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Medicare

The proposed rule increases flexibility for Medicare Advantage plans and implements the Comprehensive Addiction and Recovery Act of 2016.

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Medicare

The guidance specifies rate reductions in Medicaid fee-for-service that will not require access reviews by the Center for Medicare & Medicaid Services.

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Medicare

In response to the request for information, the association encouraged flexibility and a focus on hospitals treating high numbers of complex patients.

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Medicare

Final regulations for Medicare physician payments will increase merit-based payments to account for complex patients, allow physicians to participate in virtual groups, adjust the threshold for defining low-volume practices, and make numerous other changes.

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Medicare

The Quality Payment Program combines and replaces three separate clinician quality programs with a single system for clinicians that bill Medicare Part B.

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Medicare

The rule includes additional cuts to new off-campus, provider-based departments (PBDs), as well as physician payment and quality program changes.

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Medicare

The final rule puts expansion of services further out of reach for underserved communities and threatens access to care where access is needed most.

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Medicare

The rule cuts 340B Drug Pricing Program payments by $1.6 billion and requires hospitals to use modifiers to identify 340B drugs in Medicare claims.

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Medicare

The CHAMPIONING HEALTHY KIDS Act extends Children's Health Insurance Program funding for five years and delays cuts to Medicaid disproportionate share hospital payments for two years.

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Medicare

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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Medicare

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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Medicare

The meeting came a day after the association submitted comments to the agency in response to the proposed annual update of the Hospital Outpatient Prospective Payment System.

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Medicare

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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Medicare

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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Medicare

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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Medicare

Communities rely on essential hospitals for trauma and other lifesaving care, physician training, emergency response, and other vital services. Essential hospitals, in turn, rely on policymakers for support to keep these services available to all. Learn more about this careful balance.

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Medicare

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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Medicare

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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Medicare

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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Medicare

The Medicare Physician Fee Schedule proposed rule for calendar year 2018 includes physician payment and quality program changes.

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Medicare

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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Medicare

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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Medicare

A study finds hospitals penalized more often in the Hospital Readmissions Reduction Program's first years — including safety-net hospitals — were more likely to be penalized all five years.

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Medicare

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

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Medicare

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

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Medicare

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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Medicare

The Medicare Payment Advisory Commission's annual report examines various issues in the Medicare payment system and offers recommendations to Congress.

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Medicare

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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Medicare

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

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Medicare

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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Medicare

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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Medicare

Senate Republicans stay focused on a strategy to repeal and replace the ACA; committees hold hearings on public health, Medicare, and chronic conditions.

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Medicare

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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Medicare

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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Medicare

Hospital participation in Medicare value-based programs in 2015, including ACOs and bundled payments, was associated with 2,377 fewer readmissions and $32.7 million in savings.

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Medicare

The agency estimates that MA organization payment rates will increase by 0.45 percent on average in 2018, with an expected average revenue increase of 2.95 percent when accounting for coding changes.

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Medicare

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

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Medicare

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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Medicare

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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Medicare

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

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Medicare

CMS projects that Medicare Advantage organization payment rates will increase by 0.25 percent in 2018.

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Medicare

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

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Medicare

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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Medicare

The report is the last in a series of five by an ad hoc committee focused on social risk factors that affect the health outcomes of Medicare beneficiaries.

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Medicare

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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Medicare

OIG found that the federal portion of spending on catastrophic coverage reached $33.2 billion in 2015, compared with $10.8 billion in 2010.

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Medicare

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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Medicare

The report finds that dual enrollment status was “the most powerful predictor of poor outcomes” on many quality measures.

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Medicare

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

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Medicare

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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Medicare

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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Medicare

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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Medicare

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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Medicare

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

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Medicare

This is the fourth of five reports from an ad hoc committee to identify social risk factors affecting health outcomes of Medicare beneficiaries.

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Medicare

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

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Medicare

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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Medicare

In May, CMS paused initial patient status reviews to ensure reviews are performed consistently and the two-midnight policy is properly applied.

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Medicare

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

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Medicare

Congress seems likely to pass a continuing resolution to fund the government beyond Sept. 30. Lawmakers also are expected to approve funding to combat Zika.

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Medicare

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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Medicare

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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Medicare

Medicare Part D spending increased 17 percent, outpacing overall prescription drug spending increases, according to CMS data.

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Medicare

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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Medicare

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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Medicare

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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Medicare

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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Medicare

The report aims to identify social risk factors that affect beneficiaries' health outcomes and methods to account for these factors in payment programs.

