CMS’s 340B-acquired drug payment policy final rule is here
The 340B Drug Pricing Program final rule was published[DF1] [SS2] [SS3] in the Federal Register Nov. 8, 2023, after CMS released details of it (CMS-1793-F) on Nov. 2, 2023. The rule details the agency’s actions, and in some cases non-actions, to adjust Medicare payment rates for drugs acquired under the 340B program from calendar year 2018 through Sept.…
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 no major surprises and little to make hospitals optimistic about the government portion of their payer mix. Here are five of the most important payment and coverage takeaways from the rule, which totals 1,672 pages…
Medicare’s final $9 billion remedy plan for 340B providers doesn’t address hospitals’ key concerns
Hospitals received final details on a $9 billion remedy payment plan for participants in the 340B Drug Pricing Program, with advocates expressing disappointment that corresponding reductions to other payments will go through as previously proposed. CMS issued a Nov. 2 final rule describing the terms of the remedy payment, which was necessitated after the Supreme…
HRSA curtails pandemic-era 340B flexibilities for hospitals’ off-campus outpatient facilities
In an expected move that stands to affect the savings reaped by health systems from the 340B Drug Pricing Program, the Health Resources and Services Administration (HRSA) is tightening participation requirements for off-campus outpatient facilities. In a published alert, HRSA announced plans to end pandemic-related flexibilities that have made it easier for off-campus outpatient facilities…
Healthcare News of Note: With new treatments emerging, Medicare increases coverage of PET screening for Alzheimer’s disease
Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals. 1. CMS updates Medicare coverage of PET scans as a screening tool for Alzheimer’s disease CMS recently moved to expand Medicare coverage of screening for a primary marker of Alzheimer’s disease, a key step…
CY 2024 Physician Fee Schedule Proposed Rule Summary Part III – Quality Payment Program Updates
HFMA presents part III of three detailed summaries of the proposed 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.
CY 2024 Physician Fee Schedule Proposed Rule Summary Part II – Medicare Shared Savings Program Requirements
HFMA presents part II of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies. Part II includes proposals related to the Medicare Shared Savings Program.
In response to a congressional RFI, provider advocates give input on ways to bolster rural healthcare
Hospital and physician groups were among the respondents to a request by a key congressional committee for information on improving rural healthcare. In an RFI issued in September, the House Ways and Means Committee sought policy solutions for augmenting access to — and the quality of — healthcare in relatively remote areas. “The committee will…
CY 2024 Physician Fee Schedule Proposed Rule Summary – Part I
HFMA presents part I of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2024 and other revisions to Medicare Part B policies.
Medicaid DSH payment cut barely averted as House, Senate pass short-term federal funding
Hospitals received a last-day reprieve from substantial cuts to Medicaid disproportionate share hospital (DSH) payments, with House leaders reversing course Sept. 30 and ushering through a six-week government funding package. Language in the bill ensures a four-year, $32 billion Medicaid DSH cut will not take effect before Nov. 17. Most importantly, the bill bought time…