Medicare Payment and Reimbursement

The Blurring Boundaries of Elder Care: Implications for Providers and Patients

Healthcare providers are planning to invest in home health, palliative and end-of-life care, and geriatric caretakers in the coming years.

By Jim Watson December 5, 2018

Long-Delayed 340B Rule Takes Effect in January

Nov. 30—A highly anticipated rule to require better drug company compliance with a major discount drug program will go into effect Jan. 1—following multiple delays.

By Rich Daly December 4, 2018

Surprise Medical Bills, Direct Primary Care Gain Senate Attention

Nov. 28—Senators said they will push legislation to limit surprise medical bills and to support direct primary care as part of congressional efforts to control rising healthcare costs.

By Rich Daly November 29, 2018

CY 2019 OPPS/ASC Final Rule

This document highlights the payment rate updates for CY 2019, included in the hospital OPPS/ASC final rule, published by CMS.

By HFMA November 27, 2018

FY 2019 IPPS/LTCH Final Rule

This document summarizes key provisions of the FY 2019 IPPS/LTCH final rule, published by CMS.

By HFMA November 7, 2018

Hospitals Hit By 340B and Site-Neutral Medicare Cuts in New Rule

Nov. 5—Medicare pay cuts included in a new payment rule will affect the federal discount drug program and off-campus provider-based departments (PBDs).

By Rich Daly November 6, 2018

Providers Should Keep Watch on Payer Discount Increases

A significant uptick in payer contractual allowances and discounts in the first quarter of 2018 indicate that hospitals should remain focused on payer mix and payer category shifts.

By Jeanne M. Slates November 2, 2018

Hospital Advocates Concerned About Trump Drug Price Plan

Oct. 26—Hospitals would face uncertain financial impacts under a Medicare drug payment pilot announced this week.

By Rich Daly October 29, 2018

The Controversy over the Rules of the Game for the Medicare Shared Savings Program

Ken Perez examines the fundamental disagreement over how MSSP ACO savings are being measured and the potential fallout as participants consider leaving the program.

By Ken Perez October 16, 2018

Medicare Shared Savings Program “Pathways to Success” Proposed Rule

This document summarizes the Medicare Shared Savings Program - Pathways to Success proposed rule, published in the August 17, 2018, Federal Register.

By HFMA October 3, 2018
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