Medicare Payment and Reimbursement

FY 2024 Hospice Payment Rate Update Final Rule Summary

HFMA provides a detailed summary of the final rule updating the Medicare hospice payment rates, wage index, the cap amount and the quality reporting requirements for FY 2024.

HFMA August 15, 2023

Healthcare News of Note: 10 drugs account for a large share of Medicare Part D spending

In total, Part D gross spending rose from $166 billion in 2018 to $216 billion in 2021.  In 2023, customer personal identifiable information costs organizations $183 per record and employee PII costs $181 per record.  Average length across all clinical notes increased 8.1%, from 4,628 characters in May 2020 to 5,002 characters in April 2023. …

Deborah Filipek August 11, 2023

FY 2024 Inpatient Psychiatric Facilities PPS Final Rule Summary

HFMA presents a detailed summary of the FY 2024 final rule released by CMS that rebases and revises the inpatient psychiatric facilities (IPF) PPS market basket to reflect a 2021 base year and makes other changes affecting IPF PPS rates.

HFMA August 9, 2023

Medicare’s proposed remedy for 340B-acquired drug underpayments: Addressing only half at best?

On July 7, 2023, CMS released a proposed rule, identified as CMS-1793-P, which outlines the agency’s intended actions to address the adjustment of Medicare payment rates for drugs acquired under the 340B Drug Pricing Program. This proposed rule pertains to the period spanning from calendar year 2018 through Sept. 27, 2022. The necessity for this remedy…

Shawn Stack August 7, 2023

FY 2024 Inpatient Rehabilitation Facility PPS Final Rule Summary

HFMA presents a detailed summary of the final rule issued by CMS on the Medicare inpatient rehabilitation facility prospective payment system for FY 2024.

HFMA August 3, 2023

5 things to know about Medicare’s FY24 final rule for inpatient payments as hospitals foresee adverse impacts

The FY24 final rule for Medicare inpatient payments didn’t bring hospitals the type of rate update they sought, and for some organizations a bigger concern is changes to uncompensated care (UC) payments and disproportionate share hospital (DSH) payments. Here are five big points about the regulations, which take effect Oct. 1 and also cover Medicare…

Nick Hut August 2, 2023

A projected Medicare physician payment decrease spurs more calls to reform the system

Physician advocacy groups vehemently expressed concern about the financial consequences of CMS’s proposed rule for Medicare physician payments in 2024, intensifying a push to modify the payment system. At a time of elevated expenses in healthcare, total payments would be reduced by a projected 1.25% relative to 2023. That would follow a 2% decrease from…

Nick Hut July 24, 2023

Remedy for 340B-Acquired Drug Payment Policy Proposed Rule Summary

FMA presents a detailed summary of the proposed rule describing the Agency’s proposed actions to craft a remedy relating to the adjustment of Medicare payment rates for drugs acquired under the 340B Program from calendar 2018 through September 27, 2022.

HFMA July 21, 2023

House committee approves bill requiring national provider identifiers for off-campus outpatient departments

A bill with widespread support in Congress would affect hospital billing procedures at off-campus outpatient departments if it becomes law. The House Committee on Education and the Workforce on July 12 unanimously approved legislation called the Transparency in Billing Act, which states that starting in 2024, hospital claims for items and services furnished in off-campus…

Nick Hut July 19, 2023

Medicare outpatient payments to hospitals won’t rise considerably in 2024, according to a proposed rule

Medicare’s newly proposed outpatient payment update for 2024 is unlikely to be greeted with enthusiasm by hospitals. The update for items and services provided in the hospital outpatient or ambulatory surgical center setting would be 2.8%, mirroring the proposed change for inpatient payments. The base update would be 3%, with a statutorily required productivity adjustment…

Nick Hut July 14, 2023
googletag.cmd.push( function () { googletag.display( 'hfma-gpt-leaderboard' ); } );