CMS Issues FFY 2020 Long-Term Care Hospital PPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has issued the proposed rule for the long-term care hospital (LTCH) prospective payment system (LTCH PPS), as part of the inpatient prospective payment system (IPPS) for federal fiscal year (FFY) 2020. The provisions in the proposed rule, if finalized, would be effective Oct. 1.
CMS Issues FFY 2020 IPPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) this week released its federal fiscal year (FFY) 2020 inpatient prospective payment system (IPPS) proposed rule. In addition to annual payment updates, including changes to Medicare disproportionate share hospital (DSH) payments, CMS proposes significant changes to the hospital area wage index. CHA believes this proposal inappropriately and unnecessarily punishes states like California with a high cost of living and is analyzing the impact of the proposal to determine an appropriate political and policy response.
CMS Issues FFY 2020 Skilled-Nursing Facility PPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has issued the federal fiscal year (FFY) 2020 proposed rule for the skilled-nursing facility prospective payment system (SNF PPS). The provisions in the proposed rule, if finalized, would be effective Oct. 1, 2020.
CMS Issues FFY 2020 Inpatient Rehabilitation Facility PPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has issued the proposed rule for the inpatient rehabilitation facility prospective payment system (IRF PPS) for federal fiscal year (FFY) 2020. If finalized, the provisions would be effective Oct. 1, 2020.
CMS Issues FFY 2020 Inpatient Psychiatric Facility PPS Proposed Rule
Yesterday, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the federal fiscal year (FFY) 2020 inpatient psychiatric facility (IPF) prospective payment system (PPS).
CMS Postpones Billing Edits for OPPS Providers With Multiple Service Locations
The Centers for Medicare & Medicaid Services (CMS) has postponed billing edits for outpatient providers with multiple service locations — scheduled to start in April — for three additional months.
MedPAC Issues Recommendations to Congress
At the January meeting, the Medicare Payment Advisory Commission (MedPAC) recommended that Congress increase the rate for hospital inpatient and outpatient prospective payment systems (PPS) by 2 percent in federal fiscal year (FFY) and calendar year (CY) 2020.
CHA Issues Summary of CY 2019 OPPS Final Rule
CHA has issued a summary of the Centers for Medicare & Medicaid Services’ final rule addressing rate updates and policy changes to the Medicare outpatient prospective payment system (OPPS) and ambulatory surgical center payment system for calendar year (CY) 2019.
FFY 2019 Uncompensated Care Payments to Come From 2014, 2015 Worksheet S-10 Data
In the federal fiscal year (FFY) 2019 inpatient prospective payment system final rule, the Centers for Medicare & Medicaid Services (CMS) finalized its second year of a three-year transition to use Worksheet S-10 data for distributing Medicare disproportionate share hospital (DSH) uncompensated care payments. CMS will use two years (FFYs 2014 and 2015) of Worksheet S-10 cost report data and one year of proxy data to distribute the uncompensated care payments for FFY 2019.
In response to comments from CHA, CMS noted in the final rule that it planned audits of the data in fall 2018. In late August, CMS began audits of selected hospitals’ FFY 2015 cost reports. A number of hospitals in California have received this data request, and must respond by Sept. 28.
Because CMS has given the Medicare administrative contractors (MACs) only until the end of January to complete the audits, providers have a short timeline to complete this work with their MACs. Though CHA acknowledges that this presents a challenge from both technical and resource perspectives, CHA highly encourages hospitals that have received a request to respond as quickly as possible. Early communication with Noridian (or its subcontractor, Figliozzi & Company) is critical under this short timeline. A copy of the letter Noridian sent to select providers requesting documentation is attached; these letters are consistent across all MACs.
CHA Comments on CY 2019 Outpatient PPS Proposed Rule
CHA has submitted the attached comment letter on the calendar year (CY) 2019 outpatient prospective payment system (OPPS) proposed rule. In reviewing the policy and payment proposals outlined in the proposed rule, CHA is concerned that the agency has taken steps that are not only unlawful, but threaten the financial stability of the hospital OPPS and, in turn, access to care for Medicare beneficiaries. In particular, CHA strongly opposes CMS’ proposals to expand site-neutral payment policies for off-campus provider-based departments (PBDs) and to expand payment cuts for non-excepted PBDs participating in the 340B Drug Pricing Program. In addition, CHA provides comments on a number of other proposed payment and policy provisions. Specifically, CHA:
Urges CMS to withdraw all three of its proposals to expand site-neutral payment policies in off-campus PBDs
Opposes CMS’ proposal to reduce payments for separately payable Part B drugs from wholesale acquisition cost (WAC) plus 6 percent to WAC plus 3 percent