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Medicare

The rule, released July 7, updates physician payment rates for Medicare services and makes changes to physician quality programs.

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Medicare

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

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Medicare

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

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Medicare

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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Medicare

The updates aim to reduce incidence of infections, inappropriate use of antibiotics, and discriminatory behavior by health care providers.

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Medicare

America's Essential Hospitals gave feedback on Medicare DSH payments, payments associated with the two-midnight policy, and quality reporting programs.

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Medicare

Senate appropriators pass HHS spending bill that includes 340B Drug Pricing Program user fee and instructions to HRSA to consider stakeholder input in final mega-guidance.

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Medicare

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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Medicare

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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Medicare

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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Medicare

The House and Senate are expected to vote on Zika spending. In other activity, opioid measure are set to go to conference and committees review Part B payment model and tax-related health proposals.

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Medicare

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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Medicare

The House is expected to vote on several opioid-related measures, and 19 House Democrats sent CMS a letter of support for the Medicare Part B demonstration to reduce drug costs.

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Medicare

The Comprehensive Primary Care Plus model will encourage primary care practices to transform care delivery, including by increasing care management and coordination.

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Medicare

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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Medicare

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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Medicare

A 2015 budget law that creates site-neutral payment for off-campus hospital outpatient departments does not directly affect 340B Drug Pricing Program eligibility, but changes to how hospitals report Medicare costs does raise concerns.

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Medicare

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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Medicare

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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Medicare

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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Medicare

Tool, developed by association member University of Chicago, shows geographic disparities in health outcomes, health care use, and health care spending.

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Medicare

Department calls for interagency approach that employs alternative payment models and better communication between patients and providers.

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Medicare

March 8 proposed rule details two approaches agency will test to encourage prescribing of lower-cost medications: reimbursement rate adjustments and value-based purchasing.

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Medicare

Conservative Freedom Caucus opposes GOP budget plan; Senate-passed bill would combat opioid abuse; health committees work on mental health, Medicare improvement.

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Medicare

Essential hospitals rely on Medicare as a vital funding source for about a quarter of their patients. But funding shortfalls and regulatory changes that would further undermine the program put vulnerable patients at risk.

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Medicare

Association responds to House lawmakers' request for comment on Medicare's new payment policy for off-campus hospital outpatient departments. Congress works on FY 2017 budget, holds hearings on Zika virus and opiod abuse.

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Medicare

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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Medicare

Partisan politics follow Scalia death; House speaker to table entitlement reform until next year; congressional panels to hold hearings on HHS budget, opiod abuse, Zika virus.

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Medicare

America's Essential Hospitals welcomes proposals on Medicaid access and coverage, mental health, and others, but says proposed funding cuts would undermine work of essential hospitals.

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Medicare

State hospital association says risk adjusting CMS readmissions methodology results in significantly less variation in measured quality differences among hospitals.

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Medicare

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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Medicare

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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Medicare

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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Medicare

First of five consensus reports from National Academy of Medicine (NAM) ad hoc committee identifies social risk factors for Medicare payment and quality programs, and the measures they can impact.

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Medicare

Association expresses deep disappointment with Medicare Payment Advisory Commission (MedPAC) recommendation to cut Medicare Part B reimbursement to hospitals in the 340B Drug Pricing Program.

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Medicare

House and Senate lawmakers negotiate omnibus appropriations bill and two-year extension of tax cuts, but fail to provide relief on new Medicare site-neutral payment policy for hospital outpatient departments.

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Medicare

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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Medicare

Eligible hospitals have until Dec. 31 to submit data through QualityNet for the Inpatient Quality Reporting and Medicare Electronic Health Record Incentive programs.

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Medicare

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

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Medicare

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

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Medicare

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

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Medicare

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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Medicare

CMS released a new resource clarifying when ICD-9 and ICD-10 codes are required. Claims submitted on Oct. 1 or later but with dates of service prior to Oct. 1 require ICD-9 codes, not ICD-10.

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Medicare

The rule finalizes proposals from the stage 3 proposed rule and the proposed rule modifying the programs from 2015 to 2017. Changes include a 90-day reporting period, fewer hospital objectives, and a lower threshold for patient electronic access.

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Medicare

These findings come from GAO, which also found that essential hospitals narrowed this gap over the study, overall performance during VBP's initial years didn't change, and bonuses and penalties were less than 0.5 percent of Medicare payments per year.

