Medicare

Aug 15, 2018
Beginning in January, Medicare will pay for certain care management home visits under the Next Generation Accountable Care Organization Model. Next Generation participants and preferred providers who have initiated a care treatment plan for aligned beneficiaries will be eligible to receive up to…
Aug 10, 2018
In a brief filed today in federal court, the AHA and three member hospitals reaffirmed their support for four broad categories of non-deadline remedies to reduce the backlog of Medicare billing appeals awaiting adjudication at the Administrative Law Judge level. They also proposed that the court…
Aug 8, 2018
In a memorandum to Medicare Advantage organizations, the Centers for Medicare & Medicaid Services yesterday announced new flexibility related to the use of step therapy in coverage of Part B services. The agency will allow MA plans to impose step therapy requirements for covered Part B drugs…
Aug 2, 2018
The Centers for Medicare & Medicaid Services yesterday issued a final rule updating Medicare’s hospice payment rates, wage index and quality reporting requirements for fiscal year 2019. Like the proposed rule, the final rule will increase both aggregate hospice payments and the statutory annual…
Jun 25, 2018
The AHA today submitted comments on the Centers for Medicare & Medicaid Services’ inpatient prospective payment system proposed rule for fiscal year 2019, offering key recommendations with respect to Medicare Disproportionate Share Hospital payment, CAR T-cell therapy, rural hospitals, the wage…
Aug 14, 2018
On July 2, the Centers for Medicare & Medicaid Services published its calendar year (CY) 2019 proposed rule for the home health prospective payment system.
Aug 9, 2018
The Centers for Medicare & Medicaid Services late today issued a proposed rule that would redesign the Medicare Shared Savings Program’s participation options by offering eligible accountable care organizations two tracks, which they would agree to participate in for at least five years.…
Aug 9, 2018
Tom Nickels Executive Vice President American Hospital Association   August 9, 2018   Hospitals and health systems have embraced the Medicare Shared Savings Program and Accountable Care Organizations (ACOs) as ways to advance their ongoing efforts to transform delivery system reform…
Aug 6, 2018
On July 12, the Centers for Medicare & Medicaid Services issued a proposed rule that would update physician fee schedule payments for calendar year 2019. The rule also included several proposals to the quality payment program created by the Medicare Access and CHIP Reauthorization Act. AHA’s Regulatory Advisory offers a detailed summary of the proposed rule.
Aug 3, 2018
RE: CMS-1720-NC, Request for Information Regarding the Physician Self-referral Law dl iconDownload the letter (PDF)   The AHA’s response to the request for information from the Centers for Medicare & Medicaid Services highlights the obstacles hospitals and physicians face in moving…