Tag: CMS Proposal

Rise-in-Inaccurate-Payments

Rise in Inaccurate Payments Due to New Reimbursement Method

When the Centers for Medicare & Medicaid Services (CMS) implemented the Patient Driven Payment Model (PDPM) as the new reimbursement method for skilled nursing facilities (SNF), some of us in the coding and auditing world thought it likely to result in inaccurate payments. The old model, the Resource Utilization Group—Version IV (RUGS-IV), calculated SNF reimbursement […]
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Medicare-inpatient-reimbursement-cuts

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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Updates on End-Stage Renal Disease Prospective Payment copy

Updates on End-Stage Renal Disease Prospective Payment

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 […]
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