Prospective Payment Systems (PPS)

CMS has delayed system edits that would require hospitals and health systems with multiple locations to include on outpatient prospective payment system claims for services provided in off-campus provider-based departments the exact same provider address entered in the Medicare Provider, Enrollment…
The AHA today submitted comments on the Centers for Medicare & Medicaid Services’ hospital inpatient prospective payment system proposed rule for fiscal year 2020.
The AHA today submitted comments on the Centers for Medicare & Medicaid Services’ fiscal year 2020 proposed rule for the long-term care hospital prospective payment system.
The Centers for Medicare & Medicaid Services (CMS) April 17 issued a proposed rule for the inpatient rehabilitation facility (IRF) prospective payment system (PPS) for fiscal year (FY) 2020.
AHA today urged the Centers for Medicare & Medicaid Services to address in forthcoming rules for inpatient rehabilitation facilities and other post-acute care providers several concerns related to the agency’s revised case-mix grouping system for IRFs.
The AHA strongly opposes site-neutral proposals to reduce payment for certain hospital outpatient services furnished in excepted off-campus provider-based departments to 40 percent of the outpatient prospective payment system rate in calendar year 2019, the association told the Centers for Medicare…
The AHA appreciates the extensive work CMS has done to develop and alternative to the current SNF case-mix system. However, our evaluation of the patient-driven payment model still has several flaws, which must be addressed before the PDPM proposal can be finalized.
The AHA appreciates the extensive work CMS has done to develop and alternative to the current SNF case-mix system. However, our evaluation of the patient-driven payment model still has several flaws, which must be addressed before the PDPM proposal can be finalized.
The AHA supports several of the proposed rule’s provisions. In particular, we appreciate and endorse the agency’s proposal to permanently withdraw the 25% Rule; however, we have substantial concerns with the associated budget neutrality adjustment proposed by CMS. We also support the proposed…
The AHA continues to have concerns over the accuracy and consistency of the “Worksheet S-10” data that CMS will use to determine the cost of treating uninsured patients.