Archive for Medicare reimbursement policy

 

MedPAC Considers No Pay Raise for Ambulatory Surgical Centers

Next month MedPAC will likely vote to recommend that ambulatory surgical centers receive no increase in their Medicare payments in 2021.

Meeting last week in Washington, D.C., members of the Medicare Payment Advisory Commission appeared to support strongly a staff recommendation to keep Medicare ambulatory surgical center payments where they are now – enough so to expedite resolution of the issue by voting on it at MedPAC’s next meeting, in mid-January.

MedPAC also will vote on a proposal to require ambulatory surgical centers to provide annual cost reports to the Centers for Medicare & Medicaid Services.  CMS would use those reports to evaluate facility revenue and profits so it can better assess the adequacy of Medicare rates.

Learn more in the Becker’s ASC Review article “ASC pay increase for 2021 eliminated in MedPAC’s draft proposal.”

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 December agenda were:

  • Assessing payment adequacy and updating payments: Physician and other health professional services
  • Assessing payment adequacy and updating payments: Ambulatory surgical center services
  • Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services;
  • Mandated report: Expanding the post-acute care transfer policy to hospice
  • Assessing payment adequacy and updating payments: Skilled nursing facility services
  • Assessing payment adequacy and updating payments: Home health care services
  • Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services
  • Assessing payment adequacy and updating payments: Long-term care hospital services
  • Assessing payment adequacy and updating payments: Outpatient dialysis services
  • Assessing payment adequacy and updating payments: Hospice services
  • The Medicare Advantage program: Status report

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.…

MedPAC to Meet Tomorrow

The Medicare Payment Advisory Commission meets this Thursday and Friday in Washington, D.C.

MedPAC’s December agenda is dominated by Medicare payment issues:  how much Medicare should pay for different types of services in calendar year 2021 and FY 2021.  The services to be addressed during the December 5-6 meetings are physician and other health professional services, ambulatory surgical center services, hospital inpatient and outpatient services, skilling nursing facility services, home health services, inpatient rehabilitation facility services, long-term care hospital services, outpatient dialysis services, and hospice services.

In addition, MedPAC commissioners will discuss their mandated report on expanding Medicare’s post-acute care transfer policy to hospice and hear a status report on the Medicare Advantage program.

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, often with a major impact on health care providers.

Learn more here.…

Hospitals Sue HHS Over Payment Cut

Medicare cut hospital payments $840 million a year more than it should have and now, hospitals are suing to get their money back.

According to the lawsuit, Congress authorized Medicare to include a cut of 0.7 percent in hospital inpatient payments through FY 2017 to recoup past Medicare overpayments but Medicare continued the cut, without Congress’s approval, in FY 2018 and FY 2019.

The 600 hospitals that filed the suit estimate that the allegedly illegal cut cost them about $200,000 each and now, they want their money back – with interest.

Learn more in the Becker’s Hospital Review article “622 hospitals sue HHS, accused of illegally allowing reimbursement cut.”

Improper Medicare Payments Down in FY 2019

The amount of improper Medicare payments made by the federal government fell $7 billion in federal fiscal year 2019, the Centers for Medicare & Medicaid Services reports.

FY 2019 marked the third consecutive year that improper fee-for-service payments have fallen.  In FY 2018, improper payments accounted for 8.12 percent of Medicare fee-for-service spending but in FY 2019 that portion fell to 7.25 percent.  In FY 2019, CMS estimates that it made $28.9 billion in improper fee-for-service payments.

$5.32 billion of the $7 billion reduction came through corrective actions in Medicare home health payments.  Other Medicare Part B services accounted for $1.82 billion in savings and durable equipment improvements also accounted for significant savings.

Learn more about the decline in improper Medicare payments and the policy changes that contributed to it in this CMS news release, which also links to a CMS fact sheet and a full report.

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