surveys to help CMS determine best ways to assess infection control regulations for hospitals, nursing homes, and care transitions. Surveys to begin in FY 2016 for nursing homes and in FY 2017 for hospitals.

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CMS

Agencies seek information on quality reporting to help reduce the burden on eligible hospitals and providers; comments are due Feb. 1.

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CMS

Accountable Health Communities to test whether clinical and community-based services alignment can improve care quality and affordability. CMS offers webinars on grant application process; letters of intent are due Feb. 8.

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CMS

CMS now able to grant categorical exceptions to essential providers and hospitals that did not meet 2015 requirements; hospital applications due April 1.

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CMS

Association generally supports move toward patient-centered care, but urges CMS to ensure provisions do not place an administrative burden on hospitals.

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CMS

America's Essential Hospitals urges CMS to include hospital services among those subject to triennial state reviews to determine whether payments ensure adequate access.

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CMS

Agency to give hospitals opportunity to comment on law's requirements for notifying Medicare beneficiaries when outpatient observation services last longer than 24 hours.

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CMS

Guidance builds on 2012 final regulations that outline the process for submission and review of section 1332 waivers, which may begin as early as Jan. 1, 2017.

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CMS

Hospital performance data for FY 2016 available on Hospital Compare; hospitals in bottom quartile face 1 percent Medicare payment cut.

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CMS

CMS website includes information on changes to Medicare and Medicaid EHR Incentive Programs in recent final rule.

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CMS

Court-ordered justification provides additional insight for 0.2 percent inpatient payment rates cut agency linked to policy

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CMS

Join us to review our 2015 federal legislative and regulatory action and preview our 2016 advocacy agenda.

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CMS

Essential hospitals 2.67 times more likely than other hospitals to receive penalties under Medicare readmissions program in FY 2016

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CMS

Agency to host Nov. 30 webinar to provide information and answer questions about the bundled payment model for hip and knee replacement.

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CMS

Hospitals paid under IPPS in 67 metropolitan statistical areas will be required to participate in new payment model starting in April 2016

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CMS

Fourth cycle of grants through the Connecting Kids to Coverage program supports work to link eligible children with Medicaid, CHIP coverage; proposals due Jan. 20, 2016.

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CMS

In three FAQs, agency provides guidance on how to attest to health information exchange and patient electronic access measures, as well as objectives that require patient action.

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CMS

Rule for Medicaid FFS omits hospitals from the list of services for which a state must evaluate access. Comments on rule due Jan. 4.

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CMS

Changes include reducing OPPS payment by 0.3 percent, relaxing two-midnight policy requirements, and updating OQR measures.

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CMS

Tool gives physicians, nurses, and other health care professionals access to geographic comparisons of opioid prescribing habits and use.

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CMS

Changes for hospitals participating in Medicare and Medicaid intended to improve patient communication, outcomes; comments due Jan. 4.

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CMS

Federal grants to 24 states will promote better integration of behavioral health and primary care services and improve quality and data reporting systems. The grants are the first phase of a Section 223 Demonstration Program for Certified Community Behavioral Health Clinics.

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CMS

Feedback due Nov. 17 on provisions to implement MIPS and APM participation incentives; MIPS quality measures of particular interest to hospitals

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CMS

Oct. 20 call to discuss dry run quality report for inpatient rehabilitation facilities based on the all-cause unplanned readmission measure

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CMS

Just added: CMS contacts for provider questions. Explore fact sheets, videos, other information available to help ease Oct. 1 transition to new coding system

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CMS

Agencies say anecdotal reports of intentional nonreporting of infection data have prompted them to emphasize the importance of accurate reporting through strict adherence to NHSN definitions.

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CMS

Updates cover exclusions for submitting electronic immunization data and applicability of submitting summary of care documents for transferring patients.

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CMS

Recent narrowing of provider networks in Medicare Advantage (MA) organizations, which privately offer one or more health benefit plans to Medicare beneficiaries, has caused concerns over whether MA enrollees can adequately access care.

