The United States Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) have proposed new 2025 Medicare payment policies for hospitals and ambulatory surgical centers (ASCs) that aim to increase access to care and advance health equity. These policies are outlined in the 2025 Hospital Outpatient Prospective Payment System […]
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2025. The calendar year (CY) 2025 PFS proposed […]
CMS released the fiscal year (FY) 2023 inpatient prospective payment system proposed rule with proposals for new calculations for FY 2023 rate setting. Although CMS is proposing to use FY 2021 data for FY 2023 Medicare Severity Diagnosis-Related Groups (MS-DRG) rate setting, the agency wants a modified methodology to account for the historical and potential […]
CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Proposed Rule for FY 2023 (the Proposed Rule). In the Proposed Rule, CMS proposes to update the IPPS and LTCH payment rates, modify the payment rules for direct graduate medical education (DGME) to comply with a recent […]
The Centers for Medicare and Medicaid Services is proposing a decrease in skilled nursing facility payments by 4.6%, or $1.7 billion, in 2023 to achieve budget neutrality. As a result, there will be a decrease of approximately $320 million in Medicare Part A payments to SNFs in 2023, compared to 2022. This estimate reflects a […]
CMS’ proposed actions are intended to increase price transparency, access to care, patient safety, positive healthcare outcomes, and health equity. On July 19, 2021, the Centers for Medicare & Medicaid Services (CMS) announced new proposed actions to address the health equity gap, decrease mounting healthcare costs, and increase medical accessibility and patient quality of care. […]
Proposed rule improves payment rates, incentives, and ESRD treatment choices. Disadvantaged Medicare patients suffer from end-stage renal disease (ESRD) at higher rates and are also more likely to be readmitted to hospitals, experience higher costs, and receive in-center hemodialysis when their kidneys are no longer able to function properly. Furthermore, non-white patients with ESRD are […]
On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for the fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS). The proposed rule includes CMS proposals for certain annual Medicare payment policies and rates as well as certain quality and value-based programs for FY 2022. Stakeholders must submit […]