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Medicare

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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Medicare

CMS requests feedback on a range of provisions relating to MIPS and incentives for participation in APMs, including whether to stratify quality measure data by demographic factors.

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Medicare

CMS has tested its systems and is prepared to assist providers as problems arise. Providers should first contact their MAC for Medicare claims questions or subsequently email the ICD-10 Coordination Center or the ICD-10 ombudsman.

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Medicare

In a legal victory for hospitals, a district court said CMS did not meet legal requirements for rulemaking when it cut hospital inpatient payments by 0.2 percent in FY 2014. The court ordered CMS to reissue the FY 2014 IPPS rule.

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Medicare

The webinars will feature representatives from CMS answering questions about the model. Instructions on how to submit questions will be included in the registration confirmation email.

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Medicare

CMS has extended the deadline for the Million Hearts: CVD Risk Reduction Model due to high interest. The model will incentivize providers to target Medicare beneficiaries with the highest risk of CVD for patient-centered care.

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Medicare

Planned Parenthood remains an issue in government funding. Congress considers hospital bills, Medicare Part B premiums, medical innovation, health care competition, and Medicaid fraud and abuse, vows to focus on mental health.

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Medicare

This conference call will cover major policies included in the IPPS and LTCH PPS final rule, including quality initiatives. Question and answer period to follow presentation.

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Medicare

The Million Hearts: CVD Risk Reduction Model will incentivize providers to calculate CVD risk for Medicare beneficiaries and target those with the highest risk for patient-centered care.

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Medicare

RACs will not conduct postpayment reviews of patient status for Medicare claims with an inpatient admission between Oct. 1 and Dec. 31, 2015.

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Medicare

NOTICE Act seeks to educate patients about impact of observation status, including on cost-sharing and skilled nursing facility eligibility.

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Medicare

As we mark 50 years of Medicaid and Medicare, we reflect on the experiences of others within and beyond the four walls of essential hospitals.

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Medicare

New edition of Walls Down coincides with 50th anniversary of Medicaid and Medicare, spotlights value of coverage to access and health.

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Medicare

Sen. Grassley requested a hearing on recent 340B GAO report. House calls and clinical trials for Medicare patients each pass one chamber. Committees review Medicare hospital payments, HIT, and marketplaces.

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Medicare

Proposed rule would update physician payment rates for Medicare services, change physician quality programs, and solicit comment on MACRA requirements.

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Medicare
Medicare
Medicare

Interactive map tracks real-time weather along with locations of Medicare patients who rely on electrically powered medical equipment.

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Medicare

CBO also found that if a full ACA repeal took effect on Jan. 1, 2016, the federal deficit would increase by $137 billion between 2016 and 2025.

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Medicare

The House will vote to repeal two major ACA provisions this week - medical device tax and the IPAB - and consider four Medicare Advantage bills. Health committees are reviewing mental health and HIT.

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Medicare

The agency also finalized a new risk/reward model that offers a greater share of savings for providers who take on more financial risk.

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Medicare

Topics include Medicare Advantage, the ACA's medical device tax, Medicaid fraud and abuse, and the Medicare appeals process.

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Medicare

New law replaces sustainable growth rate with new update schedule and creates quality reporting and merit-based payment systems

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Medicare

The Million Hearts: CVD Risk Reduction Model will incentivize providers to calculate cardiovascular risk for eligible Medicare beneficiaries and target those with the highest risk for patient-centered care. Applications are due Sept. 4.

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Medicare

The Energy and Commerce Committee is scheduled to vote on 21st Century Cures Wednesday, possibly including an amendment that would make changes to the 340B Drug Pricing Program.

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Medicare

House votes on defense and late-term abortions, while the Senate votes on the trade bill, faces pharma pressure on biologics. Health committees review 21st Century Cures and Medicare patients' chronic conditions.

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Medicare

The final policy takes into account changes to Medicare DSH payments, improving the accuracy of payments to hospitals.

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Medicare

Socioeconomic factors affect health and health care outcomes. Medicare's Hospital Readmissions Reduction Program must account for this to avoid unfairly penalizing hospitals that care for large volumes of vulnerable patients.

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Medicare

There is particular interest in mechanisms for greater comprehensiveness in care delivery, care for complex patients, care coordination, and value-driven reimbursement.

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Medicare

Plus, senators are concerned with the CMS rating system for Medicare Advantage plans.

