The final rules for fiscal year 2023 include a 3.8 percent payment increase for hospice providers, 2.5 percent increase for inpatient psychiatric facilities, and 3.2 percent boost for inpatient rehabilitation facilities. CMS has released final rules solidifying Medicare reimbursement rates for hospice providers, inpatient psychiatric facilities (IPFs), and inpatient rehabilitation facilities (IRFs) for fiscal year […]
“This will not only lower the cost of prescription drugs and health care for families, it will reduce the deficit and help fight inflation.” — President Biden, in a statement on health-care provisions in pending Senate bill, July 15 After months of negotiations, the president’s expansive “Build Back Better” plan has shrunk to a handful […]
Lawmakers are also urging CMS to use its authority to adjust FY23 Medicare IPPS rates, to prevent net decreases. Medicare inpatient reimbursement cuts slated to take effect in the 2023 fiscal year would threaten access to care at hospitals, which are already facing substantially higher costs because of the ongoing COVID-19 pandemic, according to the […]
In addition to physician reimbursement cuts, CMS included changes to the Quality Payment Program in the CY 2023 Medicare Physician Fee Schedule proposed rule. In its recently released calendar year (CY) 2023 Medicare Physician Fee Schedule (PFS) proposed rule, CMS proposed Quality Payment Program (QPP) changes to the Merit-based Incentive Payment System (MIPS) and Advanced […]
Open communication, payment options, and understanding are all key to improving patient collections in a consumer-oriented healthcare landscape. The rising cost of healthcare in the United States has left consumers feeling lost and overwhelmed. High deductible healthcare plans, co-pays, and out-of-pocket medical expenses have all contributed the emergence of healthcare consumerism, which is the pursuit […]
Twenty percent of adults said they or a family member has received a surprise medical bill since the No Surprises Act went into effect on Jan. 1 according to a Morning Consultant report released July 7. Morning Consultant conducted a survey among a representative sample of 2,210 U.S. adults between June 22-24, according to the […]
A new analysis shows that claim denial rates for in-network services among Healthcare.gov marketplace payers varied significantly, with some as high as 80%. Claim denial rates varied significantly among Healthcare.gov marketplace payers, with some insurers racking up rates as high as 80 percent, according to a new analysis from Kaiser Family Foundation. Marketplace payers must […]
CMS Releases FAQ for No Surprises Act Implementation, Requirements The No Surprises Act FAQ states that balance billing protections do not apply to individuals with public healthcare coverage and notice and consent forms must be provided and received in written format. June 28, 2022 – CMS has released Frequently Asked Questions (FAQs) on the No […]
CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023. Here are four takeaways from the proposed rule: Under the proposed rule, Medicare expects to pay $8.2 billion to approximately 7,800 facilities […]
Observation, outpatient outlier payments, and the Inpatient-only List: Getting it right is not always easy. On this week’s Monitor Mondays we had a robust discussion about Condition Code 44. And on June 9, I will be presenting a webinar on the nebulous concept of “outpatient” service in a bed. Both of these have one thing […]