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CMS

New data brief from Essential Hospitals Institute investigates which hospital characteristics are linked with lower CMS star ratings and finds that large, urban, teaching hospitals tend to receive lower star ratings.

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CMS

Association calls on CMS to consider the readiness of essential hospitals and challenges of caring for the vulnerable, and risk-adjust for SDS, in finalizing its proposed rule for new CCJR payment model.

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CMS

The CMS Equity Plan aims to reduce disparities in health care over the next four years for populations including racial and ethnic minorities, sexual and gender minorities, people with disabilities, and people living in rural areas.

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CMS

In comments on the CY 2016 OPPS proposed rule, the association calls on CMS to consider the unique challenges of caring for the most vulnerable, including in relation to the two-midnight policy and ambulatory payment classification.

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CMS

CMS is proposing to risk adjust stroke mortality measures for stroke severity, which is a positive step. But measures should also account for sociodemographic factors that complicate care for vulnerable patients.

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CMS

Comments call on CMS to ensure ratings are meaningful and accurate, avoid consumer confusion, and reflect vulnerable patients' socioeconomic and demographic circumstances.

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CMS
CMS

Extension to Aug. 28 applies only to quality reporting on health care-associated infections (HAIs), not clinical data submissions through QualityNet.

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CMS

Agency resource, in preparation for Oct. 1 transition to ICD-10, can help providers determine how to accurately report codes.

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CMS

Updated guidance clarifies what codes will be accepted by CMS during one-year grace period, including examples of a code family.

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CMS

Hospitals in the overall quality rating system dry run can provide feedback until Aug. 17 and weigh in during the Aug. 13 call.

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CMS

Plans must be budget-neutral and cover as many people as traditional ACA reforms. With these waivers, states may forgo certain ACA provisions including the marketplaces and individual mandate.

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CMS

America's Essential Hospitals urges Senate to quickly confirm Slavitt as CMS administrator.

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CMS

Agency says that for one year it will not deny inaccurate claims as long as the code listed is from the correct code family.

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CMS

Join us to learn more about the ICD-10 coding system, how the transition will impact your hospital, and what you can do to prepare.

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CMS

In comments to CMS, America's Essential Hospitals also urged the agency to finalize a 90-day reporting period for all providers in 2015 and lower the threshold of the patient electronic access measure.

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CMS

UHS staff discussed how DSRIP-supported improvement projects have impacted patient care and quality outcomes.

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CMS

In comments on the agency’s proposals for stage 3 of the EHR Incentive Programs, the association called on CMS to delay finalizing the proposed rule and to provide much-needed flexibility for providers in the program.

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CMS

The funding opportunity will support navigators for up to three years in federally facilitated and state partnership health insurance marketplaces.

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CMS

CMS proposes to extend an enhanced matching rate to states to help modernize and update their Medicaid eligibility and enrollment systems.

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CMS

Learn more about Medicaid waivers being implemented across the country and their implications for essential hospitals.

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CMS

The Oncology Care Model is a multipayer payment and care delivery model designed to encourage high quality cancer care.

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CMS

A district court has granted a preliminary injunction restricting HHS and CMS from altering the hospital-specific DSH limit without following notice-and-comment procedures.

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CMS

CMS returns to a pre-2008 definition of uninsured that includes whether a patient is covered for a particular service, among other changes.

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CMS
CMS

The association advocates for a modification of the direct pay prohibition to allow states to pursue public policy goals while implementing Medicaid Managed Care

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CMS

Hospitals will be chosen for pre and postpayment audits at random or through a risk profile. CMS encourages hospitals to keep data for six years.

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CMS

OIG finds state standards for access to care for Medicaid managed care beneficiaries vary widely. OIG recommends stronger CMS oversight and more state accountability.

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CMS

Hear members of our policy team discuss the association's recently released brief on innovative alternative payment models. These models focus on ways to replace or augment existing fee-for-service and managed care models, while also increasing efficiency, coordination, and quality of care.

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CMS

Hospitals willing to resolve pending appeals will receive a timely, partial payment equal to 68 percent of the net payable amount. Provider call scheduled for Sept. 9.

