Most providers understand the “No Surprises” requirements for insured patients. Effective as of Jan. 1, 2022, uninsured (or self-pay) consumers are also protected from unexpected high medical bills. If a consumer doesn’t have health insurance or doesn’t plan to use insurance to pay for health care items or services, they must be given a “good […]
To understand this dynamic, you need to know who the customer is. One of the key questions arising from looking at financial statements is this: how do we “get to the bottom line” in healthcare? In our society and culture, we have a fascination with the term “net income,” but it may have little meaning […]
The final rules become effective Jan. 1, 2023. Amid this election season, the Centers for Medicare & Medicaid Services (CMS) has published final rules for the 2023 Part B Physician Fee Schedule and Medicare Shared Savings Program, the Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment System, the End-Stage Renal Disease (ESRD) Prospective […]
The conversion factor is down but certain public health emergency flexibilities will continue. The 2023 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program final rule, released Nov. 1, allows Part B physician payment for behavioral healthcare, cancer screening, and dental care. But while the Centers for Medicare & Medicaid Services (CMS) continues its focus […]
The federal agency released the Home Health Prospective Payment System Rate Update proposed rule for CY23, which aims to permanently adjust Medicare payment based on PDGM. CMS proposes updated Medicare payment for home health agencies CMS is looking to apply a permanent prospective payment adjustment to the home health 30-day period payment rate to account […]
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 […]
Around 3,600 healthcare providers that have experienced pandemic-related revenue losses and expenses will receive payments through this round of Phase 4 COVID-19 Provider Relief Funds. Through the Health Resources and Services Administration (HRSA), HHS has released the fifth round of Phase 4 COVID-19 Provider Relief Funds, which includes $1.75 billion for healthcare providers that have […]
With the proper funding, these actions can make your medical practice boom. 6 Ways physician funding can help grow your practice If you are looking to grow your medical practice, alternative small business funding may be the fastest and easiest way to get the working capital you need. Alternative medical practice funding is available to […]
Provisions include topsy-turvy payment adjustments across the country. A proposed rule outlines payments, wages, and policies in fiscal year (FY) 2023 for inpatient psychiatric facilities paid under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS). The Centers for Medicare & Medicaid Services (CMS) issued the proposed rule March 31 and is accepting public comments […]
On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) issued its Calendar Year (CY) 2022 Physician Fee Schedule (“PFS”) Final Rule. In this post, we sample some key highlights from the Final Rule. For more detail, take a look at our previous post, in which we highlight the PFS’s changes to the […]