Tag: Policy & Regulation

Final Surprise Billing Rules QPA

Biden Administration Releases Final Surprise Billing Rules

  The final surprise billing rules downgrade the weight the QPA has on out-of-network payment determinations and establishes documentation requirements for down coding situations. The Biden Administration has released final surprise billing rules implementing the No Surprises Act, a federal law enacted in January 2021 that protects patients from out-of-network medical bills when they seek […]
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FY23 Final Rules for Hospice Providers, IPFs, IRFs

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 […]
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Hospitals Press CMS to Rethink Proposed FY23 Medicare IPPS Rates

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 […]
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CMS Updates End-Stage Renal Disease APM, PPS to Address Health Equity

. The End-Stage Renal Disease (ESRD) Treatment Choices Model is the first to undergo changes to directly address health equity—a new goal for CMS-run alternative payment models. The ESRD Treatment Choices (ETC) Model is a mandatory alternative payment model (APM) that encourages greater utilization of home dialysis and kidney transplants for Medicare beneficiaries with the […]
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HRSA: Over 5M Claims Paid for Uninsured COVID-19 Vaccinations

The Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured, a program funded by pandemic-related legislation […]
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