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CMS

Data collection for a chart-abstracted sepsis measure is delayed until further notice based on an NQF recommendation.

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CMS

CMS is compiling three TEPs to provide technical input to CMS contractors on the development, selection, and maintenance of quality measures. Nominations are due Sept. 12 and Sept. 19.

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CMS

Models should use evidence-based social and behavioral insights to increase engagement in health outcomes for Medicare beneficiaries, Medicaid beneficiaries, dual-eligible patients, and/or Children’s Health Insurance Program (CHIP) beneficiaries.

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CMS

GAO released a report recommending that CMS increase oversight of the Medicare claims review process and release additional guidance for contractors to increase efficiency and reduce duplicative claim reviews.

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CMS

The House and Senate head into August recess after voting to clear a VA assistance bill, sending it to the president on Friday. The Senate couldn't pass border emergency supplemental legislation, while the House passed a less expensive version. CMS faced tough criticism from Republicans about HealthCare.gov contractors.

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CMS

CMS issued a final rule establishing Oct. 1, 2015 as the transition date to International Classification of Diseases, 10th Edition (ICD-10) diagnosis and procedure codes. The Protecting Access to Medicare Act of 2014 required at least a one-year delay of this transition date, previously set for Oct. 1, 2014.

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CMS

The guidance could subject certain assessments on Medicaid managed care organizations to provider tax rules. CMS will allow a state until the end of its next regular legislative session to make changes that comply with the guidance.

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CMS

CMS awarded contracts to 14 organizations as part of the restructuring of the Quality Improvement Organization (QIO) Program. These organizations will work with providers to increase quality of care.

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CMS

Thirteen states received letters stating that enrollment and eligibility issues must be addressed.

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CMS

CMS seeks perspectives on strengths and weaknesses of the program and processes surrounding data accuracy.

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CMS

CMS outlines three methods for reviewing enrollee coverage eligibility for insurance purchased through the federally facilitated marketplace.

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CMS

GAO released a report on the integrity of Medicaid managed care programs, detailing recommendations for CMS. The report identified potential gaps and duplication of program integrity efforts and listed recommendations, including additional oversight.

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CMS

HHS announced recipients of Health Care Innovation Awards and a call for applications for the State Innovation Models Initiative. These programs were created through the Affordable Care Act to give stakeholders and states tools and flexibility to transform health care delivery system models.

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CMS

CMS finalized its proposal to rescind the requirement that a hospital's governing body include a member of the medical staff and revised its position that each hospital, including those in a multihospital system, have a separate and distinct medical staff. America's Essential Hospitals urged CMS to take both of these actions.

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CMS

America’s Essential Hospitals would like to hear from its members on their experiences and difficulties with stages 1 and 2 so that we can convey any concerns to CMS and the HIT Policy Committee as they finalize stage 3 recommendations.

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CMS

CMS will release an interim final rule requiring the use of ICD-10 beginning Oct. 1, 2015. The rule will require the continued use of ICD-9, Clinical Modification, through Sept. 30, 2015. The Protecting Access to Medicare Act of 2014 forbade CMS from adopting ICD-10 prior to Oct. 1, 2015, which is one year after CMS originally planned to implement it.

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CMS

CMS released the final rule with comment period regarding the new Medicare FQHC prospective payment system. The payment system could increase Medicare payments to FQHCs by as much as 32 percent.

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CMS

It provides information to help states prepare for the end of the transition period established in 2008. CMS specifically outlines the requirements independent auditors must follow when conducting annual DSH audits, as well as information to help states calculate uncompensated care costs.

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CMS

CMS is allowing consumers to enroll in the federally facilitated marketplace under a special enrollment period if they experienced life changes, exceptional circumstances, or technical problems with healthcare.gov. Coverage will be effective for 2014. HHS reported that 7.1 million people enrolled in health insurance through the marketplaces before the March 31 open enrollment deadline.

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CMS

A new FAQ is available on the patient electronic access objective. Updated FAQs provide information on the summary of care objective and AIU attestation.

