Medicare Payment and Reimbursement

News Briefs: Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule 

The final rule setting Medicare’s 2024 payment rates and policies for hospital outpatient services and ambulatory surgical centers (ASCs) contained little to make hospitals optimistic about the government portion of their payer mix.  Base payments for items and services furnished in hospital outpatient settings and ASCs will increase by 3.1% after factoring in the usual…

Nick Hut December 12, 2023

10 Keys to Restoring Trust in Healthcare

The issue of restoring consumer trust in the U.S. healthcare system encompasses a wide range of concerns. Factors in the perceived loss of trust include anxiety and confusion over costs, entrenched inequity, a glut of misinformation about vaccines and other treatments, and data and privacy breaches. To examine the problem and explore solutions, HFMA’s 16th…

Nick Hut December 7, 2023

CY 2024 Physician Fee Schedule Final Rule Summary Part III – Quality Payment Program Updates

HFMA presents part III of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part III covers the updates to the Quality Payment Program.

HFMA December 4, 2023

Prior authorization in Medicare Advantage remains in the policy spotlight as 2024 regulations take effect

Healthcare policymakers and stakeholders continue to mull the need for guardrails to ensure optimal customer service among Medicare Advantage (MA) health plans. The American Hospital Association wrote a Nov. 20 letter to CMS stating that MA plans are looking to skirt policies designed to ensure straightforward coverage of essential healthcare services. These policies, finalized earlier…

Nick Hut December 1, 2023

CY 2024 Physician Fee Schedule Final Rule Summary Part II – Medicare Shared Savings Program Requirements

HFMA presents part II of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part II covers the Medicare Shared Savings Program Requirements.

HFMA December 1, 2023

CY 2024 Physician Fee Schedule Final Rule Summary – Part I

HFMA presents part I of three detailed summaries of the final rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies.

HFMA December 1, 2023

Congress doesn’t seem to be mulling a fix for the 2024 Medicare physician payment cut

Congress has mitigated a scheduled Medicare payment cut for physicians going into each of the last three years, but relief does not appear to be on the way for a fourth year running. Medicare’s 2024 final rule for physician payments includes a $1.15 decrease to the conversion factor, amounting to a reduction of more than…

Nick Hut November 27, 2023

Remedy for the 340B-Acquired Drug Payment Policy Final Rule Summary

HFMA presents a detailed summary of the final rule released by CMS describing its actions to craft a remedy relating to the adjustment of Medicare payment rates for drugs acquired under the 340B Program from calendar year 2018 through September 27, 2022.

HFMA November 20, 2023

Proposed rule sets Medicare penalties for providers that commit information-blocking infractions

Hospitals and other healthcare providers would face penalties for knowingly engaging in information blocking, with the sanctions affecting their Medicare reimbursement, according to a proposed rule from the U.S. Department of Health and Human Services (HHS) and CMS. Published at the beginning of November, the rule implements some terms of the 21st Century Cures Act,…

Nick Hut November 17, 2023

Senate bill would give hospitals a big break from looming Medicaid disproportionate share hospital cuts (updated)

Nov. 15 update: On Nov. 14, the House passed legislation on a bipartisan basis to keep the government funded through Jan. 19. Medicaid disproportionate share hospital payments would be guaranteed to remain at their full amount through that date, and the bill similarly maintains short-term funding for graduate medical education, community health centers and the…

Nick Hut November 13, 2023
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