Healthcare Reimbursement News

CY 2025 Physician Fee Schedule Proposed Rule Summary Part III – Quality Payment Program Updates

HFMA presents part III of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2025 and other revisions to Medicare Part B policies. Part III covers the updates to the Quality Payment Program.

By HFMA September 6, 2024

Congress only has a few more months to ensure expansive telehealth access continues (updated)

Note: This article was updated Sept. 18 and Sept. 19 with information about new telehealth legislation. See the updates below. The clock is ticking on efforts to maintain the telehealth flexibilities that have been in place since the start of the COVID-19 pandemic, with advocates hoping Congress will act before year’s end. Key waivers will…

By Nick Hut September 4, 2024

A key election question: What will happen to the enhanced Affordable Care Act subsidies?

Earl Pomeroy knows from experience that the politics surrounding the Affordable Care Act (ACA) are dicey. As a Democratic member of the House Ways and Means Committee, Pomeroy helped pass the ACA during his ninth term representing North Dakota. After that, “I lost my job,” he recalled. Since his time in Congress ended with his…

By Nick Hut August 26, 2024

CY 2025 OPPS/ASC Proposed Rule Summary

HFMA presents a detailed summary of the proposed rule issued by CMS updating payments under the hospital outpatient prospective payment system and the ambulatory surgical center payment system for CY 2025.

By HFMA August 21, 2024

Hospital revenue is enhanced by state-directed Medicaid payments, health systems report

State-directed supplemental payments made through Medicaid are a growing source of hospital revenue, according to financial reporting from the for-profit hospital sector. In reporting their Q2 financials, several of the nation’s largest health systems cited Medicaid supplemental payments as a boost. State-directed payments are a relatively new form of those payments, applying to Medicaid managed…

By Nick Hut August 13, 2024

CY 2025 Physician Fee Schedule Proposed Rule Summary – Part I

HFMA presents Part I of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2025 and other revisions to Medicare Part B policies.

By HFMA August 9, 2024

The courts continue to favor providers in No Surprises Act litigation, this time at the appellate level

After a string of victories in federal district court, a medical association’s success at contesting aspects of the No Surprises Act’s arbitration process recently continued at the appellate level. In an Aug. 2 ruling, the U.S. Court of Appeals for the Fifth Circuit upheld a lower court’s finding that regulations issued in 2022 gave too…

By Nick Hut August 9, 2024

Mandatory Medicare bundled payments and respiratory disease reporting are on the way for hospitals

Hospitals in nearly a quarter of U.S. markets soon will be required to participate in a Medicare bundled payment model covering five surgical procedures, CMS said in newly released regulations. The model is among several policies of note in Medicare’s FY25 final rule for hospital inpatient care and long-term care hospitals. See this previous article…

By Nick Hut August 7, 2024

CY 2025 Home Health Prospective Payment System Proposed Rule Summary

HFMA presents a detailed summary of the CY 2025 proposed rule updating payment rates for home health agencies.

By HFMA August 7, 2024

Hospitals will get only a small bump in Medicare inpatient payments for FY25

Hospital representatives were less than excited about the rate update in Medicare’s FY25 final rule for inpatient care and long-term care hospitals. Published Aug. 1, the rule includes a 2.9% rate increase for acute care hospitals in the fiscal year that begins Oct. 1. The increase is derived from a 3.4% hike in the market…

By Nick Hut August 2, 2024
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