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CMS

Providers interested in participating in an ACO through the MSSP must submit a notice of intent to CMS by May 30 and a final application to CMS by July 31.

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CMS

This week the longest serving member of Congress, Rep. John Dingell, announced he will retire. Dingell served for 29 terms and through 11 different presidents. The House Energy and Commerce Committee will look at the changes CMS is making to Medicare Part D, and House Majority Leader Eric Cantor announced that the chamber would vote on the ACA's 30-hour work week definition.

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CMS

Inpatient population and sampling data for chart-abstracted quality measures for the third quarter of 2013 (discharges from July 1 through Sept. 30, 2013) will be due Feb. 8 for the IQR Program. Outpatient population and sampling data and outpatient chart-abstracted measures will be due Feb. 8 for the OQR Program.

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CMS

The Centers for Medicare & Medicaid Services (CMS) hosted today a follow-up Special Open Door Forum on the two-midnight policy. The call discussed physician order and physician certification, inpatient hospital admission, and medical review criteria.

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CMS

ACOs allow hospitals, health care providers to improve quality, slow cost growth through coordinated care while sharing in savings

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CMS

Codes provide data that help improve care, can be exchanged with health care systems across the world

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CMS

The report found that all states varied Medicaid provider payment rates for some services

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The new office will take over several functions of the abolished Office of Public Engagement

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Letter underscores necessity for more time for CMS to assess policy's impact on patients, hospitals

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CMS

Call will cover inpatient hospital admission, medical review criteria and offer case scenarios

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CMS

Fact sheets, database available through healthcare.gov

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CMS

Rule proposes national emergency preparedness requirements for health care facilities

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CMS

Will provide high-quality, coordinated care to about 1.5 million Medicare beneficiaries

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CMS

Policy and legislative experts discussed the proposed rule and implications for essential hospitals

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CMS

MACPAC commissioners voted to increase standardization and transparency around UPL payments.

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CMS

Hospitals will have through FY 2016 to meet Stage 2 requirements

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CMS

States expanding their Medicaid programs saw a 15.5 percent increase in applications

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CMS

The rule replaces outpatient visit codes with a single code describing all clinic visits

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CMS

The rule reduces Medicare rates by 20.1 percent

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CMS

Revised policy presumes inpatient admissions fewer than two midnights are inappropriate for inpatient reimbursement

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CMS

Standards, implementation specifications, and certification criteria for stage 1

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CMS

The final rule modifies stage 1 meaningful use criteria for hospitals and eligible professionals

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CMS

The ONC policy committee requested comments regarding stage 3 Meaningful Use criteria

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CMS

The CoP set standards for health and safety, aim to improve health care quality and the safety of beneficiaries

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CMS

The Affordable Care Act expanded the RAC program to Medicaid

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CMS

This rule clarifies several provisions related to the cost limit for public providers

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CMS

Expressed concern that several provisions could challenge the ability of FQHCs to integrate care and address patient needs

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CMS

Congress holds healthcare.gov hearings, planned vote on "Keep Your Health Plan" Act

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CMS

Guidance extends the existing enforcement delay by three months

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CMS

Hospitals were urged to attest that they have meaningfully used certified EHR technology

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CMS

The agency's quality strategy aligns the agency’s goals with the National Quality Strategy’s six priorities.

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CMS

CMS updates earlier guidance, CCIIO addresses third-party payments of premiums for individuals covered by QHPs

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CMS

Offered direction on how to select hospital claims during inpatient probe and educate program

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CMS

Senate Democrats pressured Obama administration to fix healthcare.gov, SGR agreement gained support

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CMS

Congress holds healthcare.gov hearings, committee met on budget agreement

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CMS

The final rule was delayed due to the partial government shutdown

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CMS

The rule finalizes a number of provisions regarding health insurance marketplaces

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CMS

Guidance focuses on CAC organizations in federally facilitated marketplaces

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Rule establishes presumption of medical need for Medicare hospital inpatient admissions that span two midnights

