After OIG says hospitals may be engaging in upcoding, CMS and AHA dispute the finding
The HHS Office of Inspector General says a significant rise in high-severity inpatient admissions with no corresponding increase in length of stay indicates a possible pattern of upcoding by hospitals in recent years.
Hospitals seek reversals of Trump policies, among various requests of Biden
Hospitals are urging a range of policy changes, including halting the new price transparency rules, by the incoming Biden administration.
CMS warns a common hospital price transparency approach is noncompliant with new requirements
Many hospitals are using a rate-averaging approach to meet transparency requirements, which CMS recently deemed noncompliant.
CMS plans aggressive price transparency enforcement while hospitals urge a halt to the new rules
CMS plans aggressive enforcement of the looming hospital price transparency requirements, as hospitals urge judicial and Biden administration interventions.
HHS starts distribution of $24 billion more in COVID grants but rejects one-third of applicants
More than 70,000 providers will share in the latest round of Provider Relief Fund grants, which total $24.5 billion.
Medicare phases out the inpatient-only list, backs off further 340B payment cuts
The final rule for the CY21 Medicare Outpatient Prospective Payment System will phase out the inpatient-only list but won’t implement steeper 340B cuts.
Stark, Anti-Kickback changes draw praise from providers
Final rules modifying enforcement of the Stark Law and the Anti-Kickback Statute aim to remove barriers to participation in value-based payment models.
CMS finalizes requirement for hospitals to report MA plan rates
In the FY21 IPPS final rule, CMS expanded controversial negotiated-price reporting requirements.
Providers should prepare for a possible expansion of Medicare site-neutral policies
HFMA’s Chad Mulvany says if the CY2021 OPPS rule is finalized as proposed without significant modifications to CMS's MS-DRG weight-setting process, it heightens the need for hospitals to expand outpatient/ASC capacity and continue aggressive cost management.
CMS to add COVID-19-related waivers to value-based payment models, Verma says
Medicare plans to add pandemic-era waivers to its value-based payment models as a way to incentivize provider participation.