On August 2, 2013, the Centers for Medicare & Medicaid Services (CMS) released the 2014 IPPS Final Rule. In the final rule, CMS made a few revisions from the proposed rule related to the Disproportionate Share Hospital (DSH) calculation
The Centers for Medicare & Medicaid Services (CMS) released the 2014 IPPS Proposed Rule on April 26, 2013, proposing several payment revisions as a result of the Patient Protection and Affordable Care Act (PPACA).
As a result of the Budget Control Act of 2011 , mandatory federal spending cuts, commonly known as “sequestration,” are required. This law is expected to generate spending cuts of $109 billion in the first year and $1.2 trillion through 2021. Sequestration was originally expected to begin January 2, 2013, but was postponed for two months through the American Taxpayer Relief Act of 2012 , passed on December 31, 2012.
Although the hospital industry has weathered difficult conditions in the past, widespread challenges continue to push change within the sector. Widely reported regulatory changes and the need to obtain operational and financial scale and scope in the health care industry have combined with other auxiliary issues to compound the need for further change within the sector
Regulated transactions with physicians are now common for hospitals. With the significant number of physician practice acquisitions and other affiliations, the number of regulated transactions with physicians has gone up exponentially
In the fiscal year 2013 Medicare inpatient prospective payment system (IPPS) final rule, the Centers for Medicare & Medicaid Services finalized which hospitals are subject to the Hospital Readmissions Reduction Program (HRRP), as well as what portion of the IPPS payment will be affected by the readmission adjustment factor. The impact on the diagnosis-related group (DRG) reimbursement will begin October 1, 2012, with the beginning of the federal fiscal year (FY). Studies show nearly one in five patients discharged are readmitted within 30 days, at a cost to the Medicare program of $15 billion per year. Beginning in October, hospitals with readmission rates higher than a certain threshold for the three conditions below will be penalized up to 1 percent of their aggregate base DRG rate. The penalty increases to a maximum of 2 percent in FY 2014 and 3 percent in FY 2015. In addition, the list of conditions measured increases in FY 2015
On Monday, May 21, 2012, the Centers for Medicare & Medicaid (CMS) published a reminder that, effective for services provided on or after July 1, 2012, the statutory moratorium allowing certain pathologists and independent laboratories to bill for the technical component (TC) of pathology services expires. This means the TC for those surgical pathology services provided under arrangement to Medicare hospital patients only will be considered covered and payable by Medicare if billed by the hospital. The hospital will receive additional payment under the Outpatient Prospective Payment System (OPPS) for services provided to outpatients, but such services are considered included in the diagnosis-related group reimbursement for inpatients
Payment Rate Updates CMS has proposed a 2.1 percent update to the federal operating standardized amount. This is based on a 3 percent market basket update, reduced by two factors mandated by the Patient Protection and Affordable Care Act (PPACA): a 0.8 percent economy wide productivity adjustment and an additional 0.1 percent reduction.
The Centers for Medicare & Medicaid Services (CMS) is accepting comments through June 25, 2012, on the proposed rule changes to the hospital inpatient prospective payment system (IPPS) for federal fiscal year (FY) 2013. The proposed rule identifies CMS’ changes to the annual payment policy updates for hospitals as well as revisions to the wage index, quality reporting requirements and value-based purchasing. The proposed Payment Rate Updates establish the FY 2013 operating standardized amount at $5,325.62, a 2.1 percent increase from prior year for those reporting quality data.
The 2012 Mississippi legislative session was closely watched as Gov. Phil Bryant and Lt.