Medicare Payment and Reimbursement

This too contains useful information on CMS's Value-Based Purchasing Program and other initiatives that will help improve the quality of care in hospitals.

This fact sheet highlights payment rate updates under the OPPS for CY15.

This document highlights important updates to the 2015 payment rates to hospitals under the FY15 Inpatient Prospective Payment System final rule.

HFMA comments the 2015 Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Physician-Owned Hospitals: Data Sources for Expansion Exception; Physician Certification of Inpatient Hospital Services; Medicare Advantage Organizations and Part D Sponsors: Appeals Process for Overpayments Associated With Submitted Data; Proposed Rule (hereafter referred to as the 2015 OPPS Proposed Rule) published in the July 14, 2014, Federal Register. 

This document provides an overview of the CY15 proposed changes to payment rates under the outpatient prospective payment system (OPPS).

HFMA submitted a comment letter on key issues contained in CMS's Proposed Rule for FY2015 PPS for inpatient hospitals. Significant concerns relate to DSH, HACs, VBP, short stays, and other issues.

This document summarizes important proposed updates to payment rates to IPPS hospitals for FY15.

HFMA comments on CMS's IFR to codify the guidance related to third party premium payment for individuals enrolling in QHPs. However, the IFR does not resolve the ambiguity created by CMS’s conflicting statements on the issue.

With weeks remaining in the open enrollment period it appears highly unlikely that the CBO's May 2013 estimate of a reduction in the uninsured by 14 million individuals in 2014 will be achieved. 

Read HFMA's comments to Centers for Medicare & Medicaid Services regarding its FY2014 proposed rule for Hospital Inpatient Prospective Payment Systems.