About Medicare
The federal Medicare program is an essential pillar of the state’s health care system, supporting more than 6 million Californians over the age of 65 and younger Californians with disabilities. One in five hospitals is at risk of closing, in part because Medicare reimbursement rates are far lower than the cost of providing care. It’s essential that future federal Medicare policy protects patient care.
DHCS Updates 2021-22 DRG Pricing Calculators
The Department of Health Care Services has updated the state fiscal year (SFY) 2021-22 Diagnosis Related Group (DRG) pricing calculators to correct an error on reference tab “5-Policy Adjustors.”
CMS Issues CY 2022 Physician Fee Schedule Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) issued its calendar year (CY) 2022 physician fee schedule (PFS) proposed rule on July 13. Comments on the rule are due by 2 p.m. (PT) on Sept. 13.
CHA Issues Summary of CY 2022 Home Health Prospective Payment System Proposed Rule
CHA has issued a members-only summary, prepared by Health Policy Alternatives, Inc., of the calendar year 2022 home health prospective payment system (PPS) proposed rule. Comments on the rule are due to the Centers for Medicare & Medicaid Services (CMS) by 2 p.m. (PT) on Aug. 27.
CMS Issues CY 2022 End-Stage Renal Disease Prospective Payment System Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has issued its proposed rule updating the end-stage renal disease (ESRD) prospective payment system (PPS) for calendar year (CY) 2022. In addition to proposed ESRD PPS payment rates updates, the proposed rule includes changes to the ESRD Quality Incentive Program (QIP) and to the ESRD Treatment Choices Model to address health equity. Comments on the proposed rule are due Aug. 31.
Initial Surprise Bill Medical Billing Regulations Issued by Tri-Agencies
On July 1, the Departments of Health and Human Services, Labor, and Treasury (tri-agencies) released an interim final rule implementing the No Surprises Act.
Supreme Court Will Hear Case Challenging Medicare’s 340B Payment Cuts
On July 2, the Supreme Court agreed to hear American Hospital Association v. Becerra, a case that challenges Medicare’s 22.5% payment reduction to hospitals for certain separately payable outpatient drugs acquired under the 340B program.
Supreme Court Refuses to Hear Challenge to Site-Neutral Payment Policy for Clinic Visits
On Monday, the Supreme Court declined to hear the American Hospital Association’s challenge to the Centers for Medicare & Medicaid Services’ (CMS) calendar year (CY) 2019 site-neutral payment reduction when clinic visits are provided in off-campus hospital-based outpatient departments (HOPDs).
CHA Issues Comments on FFY 2022 IPPS Proposed Rule
CHA has issued a comment letter on the federal fiscal year (FFY) 2022 inpatient prospective payment system (IPPS) proposed rule.
MedPAC Releases June 2021 Report to Congress
The Medicare Payment Advisory Commission (MedPAC) has released its June 2021 Report to the Congress, a mandated report that details analysis and recommendations about the Medicare program and health care delivery system.
CMS Updates Guidance for IRF, LTCH Patient Assessment
The Centers for Medicare & Medicaid Services (CMS) has issued additional information on the accurate completion of post-acute care patient assessment tools. Through inquiries to the Post-Acute Care Quality Reporting Program Help Desk, CMS identifies the opportunity to clarify or refine guidance. The quarterly Frequently Asked Questions consolidate information from June 2020 to June 2021 relating to the completion of the inpatient […]