Tag: Medicare Reimbursement

Home Health Medicare Reimbursement

Recent Updates on Home Health Medicare Reimbursement

AHA said that the 2.7 percent Medicare reimbursement update for home health agencies does not accurately reflect the financial challenges that home health agencies have faced during the pandemic. The American Hospital Association (AHA) has urged CMS to reconsider the Medicare reimbursement update for home health agencies proposed in the Calendar Year 2023 Home Health […]
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Prior Authorizations and MedPAC Recommendations: MGMA’s view

Prior authorizations and Medicare reimbursements are some of the most consistently cited sources of issues at primary care practices. Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association (MGMA), joined us in April to discuss his organization’s lobbying efforts. The following interview has been edited for length and clarity. Medical […]
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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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Update on Medicare Reimbursement for ESRD facilities

The CY23 End-Stage Renal Disease (ESRD) Prospective Payment System Proposed Rule would increase Medicare reimbursement rates, among other policy changes. CMS recently proposed the Calendar Year 2023 End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) Proposed Rule, which would boost Medicare reimbursement for ESRD facilities and refine a new mandatory value-based purchasing program. The proposed […]
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Permanent Medicare Payment Adjustment for Home Health

Permanent Payment Adjustment for Home Health

The federal agency released the Home Health Prospective Payment System Rate Update proposed rule for CY23, which aims to permanently adjust Medicare payment based on PDGM. CMS proposes updated Medicare payment for home health agencies CMS is looking to apply a permanent prospective payment adjustment to the home health 30-day period payment rate to account […]
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Medicare, Beneficiaries Saw Higher Prices at Provider-Based Facilities

The Medicare program and Medicare beneficiaries could have saved a combined $1.6 billion if provider-based facilities charged the same payment rate as freestanding facilities, OIG found. Medicare and its beneficiaries paid significantly higher prices at provider-based facilities than they would have paid to freestanding facilities for the same services, according to a report from the […]
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CMS, HHS Finalize 2023 Notice of Benefits, Payment Parameters

  CMS and the Department of Health and Human Services (HHS) released the 2023 Notice of Benefits and Payment Parameters Final Rule, which includes standardized plan options, changes to network adequacy reviews, refinements to the Affordable Care Act’s essential health benefits nondiscrimination policy, and other changes. “The recent Open Enrollment Period demonstrated the demand for […]
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Barostim Heart Failure Treatment: Coding Training

The Centers for Medicare & Medicaid Services (CMS) has begun covering a portion of the device cost for Barostim Neo, a neuromodulation device for treating chronic heart failure. In late 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it would begin covering a substantial portion of the cost of implantable heart failure […]
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Key Advantages of Medicare Advantage Plans Versus FFS Medicare

Medicare Advantage plans draw a more diverse beneficiary population and can result in lower healthcare spending for low-income beneficiaries. Medicare Advantage plans may provide better access to care and lower healthcare spending for enrollees, compared to fee-for-service Medicare, according to a study from ATI Advisory conducted on behalf of Better Medicare Alliance (BMA). “Medicare Advantage […]
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