FY 2027 Hospice Payment Rate Update Final Rule Summary
HFMA presents a detailed summary of the final rule updating the Medicare hospice payment rates, wage index and Hospital Quality Reporting Program for FY 2027.
FY 2027 Skilled Nursing Facility PPS Final Rule Summary
HFMA presents a detailed summary of the final rule updating for FY 2027 the Medicare skilled nursing facility (SNF) payment rates, SNF Quality Reporting Program and the SNF Value-Based Purchasing Program.
Medicaid Indirect Hold Harmless Threshold Proposed Rule Summary
HFMA provides a detailed summary of the proposed rule to revise standards for determining whether an indirect hold harmless arrangement exists for a health care-related tax (sometimes referred to as a provider tax).
FY 2027 Inpatient Rehabilitation Facility PPS Final Rule Summary
HFMA presents a detailed summary of the FY 2027 final rule updating the Medicare inpatient rehabilitation facility prospective payment system.
Medicare DSH payments ruling could boost hospital reimbursement under 1115 waivers
Hospitals obtained a victory in a case about Medicare disproportionate share hospital (DSH) payments, with potentially significant reimbursement implications. In a July 27 ruling in Covenant Medical Center v. Kennedy, a judge with the U.S. District Court for Northern Texas struck down an HHS rule that excluded certain patients from the DSH formula if they were…
Senate Medicaid hearing highlights the debate over federal spending cuts
Cuts to federal Medicaid spending are necessary to streamline the program and don’t necessarily portend tough times for providers, conservative policymakers and analysts argued during a Senate hearing. The Aug. 4 hearing of the Senate Budget Committee included discussion of whether healthcare policies in the One Big Beautiful Bill Act (OBBBA) should be scaled back…
CY 2027 Physician Fee Schedule Proposed Rule Summary Part III – Quality Payment Program
HFMA presents Part III of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2027 and other revisions to Medicare Part B policies.
CY 2027 Physician Fee Schedule Proposed Rule Summary Part II – MSSP Requirements
HFMA presents Part II of three detailed summaries of the proposed rule relating to the Medicare physician fee schedule for CY 2027 and other revisions to Medicare Part B policies.
SUSTAIN 340B Act proposes major changes for hospitals and pharmacies
A bipartisan working group in Congress released a preliminary legislative draft that attempts to resolve some of the most disputed aspects of the 340B Drug Pricing Program. One noteworthy provision in the legislation would curtail the 340B rebate model, which was finalized by the Health Resources and Services Administration on July 31 and is scheduled to begin Jan.…
CJR-X mandatory bundled payment model begins for hospitals in 2028
Hospitals have 17 months to prepare for the first mandatory nationwide alternative payment model, as established in Medicare’s FY27 final rule for the Inpatient Prospective Payment System (IPPS) and long-term care hospitals (LTCHs). The final rule makes no major changes to the proposal issued earlier this year for the CJR-X Model, which will require most…