Medicare Payment and Reimbursement

Susan Dentzer: Perspectives differ on Medicare’s 2 houses

Drive through rural New England and you’ll see them: “connected farms,” cobbling together houses, sheds, barns and outbuildings in disjointed structures. Often centuries old, they are at once unlovely, yet exude charm. To me, they’re a perfect metaphor for the jumble of Medicare. How else does one describe a program that baffles new enrollees as…

By Susan Dentzer, MS April 28, 2023

News Briefs: Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say

Hospitals are less than pleased with Medicare’s proposed FY24 payment increase for inpatient care. In regulations released April 10, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify…

By Nick Hut April 28, 2023

FY 2024 IPPS/LTCH Proposed Rule Summary

HFMA presents a detailed summary of its proposed rule describing federal fiscal year (FY) 2024 policies and rates for Medicare’s inpatient prospective payment system and the long-term care hospital prospective payment system.

By HFMA April 26, 2023

FY 2024 Skilled Nursing Facilities PPS Proposed Rule Summary

HFMA presents a detailed summary of the proposed rule updating the Medicare skilled nursing facility (SNF) payment rates for fiscal year (FY) 2024.

By HFMA April 26, 2023

Hospitals are facing a long slog to return to pre-pandemic normalcy, panelists say

The logjam of patients who cannot be seen expeditiously at hospitals is becoming an entrenched problem with no imminent solutions, a CMS leader said this week. “The data tells us healthcare services, particularly for the Medicare population, have not come back to pre-pandemic levels,” said Jonathan Blum, principal deputy administrator and COO with CMS. “We’re…

By Nick Hut April 21, 2023

FY 2024 Inpatient Psychiatric Facilities Prospective Payment System Proposed Rule Summary

HFMA presents a detailed summary of the fiscal year (FY) 2024 Inpatient Psychiatric Facilities Prospective Payment System proposed rule, published in the April 10, 2023, Federal Register.

By HFMA April 19, 2023

FY 2024 Hospice Wage Index and Payment Rate Update Proposed Rule Summary

HFMA presents a detailed summary of the proposed rule updating the Medicare hospice payment rates, wage index, the cap amount, and the quality reporting requirements for federal fiscal year (FY) 2024.

By HFMA April 19, 2023

State of Medicare: Some good news on program solvency still leaves questions and challenges

Medicare should remain solvent a little bit longer than previously anticipated, while a policy debate is ramping up over how to make the program sustainable for the long term. The 2023 annual report of the Medicare Boards of Trustees projects that the Hospital Insurance (HI) trust fund, which subsidizes Part A services, essentially will be…

By Nick Hut April 17, 2023

Medicare’s proposed FY24 update to inpatient payments falls short, hospitals say

Hospitals are less than pleased with Medicare’s proposed FY24 payment update for inpatient care. In proposed regulations, the net inpatient payment update is 2.8% after factoring in a mandatory productivity adjustment of -0.2 percentage points. As usual, the update would be reduced for any hospital that does not fulfill quality-reporting requirements or qualify as a…

By Nick Hut April 12, 2023

CMS and other stakeholders take steps to improve prior authorization in Medicare Advantage and beyond

Several recent developments point to an industrywide effort to ease the burden of prior authorization. Most notably, CMS on April 5 finalized a rule that includes provisions designed to improve prior authorization in Medicare Advantage (MA) starting with the 2024 plan year. The rule addresses a few aspects of prior authorization, among them the way…

By Nick Hut April 6, 2023
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