Medicare Payment and Reimbursement

HFMA submits comments to CMS on the CY 2019 hospital OPPS/ASC proposed rule, published in the July 31, 2018, Federal Register. 

Sept. 26—Amid rising concern in Congress over rural hospital failures, some stakeholders are renewing their push for a long-sought Medicare payment change that was described during a recent hearing as “one of the single most important” financial fixes for those organizations.

Sept. 25—Among reactions to a range of thorny policy proposals, hospital advocates are urging Medicare to withdraw a $760 million payment cut for outpatient services.

CMS published a proposed rule updating OPPS/ASC payments for CY 2019, in the July 31, 2018, Federal Register.

Sept. 12—A Medicare proposal to simplify evaluation and management (E/M) codes could hit hospitals’ bottom lines, hospital advocates recently warned the Trump administration.

HFMA submits comments to CMS on the CY 2019 Medicare Physician Fee Schedule Proposed Rule, published in the July 27, 2018, Federal Register.

Fee-for-service is still the dominant payment method because of certain economic factors and a traditional industrial mindset that values volume.

A deep understanding of active contracts, combined with proactive and purposeful performance monitoring and open communication with health plans must be in place to ensure that hospitals are appropriately paid and the incentives available to them are aligned.

Aug. 10—The U.S. Department of Health and Human Services (HHS) would receive a small increase and funding for several hospital priorities under a FY19 funding bill that the Senate is expected to vote on next week.

Aug. 6—More than 3,000 hospitals will receive an average increase of nearly 3 percent in their Medicare inpatient payment rates—along with a slew of policy changes—under a recently issued final rule.