Medicare
The AHA recommends that the Centers for Medicare & Medicaid Services (CMS) require greater transparency in how states set MCO capitation rates.
Fundamental reform of the RAC process is at the heart of an effective and permanent solution to the appeal backlog problem and will enable hospitals to get timely administrative review that clearly is required by the Medicare statute.
CMS published in the Nov. 13 Federal Register the final rule for calendar year (CY) 2015 with changes to the Medicare physician fee schedule (PFS) and other revisions under Medicare Part B. Without additional congressional action, CMS estimates that Medicare physician payments will decline by a…
We are truly dismayed to see that despite the numerous legal defects that we identified in these audits, the OIG has proceeded to issue at least four new audit reports using extrapolation in the last month that include many of the same flaws.
Comparison of Final 2015 OPPS Addendum B With October 2014 Addendum B
Comparison of Final 2015 OPPS Addendum A with October 2014 Addendum A
CMS published in the Nov. 6 Federal Register the end-stage renal disease prospective payment system (PPS) final rule for calendar year 2015.
Signed into law on Oct. 6, the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014 expands the reporting requirements for post-acute care (PAC) providers.