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Medicare

Brief finds that hospitals with more than 400 beds, teaching hospitals, those treating complex patients, and essential hospitals more likely to receive penalties; no evidence that penalties align with outcomes

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Medicare

Top issues include protecting Medicaid and Medicare from cuts, protecting the 340B program, and risk adjusting quality incentive program measures

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Medicare

The proposals seek to add flexibility for participants and encourage participants to assume more risk to be be rewarded with greater shared savings.

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Medicare

Multiple exceptions are proposed to the fraud and abuse regulations that govern Medicare and Medicaid, including changes to the definition of "remuneration" in the CMP regulations and codification of the gainsharing CMP.

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Medicare

Congress concluded business until after the Nov. 4 election, passing legislation to fund the government through Dec. 11. Bills funding children's health services and addressing postacute care quality were also sent to the president's desk.

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Medicare

During its September public meeting, MedPAC discussed alternatives to the two-midnight policy, the need for audit reform, and the 3-day SNF rule. The commission will continue to focus on these issues.

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Medicare

America's Essential Hospitals urged CMS to ensure any changes to the MSSP encourage and emphasize quality of care for beneficiaries.

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Medicare

The association urged CMS to revise its C-APC proposal and opposed its proposal to add a claims-based modifier for every outpatient service provided in off-campus provider-based departments.

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Medicare

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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Medicare

Data entry deadline has passed, contact National Healthcare Safety Network help desk for questions or assistance

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Medicare

The final rule updates Medicare payment policies, rates for inpatient stays at general acute care hospitals, and provisions related to quality improvement programs.

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Medicare

Congress considers Veteran Affairs, Medicare, and immigration bills as August recess nears; House holds hearing on state Medicaid funding.

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Medicare

The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. CMS also proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.

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Medicare

CMS will introduce star ratings to Hospital Compare, Dialysis Facility Compare, and Home Health Compare as part of an effort to make information on quality of care easier to understand and compare.

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Medicare

Congress returns to session focused on improving access in the VA health care system. The Senate Appropriations Committee will review the president's request for funding to contain illegal immigration of minors, and House committees will look at 21st Century Cures and Medicare reforms.

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Medicare

CMS proposes to update how participants in the MSSP capture and submit quality metric data to gauge improvements to quality of care. The proposed update includes changes to the measure set and the benchmark time period.

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Medicare

CMS released the rule July 3. The agency proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015. In addition, CMS proposes to collect data on services provided in off-campus provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.

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Medicare

Comments cover topics such as Medicare disproportionate share hospital payment cuts and risk adjustment for socioeconomic status.

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Medicare

Congress is on recess for July 4th. Last week leaders in the Finance and Ways and Means committees introduced the IMPACT Act regarding postacute care in Medicare. Energy and Commerce held hearings on Medicare program integrity and digital health's impact on 21st century cures.

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Medicare

Acute care facilities that participate in the Hospital Inpatient Quality Reporting Program must enter Medicare beneficiary numbers on event records for all Medicare patients into the National Healthcare Safety Network, beginning July 1.

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Medicare

House GOP Leadership elected Rep. Kevin McCarthy as majority leader and Rep. Steve Scalise as Whip. This week, the House Energy and Commerce Committee will hold two health care related hearings, one on their 21st Century Cures initiative and the second on Medicare program integrity.

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Medicare

MedPAC announced that it will look into alternatives for the two-midnight rule. The potential alternative policy will clarify the inpatient payment system to clarify when a patient is considered an inpatient and alter payment mechanisms to require less observation care.

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Medicare

The Labor/HHS appropriations bill vote was cancelled due to Republican threats to derail the process over ACA funding. House Majority Leader Cantor's loss has House Republicans vying for his seat. MedPAC shares its biannual report to Congress on Wednesday.

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Medicare

America's Essential Hospitals submitted public comments to the Ways and Means committee regarding Medicare hospital payment issues, including the two-midnight rule, short inpatient stays, and RAC auditing, addressed in a committee hearing in May.

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Medicare

CMS is urging hospitals to register soon for the QualityNet Secure Portal to ensure access on July 1 to meet reporting requirements for the Hospital Inpatient Quality Reporting and Hospital Outpatient Quality Reporting Programs.

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Medicare

Providers with pending appeals on the number of Medicaid eligible days used in the calculation of the Medicaid fraction of their disproportionate patient percentage must provide supporting information and documentation to the PRRB by July 22.

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Medicare

The subcommittee focused on three issues pertaining to hospital inpatient reimbursement: 1) the two-midnight rule that redefined which hospital stays qualify for inpatient reimbursement; 2) RAC reviews of hospital payment determinations; and 3) provider appeals of Medicare payment determinations.

