The rule includes numerous policy and payment changes for Medicare’s Inpatient Prospective Payment System for fiscal year 2022, including a 2.5 percent increase in inpatient payment rates.
view more »Biden Administration Freezes Pending Regulations
Jan. 26, 2021 ||The regulatory freeze could affect rules directing health clinics to pass certain drug discounts on to patients, establishing minimum standards in Medicaid state drug utilization review, and modifying Health Insurance Portability and Accountability Act privacy arrangements.
view more »The two rules, finalized Nov. 20, aim to eliminate barriers to care coordination and undue burden under current fraud and abuse laws. One provides exceptions to the physician anti-referral law, and one modifies existing safe harbor protections under the anti-kickback statute.
view more »Policies finalized for the 2021 Medicare Inpatient Prospective Payment System call for increasing inpatient payment rates by 2.9 percent, reducing Medicare disproportionate share hospital payments, and collecting median Medicare Advantage charge data.
view more »Proposed Rule Supports Value-Based Payments for Medicaid Drugs
June 23, 2020 ||The proposed rule, issued by CMS, aims to advance Medicaid prescription drug value-based purchasing arrangements between states and manufacturers, set standards to promote safe opioid prescribing, and amend regulations related to the Medicaid drug rebate program.
view more »Association Comments on Fraud and Abuse Proposals
Dec. 20, 2019 ||America’s Essential Hospitals said the federal Anti-Kickback Statute and Physician Self-Referral Law should be modified to remove barriers to coordinating care for the complex patients essential hospitals serve.
view more »Patient Experience and HCAHPS at Essential Hospitals
Oct. 15, 2019 ||This new brief can help hospitals identify changes that might improve patient experience scores, as well as help policymakers understand how structural factors influence scores and design incentives accordingly.
view more »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.
view more »CMS Publishes Final Rule for FY 2020 Medicare IPPS
Aug. 4, 2019 ||The rule increases inpatient operating payment rates by 3.1 percent, makes other payment and quality reporting policy changes, and estimates a $140 million increase in Medicare disproportionate share hospital payments.
view more »CMS Approves La. Value-based Arrangement
June 27, 2019 ||Louisiana is the fifth state cleared to pursue value-based purchasing agreements for supplemental rebates with manufacturers through a state plan amendment.
view more »MedPAC Releases March Report to Congress
March 20, 2019 ||The report includes recommendations on several issues of importance to essential hospitals, including hospital inpatient and outpatient services, hospital quality incentive programs, and alternatives to opioids.
view more »Federal Action Aims to Curb Rising Medicaid Drug Costs
Nov. 5, 2018 ||The nature of the Medicaid program means these skyrocketing costs have strained federal and state resources, prompting action through both policy and legislation.
view more »Association Comments on Annual Medicare Inpatient Payment Rule
June 29, 2018 ||America's Essential Hospitals urged the Centers for Medicare & Medicaid Services to implement its Medicare disproportionate share hospital payment methodology and quality measurement programs in a way that accounts for the unique needs and patient populations served by essential hospitals.
view more »The new proposed IPPS rule for FY 2019 contains numerous policy and payment changes, including increasing net inpatient payment rates by 1.75 percent.
view more »CMS Issues FY 2019 IPPS Proposed Rule
April 25, 2018 ||A new proposed rule for Medicare’s Inpatient Prospective Payment System for fiscal year 2019 would increase inpatient operating payment rates by 1.75 percent.
view more »CMS Advises States on Directed Provider Payments in Managed Care
Nov. 3, 2017 ||An agency bulletin instructs states on how to seek approval for state-directed payment arrangements and distinguishes directed payments from other payment models.
view more »CMS Exceptions Granted To Hospitals Affected by Hurricane Harvey
Sept. 5, 2017 ||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.
view more »The new rule would affect inpatient operating payments, Medicare disproportionate share hospital payments, and the Hospital Readmissions Reduction Program.
view more »Association Comments on 2018 Medicare Inpatient Payment Proposals
June 13, 2017 ||America’s Essential Hospitals encourages CMS to improve transparency, risk adjust, and reduce regulatory burden for essential hospitals.
view more »The rule would raise inpatient operating payment rates, revise Medicare DSH payment methodology, and apply a transitional methodology for HRRP penalties.
view more »CMS Issues FY 2018 IPPS Proposed Rule
April 17, 2017 ||The rule contains provisions on the Hospital Readmissions Reduction Program, Medicare DSH, the Inpatient Quality Reporting program, and more.
view more »Review Periods Open for Quality, Value-Based Purchasing Reports
April 11, 2017 ||Hospitals have until May 5 to review overall Hospital Compare star rating and until May 10 to review value-based purchasing hospital-specific reports.
view more »CMS Updates Hospital Compare Data
Dec. 20, 2016 ||CMS on Dec. 19 refreshed its Hospital Compare site, including data on the Ambulatory Surgical Center Program, Hospital Readmission Reduction Program & more.