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CMS

Cited concerns that hospitals may be undercompensated for providing necessary services that do not meet new criteria

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CMS

Proposed rule establishes framework for several program elements

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CMS

House abandoned plans to vote on a bill to extend the continuing resolution

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CMS

Rule outlines CMS' methodology for annual reductions to DSH payments

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CMS

Suggests CMS convene hospital industry work group to better understand off-campus outpatient care

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CMS

Talk focused on insurance coverage expansion activities and impact on essential hospitals

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CMS

Office urges action to ensure contractors identify, report improper payments and potential fraud

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CMS

Documents provide answers on coverage and enrollment

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CMS

Agency provides methodological considerations, questions for states to address in program proposals

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CMS

Report evaluates differences among four types of postpayment review contractors CMS uses

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CMS

Programs will replace payment error rate measurement reviews, eligibility quality control program

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Extension applies to data submitted to Medicare inpatient quality reporting program

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CMS

Will take comment on physician order and certification, medical review criteria, and other issues

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CMS

Tool uses 2011 Medicare cost data aggregated by demographic, spending, utilization, quality indicators

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CMS

Effort will seek to increase understanding of low-income and minority populations’ experiences with exchanges

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CMS

Document, released as frequently asked questions, indicates exchanges will use tax filings and Social Security data

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Hospital inpatient quality reporting program intended to provide consumers with quality of care information

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CMS

Rule finalizes several inpatient prospective payment system provisions

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CMS

Rule also finalizes use of Medicaid and low-income Medicare inpatient days as uncompensated care proxy

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CMS

Responds to CMS concern that Medicare and beneficiaries might pay more for outpatient care

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CMS

Hospitals may review and request correction of performance scores

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Document explores care delivery and payment models that help states care for challenging patients

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CMS

CMS says all 32 pioneer ACOs improved quality, performed better than published rates in fee-for-service Medicare

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CMS

Rule proposes several outpatient prospective payment system provisions

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CMS

Agency seeks to understand type and frequency of, and payment for, services furnished in off-campus outpatient departments

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CMS

Association urges CMS to accurately capture uncompensated care data to implement Medicare DSH cuts

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CMS

Will support demonstration ombudsman programs to provide Medicare-Medicaid enrollees with more person-centered, coordinated care

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CMS

Agency accepts applications for Model 1 bundled payment initiative

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CMS

Calculation will determine reduction to each state's DSH allotment for FYs 2014 and 2015

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CMS

Rule proposes implementation of the Affordable Care Act's Medicaid DSH cuts

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CMS

Notes new administrator's distinguished career in health care, experience with hospitals and health systems

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CMS

Renews call for Congress to delay Medicaid DSH cuts to allow time for informed, rational funding discussions

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CMS

Says data release lacks proper context consumers need to make informed decisions about care

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Rule includes proposed formula to make Medicare DSH reductions under ACA

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CMS

Rule proposes several inpatient prospective payment system provisions

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CMS

Letter offers issuers operational and technical guidance on how to successfully participate

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CMS

Agency also releases FAQ on state-supplied premium assistance option

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CMS

Letter to state Medicaid directors details federal-state efforts to strengthen program integrity

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CMS

Lawmakers turn back governor's plan to accept expansion for three years

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CMS

Most health care spending outside of Medicare and Medicaid was subject to cuts

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CMS

Document addresses questions about federal medical assistance percentages

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CMS

Commends president for commitment to "stable leadership" for programs that provide access to essential care services

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CMS

Rule continues agency's 2012 efforts to reform hospital conditions of participation

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Urges CMS to keep nation's safety net in mind as agency fine tunes marketplace framework

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Says agency guidance follows "letter and spirit of the law" and takes step toward significantly reducing uninsured

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About America’s Essential Hospitals

America’s Essential Hospitals is the leading association and champion for hospitals and health systems dedicated to high-quality care for all, including the most vulnerable. Since 1981, America’s Essential Hospitals has initiated, advanced, and preserved programs and policies that help these hospitals ensure access to care. We support members with advocacy, policy development, research, and education.