Proposed rules for Medicare’s OPPS and PFS for calendar year 2024 would maintain full Medicare Part B drug payment to hospitals in the 340B Drug Pricing Program, revise site-neutral payment policies, and amend price transparency policies, among other changes.

Applications close May 31 for the two-year extension of the Bundled Payments for Care Improvement Advanced voluntary payment model.

CMS extends for two years the Bundled Payments for Care Improvement Advanced Model and alters the accounting process for beneficiaries with COVID-19.

The association urged CMS to adequately reimburse off-campus, provider-based departments; refine physician quality reporting; and codify a definition of essential hospitals.

CMS seeks feedback at a July 21 listening session on the 5 percent lump sum Alternative Payment Model Incentive Payment, set to expire at the end of 2022. 

The rule adjusts the conversion factor used to determine physician payment rates and includes provisions related to appropriate use criteria, Medicare reimbursement for telehealth services, vaccine payment rates, the Quality Payment Program, and the Medicare Shared Savings Program.

The calendar year 2022 Physician Fee Schedule proposed rule includes provisions on Medicare payment for telehealth services, the Quality Payment Program, and more. The association also responded to a request for information on improving health equity through data collection.

Proposed rules for Medicare’s Outpatient Prospective Payment System and Physician Fee Schedule would continue Medicare Part B cuts, continue site-neutral policies, and halt the phase-out of the inpatient-only list. Both rules also contain an information request on closing the health equity gap.

The rule includes provisions related to telehealth, vaccine payment rates, the Quality Payment Program, and the Medicare Shared Savings Program; comments are due to CMS by Sept. 13.

America's Essential Hospitals commented on several policy proposals of interest to essential hospitals in the Inpatient Prospective Payment System rule and responded to a request for information on closing the health equity gap in hospital quality programs.

CMS establishes a conversion factor of $32.41 — a decrease of $3.68 from CY 2020. The final rule also includes provisions related to Medicare reimbursement for telehealth services, the Quality Payment Program, and the Medicare Shared Savings Program.

The proposed rules would deepen Medicare Part B cuts to hospitals in the 340B Drug Pricing Program, continue site-neutral payment policies, and revise the overall hospital star rating methodology. The association urged CMS to protect funding for essential hospitals and access to care.

CMS proposes to decrease the conversion factor determining physician payment rates for specific services by $3.83. The proposed rule also includes provisions related to Medicare reimbursement of telehealth services, the Quality Payment Program, and the Medicare Shared Savings Program.

CMS announces the end of the blanket Extraordinary Circumstances Exception for quality reporting and value-based purchasing programs. HHS issues a remdesivir allocation fact sheet, and FDA approves a third influenza and COVID-19 combination diagnostic test.

The proposed rule would increase inpatient payment rates by 3.1 percent, reduce Medicare disproportionate share hospital payments by about $0.9 billion compared with fiscal year 2020, and collect median third-party charge data on Medicare cost reports.

CDC revised its testing guidance to reflect six new COVID-19 symptoms: chills, repeated shaking with chills, muscle pain, headache, sore throat, and new loss of taste or smell. HHS released a Workforce Virtual Toolkit, and CMS released a State Medicaid and CHIP Telehealth Toolkit.

CMS issues elective surgery guidance, telehealth toolkits, and information on quality reporting flexibility amid the COVID-19 pandemic; The Joint Commission suspends regular surveys.

The final rules for Medicare’s Outpatient Prospective Payment System and Physician Fee Schedule for calendar year 2020 also expand access to opioid use disorder treatment and establish a prior authorization process for certain services.

The final rule includes provisions related to the Quality Payment Program, evaluation and management services, telehealth services, and the Medicare Shared Savings Program.

The updated resource library includes new fact sheets and guides for the Merit-based Incentive Payment System and Advanced Alternative Payment Models.

Facilities located in areas designated as emergency or major disaster areas will be exempt from provisions of Medicare quality reporting programs.

Merit-based Incentive Payment System participants can request a targeted review of their performance feedback and final score if they find an error in their 2020 payment adjustment calculation.

An Aug. 2 final rule for Medicare’s Inpatient Prospective Payment System for fiscal year 2020 will increase inpatient operating payments and Medicare disproportionate share hospital funding and make changes to electronic health records use and quality reporting programs.

The calendar year 2020 proposed rule includes updates to the Quality Payment Program, a request for information on the creation of Merit-based Incentive Payment System Value Pathways, and other topics of interest to essential hospitals.

The recently released 2017 Quality Payment Program Experience Report includes participation and performance statistics for the Merit-based Incentive Payment System and Advanced Alternative Payment Model tracks.

The tool includes 2018 Qualifying Alternative Payment Model (APM) Participant and Merit-based Incentive Payment System APM status.

More than 1 million eligible clinicians received a neutral or better payment adjustment in the first year of the Merit-based Incentive Payment System, one of two tracks in the Quality Payment Program.

The rule includes updates to the Quality Payment Program and documentation and payment changes for evaluation and management services.

Cooperative agreements with seven organizations aim to develop, improve, update, or expand quality measures for Medicare’s Quality Payment Program.

The Sept. 26 webinar will review requirements for submitting value-based payment approaches as an Other Payer Advanced Alternative Payment Model under the Medicare Access and CHIP Reauthorization Act of 2015.

In the rule, the Centers for Medicare & Medicaid Services continues a policy of reduced payments to new off-campus provider-based departments; the agency also provides updates to the Quality Payment Program.

Merit-based Incentive Payment System participants can request a targeted review of their performance feedback and final score if they find an error in their 2019 payment adjustment calculation.

Clinicians eligible for the Merit-based Incentive Payment System can receive Improvement Activity credit for participating in a study on quality reporting burdens; applications are due April 30.

Providers who submitted data through the Quality Payment Program website can review preliminary performance feedback. Final scores and feedback will be available July 1.

Group reporting through the Centers for Medicare & Medicaid Services web interface must be completed by March 16; all other Merit-based Incentive Payment System data must be submitted by March 31.

The table identifies which alternative payment models (APMs) are designated as Advanced APMs under the Quality Payment Program or the Merit-based Incentive Payment System.

Under the new payment model, a single bundled payment will cover services furnished by various providers across care settings. Participants can earn additional payment if they reduce costs over the course of a beneficiary’s 90-day episode of care while meeting quality benchmarks.

The new system streamlines quality reporting through one portal; the data submission period runs from Jan. 2 to March 31.

In response to an annual update to the Quality Payment Program, the association called for increased flexibility and risk adjustment for socioeconomic factors.

The cancellation of three episode payment models and an incentive payment model comes in response to stakeholder feedback about the burden of these models.

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.

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

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.

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.

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.

Merit-based Incentive Payment System–eligible clinicians and groups may apply for hardship exceptions due to connectivity issues or extreme circumstances, such as disasters.

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.

Exceptions are available for Merit-based Incentive Payment System eligible clinicians and groups that experienced insufficient internet connectivity, uncontrollable circumstances, or other issues; applications are due Oct. 1.