view more »Obama Signs Law with SES Risk Adjustment for Readmissions
Dec. 13, 2016 ||President Obama signs the 21st Century Cures Act, which includes the historic risk adjustment provision and also provides partial relief to hospitals from cuts to off-campus outpatient department payments.
view more »Hennepin Health: A Spotlight on Collaboration
Sept. 19, 2016 ||Hear insights and lessons learned regarding value-based care from representatives of the foundation of Hennepin Health.
view more »Report IDs Social Risk Factor Criteria for Medicare Payments
July 20, 2016 ||The report aims to identify social risk factors that affect beneficiaries' health outcomes and methods to account for these factors in payment programs.
view more »HHS Announces New Steps To Combat Opioid Epidemic
July 13, 2016 ||The actions build on the National Pain Strategy, a federally coordinated plan for reducing and better treating chronic pain.
view more »The proposed rule updates the payment rate for services provided in hospital outpatient departments and provisions relating to quality reporting.
view more »Essential Hospitals Face Larger VBP Penalties
Oct. 5, 2015 ||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.
view more »Rule includes a net increase in IPPS payment rates of 0.9 percent, Medicare DSH cuts of $1.2 billion in FY 2016, and updates to the HAC Reduction, Hospital VBP, IQR, and EHR Incentive programs.
view more »Association Comments on FY 2016 IPPS Proposed Rule
June 16, 2015 ||Comments caution CMS about Medicare DSH payment cuts and urge CMS to ensure measures and methodologies used in quality reporting programs are adjusted for sociodemographic factors.
view more »CMS Seeks Nominations for APM Work Group
June 15, 2015 ||Nominations are due June 19. The work group will define terms related to alternative payment models and a strategy to track progress of APM implementation.
view more »CMS to Discuss Pay for Performance Programs May 12
May 5, 2015 ||The national provider call will cover alignment and goals for a number of Medicare pay-for-performance programs, including the Inpatient Quality Reporting Program and the Value-Based Purchasing Program.
view more »The rule includes provisions on several topics, including a payment update, Medicare disproportionate share hospital cuts, Medicare payment for short inpatient hospital stays, and the Readmissions Reduction Program.
view more »The first of four installments in the Patient Experience (HCAHPS) Forum
view more »Stakeholders Needed for HHS Alternative Payment Model Network
March 3, 2015 ||The Network will support the transition toward alternative payment models, using efforts in the Medicare Program as a guide.
view more »CMS Seeks Input on Primary Care Innovations
Feb. 18, 2015 ||There is particular interest in mechanisms for greater comprehensiveness in care delivery, care for complex patients, care coordination, and value-driven reimbursement.
view more »Federal Incentives – Right Intentions, Wrong Impact?
Aug. 14, 2014 ||An examination of a recent study highlighting the challenge of providing financial incentives fairly based on outcomes and hospital characteristics.
view more »A recent study published in Health Affairs found that California essential hospitals were more likely to be penalized than other California hospitals under the Hospital Readmissions Reduction Program, despite lower 30-day risk-adjusted mortality rates.
view more »Association Comments on FY 2015 IPPS Proposed Rule
July 1, 2014 ||Comments cover topics such as Medicare disproportionate share hospital payment cuts and risk adjustment for socioeconomic status.
view more »New HCAHPS Data Released
Jan. 23, 2014 ||Data has been released for the reporting period of April 2012 through March 2013
view more »Navigating a Value-Based Payment System
Jan. 6, 2014 ||Summaries of journal abstracts that highlight physician training and value-based purchasing issues.
view more »Rule finalizes several Outpatient Prospective Payment System provisions
view more »Value-Based Purchasing (VBP) Program Rules and Comments
Nov. 25, 2013 ||The VBP program links Medicare inpatient payments to quality measure performance
view more »Extension applies to data submitted to Medicare inpatient quality reporting program
view more »Rule finalizes several inpatient prospective payment system provisions
view more »Hospitals may review and request correction of performance scores
view more »Rule proposes several outpatient prospective payment system provisions
view more »CMS Releases CY 2014 OPPS Proposed Rule
July 9, 2013 ||Agency seeks to understand type and frequency of, and payment for, services furnished in off-campus outpatient departments
view more »Hill Leaders Release Blueprint for Updating Medicaid
May 10, 2013 ||Plan outlines options for states to adopt delivery system reforms
view more »Statement on CMS Hospital Pricing Data Release
May 8, 2013 ||Says data release lacks proper context consumers need to make informed decisions about care
view more »CMS Releases FY 2014 IPPS Proposed Rule
May 2, 2013 ||Rule includes proposed formula to make Medicare DSH reductions under ACA
view more »Rule proposes several inpatient prospective payment system provisions
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