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Medicare

The Ways and Means Committee reviewed hospital issues as part of the Medicare Program. Two Louisiana delegates urged CMS to accept nonprofit-provided premium assistance. The Senate Veterans Affairs Committee held a hearing featuring Secretary Shinseki.

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Medicare

For inpatient admissions with dates of admission between Oct. 1, 2013, and March 31, 2015, MACs and recovery audit contractors will not conduct postpayment patient status reviews. MACs will continue to conduct prepayment probe reviews of short stays with dates of admission between Oct. 1, 2013, and March 31, 2015.

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Medicare

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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Medicare

On April 30, CMS issued the IPPS proposed rule for fiscal year 2015. The rule updates Medicare payment policies, rates for inpatient stays at general acute care hospitals, and provisions related to quality improvement programs. CMS will accept comments on the proposed rule through June 30.

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Medicare

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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Medicare

CMS released the FY 2015 proposed IPPS rule April 30. The proposed rule updates Medicare payment policies and rates for inpatient stays at general acute care hospitals, as well as provisions regarding quality improvement programs.

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Medicare

CMS adjusts FFS claims from 2008-2012 for DSH hospitals. The adjustment accounts for changes to Medicare DSH payments and for FY 2014 uncompensated care payments.

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Medicare

CMS released new data on Medicare Part B payments to more than 800,000 physicians and other health care professionals. The data set includes calendar year 2012 data on the number and type of services provided to beneficiaries, average payments to providers for services, and the provider's average charge for services.

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Medicare

The plan would partially privatize Medicare and turn Medicaid into state block grants. It also repeals the ACA.

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Medicare

The bill replaces the SGR with a sensible physician payment system, ensures the continuation of health policies that help low-income patients access health care, and mandates an annual report on Medicaid DSH payments. The association notes that it would not support any methods of paying for the legislation that would "damage access to and quality of care..."

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Medicare

House and Senate differ on offsets for SGR repeal and replace; ACA alternative details under wraps

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Medicare

CMS will host a National Provider Call March 18, from 1:30 to 3 pm Eastern time, on 2014 Medicare quality reporting programs. During the call, officials will provide an overview of how to report quality measures in various Medicare programs, including those for electronic health records incentives and accountable care organizations.

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Medicare

The Centers for Medicare & Medicaid Services has made available resources to help providers prepare for and transition to International Classification of Diseases, 10th Edition (ICD-10) diagnosis and procedure codes by Oct. 1, 2014. Resources include fact sheets, frequently asked question, webinars, and an offer to participate in end-to-end testing.

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Medicare

Health and Human Services Secretary Kathleen Sebelius will testify on the president's budget before two congressional panels this week. Meanwhile, the House will consider a bill to repeal the sustainable growth rate (SGR) physician payment formula. Republicans are expected to tie SGR fix to repeal of the Affordable Care Act’s individual insurance mandate.

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Medicare

This week Congress is off to a slow start after heavy snow closed the federal government on Monday. President Obama released his budget, and the House Ways and Means chair introduced a comprehensive tax reform plan. Energy and Commerce will look at ways to protect seniors in the Medicaid program.

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Medicare

CMS proposes to adjust FFS claims from 2008-2012 for DSH hospitals. The proposed adjustment accounts for changes to Medicare DSH payments and for FY 2014 uncompensated care payments. Comments on the proposed call letter are due March 7.

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Medicare

As of Feb. 21, hospitals will not receive new RAC ADRs until the next round of contracts are awarded. In addition, CMS announced five changes to the RAC program that will take effect under new RAC contracts. CMS has not announced when it plans to finalize new contracts.

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Medicare

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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Medicare

Congress has increased the debt limit but did not patch the Medicare physician payment system, as physician groups want a full repeal rather than a temporary fix. The Senate Finance Committee has a new chairman, Sen. Ron Wyden (D-OR). Wyden assumed the position after Sen. Max Baucus (D-MT) left to serve as ambassador to China.

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Medicare

On November 27, the Centers for Medicare & Medicaid Services (CMS) issued the Outpatient Prospective Payment System (OPPS) final rule for calendar year (CY) 2014. Included in the rule are provisions related to the following: payment for hospital outpatient visits data collection in off-campus, provider-based departments Hospital Outpatient Quality Reporting (OQR) Program Hospital Value-Based Purchasing

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Medicare

Association develops entitlement reform principles to guide possible future discussions around changes to the Medicare and Medicaid programs.

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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.