Archive for Medicare regulations

 

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

MedPAC’s proposed Medicare 2021 payment recommendations dominated the December agenda, including:

  • hospital inpatient and outpatient payments
  • ambulatory surgical center payments
  • physician and health professional payments
  • hospice payments
  • home health care payments
  • inpatient rehabilitation facility payments
  • long-term care hospital payments

In addition, MedPAC discussed Medicare’s policy for transfers between post-acute-care facilities and hospice and received a staff update on the Medicare Advantage program.

MedPAC is an independent congressional agency that advises Congress on issues involving Medicare.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues and for a transcript of the two days of meetings.…

MedPAC Meets

Earlier this week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

Among the issues on MedPAC’s November agenda were:

  • expansion of telehealth in Medicare
  • report on Medicare beneficiaries’ access to care in rural areas
  • effects of pharmaceutical rebates on Part D’s risk adjustment
  • improving competition among Medicare Part D’s benchmark plans
  • separately payable drugs in the hospital outpatient prospective payment system
  • Medicare Advantage payment and access for enrollees with end-stage renal disease

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.…

Most Hospitals Fined by Medicare Over Readmissions

More than 80 percent of all hospitals subject to Medicare’s hospital readmissions reduction program, and half of all of hospitals in the country, will be penalized in FY 2021 under that program because they have what Medicare considers to be too many avoidable readmissions.

In all, 2556 of the 3080 hospitals subject to the program will be penalized.  More than 600 will see their inpatient payments cut one percent as a result and the average cut will be 0.69 percent.

The penalties are based on hospital performance with patients experiencing congestive heart failure, heart attacks, chronic obstructive pulmonary disease, coronary artery bypass graft surgery, pneumonia, and knee and hip replacement.  Such patients are considered readmitted if they return to the hospital within 30 days of their discharge for these conditions unless their return to the hospital was planned as part of their treatment.

Learn more about hospital performance under Medicare’s hospital readmissions reduction program and find links to tools to look up individual hospitals and download nation-wide hospital 2021 readmissions data in the Kaiser Health News article “Medicare Fines Half of Hospitals for Readmitting Too Many Patients.”

HHS Webinar Thursday

The Department of Health and Human Services will hold a webinar on Thursday, October 22 at 1:00 (eastern) about the Centers for Medicare & Medicaid Services’ recent guidance explaining how it will implement an interim final rule that makes the collection and reporting of COVID-19 data a condition of participation in Medicare for hospitals.

On August 24 CMS published an interim final rule establishing new requirements in the hospital conditions of participation in Medicare and on October 6 HHS published the updated document “COVID-19 Guidance for Hospital Reporting and FAQs For Hospitals, Hospital Laboratory, and Acute Care Facility Reporting.”  Among the data elements hospitals are required to report are their current count of lab-confirmed COVID-19 patients, number of staffed beds, number of occupied ICU beds, and information about personal protective equipment and ventilators.

The purpose of the webinar is to explain to providers how HHS will implement these requirements.

Go here to register for the webinar.…

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s October agenda were:

  • the skilled nursing facility value-based payment system
  • future research directions in hospice payments
  • Medicare Advantage benchmark policy
  • indirect medical education:  current Medicare policy, concerns, and principles for revising
  • the evolution of Medicare’s advanced alternative payment models
  • vertical integration and Medicare payment policy

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues and here for a transcript of the proceedings.…