The newsroom includes access to CHA News, which provides timely information to members every Thursday and is at the core of CHA benefits. In addition, it is also home to resources such as toolkits and talking points designed to help member hospitals and health systems communicate with internal and external audiences on a range of current health care-related issues. Links to CHA media statements and press releases can also be found here.
Newsroom
Hospitals Reminded to Submit Revised Worksheet S-10 Data to CMS
This post has been archived and contains information that may be out of date.
The Centers for Medicare & Medicaid Services’ (CMS’) federal fiscal year (FFY) 2018 inpatient prospective payment system final rule establishes changes to fund distribution for Medicare disproportionate share hospital (DSH) uncompensated care (UCC) payments. CMS determined that it will phase-in payments based on information collected from Line 30 on the S-10 Worksheet of the Medicare cost report to determine the UCC payment factor, starting with FFY 2014 cost reports for DSH UCC payments in FFY 2018.
As previously reported in CHA News, hospitals may submit revisions to Worksheet S-10 of their Medicare cost report for FFYs 2014 and 2015. CHA urges members to review Worksheet S-10 of their FFY 2014 and 2015 cost reports and submit amendments to their respective Medicare administrative contractors before the Oct. 31 deadline.
CMS Proposed Rule Cancels Cardiac EPM, Modifies CJR Participation
This post has been archived and contains information that may be out of date.
The Centers for Medicare & Medicaid Services (CMS) has issued the attached proposed rule that would cancel the episode payment models (EPMs) and the cardiac rehabilitation incentive payment model, scheduled to begin Jan. 1, 2018. The proposed rule would also reduce the number of mandatory metropolitan statistical areas (MSAs) participating in the Comprehensive Care for Joint Replacement (CJR) model, including two in California: Modesto and San Francisco-Oakland-Hayward. Los Angeles-Long Beach-Anaheim remains on CMS’ list of MSAs for mandatory participation.
In addition, CMS proposes to exempt rural hospitals and low-volume hospitals located in the mandatory participation MSAs from required participation in the CJR model beginning in February 2018, and allow them instead to make a one-time voluntary participation election.
CMS Finalizes Implementation of Worksheet S-10 for Medicare DSH Uncompensated Care Payments
This post has been archived and contains information that may be out of date.
Today, the Centers for Medicare & Medicaid Services (CMS) issued its final rule updating the inpatient and long-term care hospital prospective payment systems (PPS) for federal fiscal year (FFY) 2018.
For inpatient PPS hospitals, CMS finalized a market-basket update of 2.7 percent, reduced by a negative 0.6 percent productivity adjustment and the negative 0.75 adjustment required by the Affordable Care Act (ACA), as well as a cut of 0.6 percent to remove the one-time, temporary adjustment that it made in FFY 2017 to restore the unlawfully instituted two-midnight policy cuts. In addition, CMS finalized an increase of 0.4588 percent, as required by the 21st Century Cures Act, to partially restore cuts made as a result of the American Taxpayer Relief Act of 2012. CMS estimates total Medicare spending on inpatient hospital services will increase by approximately 1.2 percent, or $2.4 billion, as compared to FFY 2017.
The final rule also implements ACA-mandated Medicare disproportionate share hospital (DSH) reductions. Despite CHA’s strong opposition, CMS has adopted its proposed Medicare DSH policy with slight modifications. CMS will proceed in implementing a three-year transition period, beginning in FFY 2018, during which it will utilize a blend of the current proxy and uncompensated care cost data from Worksheet S-10 of the Medicare cost report in the methodology for distributing Medicare DSH uncompensated care payments. CMS did, however, modify the trim methodology and comments on aberrant data. CHA is currently analyzing those provisions.
CHA Provides Details on CY 2018 Physician Fee Schedule Proposed Rule
This post has been archived and contains information that may be out of date.
The Centers for Medicare & Medicaid Services (CMS) has issued the attached proposed rule updating the physician fee schedule (PFS) for calendar year (CY) 2018. The proposed rule includes a number of provisions that will impact hospitals, including a proposal to reduce payments to non-excepted, off-campus provider-based departments to 25 percent, rather than 50 percent, of the outpatient prospective payment system (OPPS) rates. That provision is described in more detail in CHA’s overview of the CY 2018 OPPS proposed rule. Under the PFS, CMS proposes a total increase in payment rates of 0.31 percent for CY 2018, which includes a 0.5 percent update as required by the Medicare Access and CHIP Reauthorization Act 2015, adjusted for a misvalued code as required under the Achieving a Better Life Experience Act of 2014.
Other provisions that will impact hospitals are:
Telehealth Services: CMS proposes to add a number of codes to the list of Medicare-payable telehealth services, including psychotherapy for crisis, health risk assessments, care planning for chronic care management, interactive complexity and counseling visits to determine low dose computed tomography eligibility.
CMS Instructs MACs to Accept Worksheet S-10 Revisions for FY 2015
This post has been archived and contains information that may be out of date.
The Centers for Medicare & Medicaid Services (CMS) issued the attached guidance to Medicare administrative contractors (MACs) on accepting fiscal year (FY) 2015 amended cost reports from hospitals requesting to revise Worksheet S-10. The guidance is issued in conjunction with CMS’ FY 2018 inpatient prospective payment system (IPPS) proposed rule, which proposes to utilize Worksheet S-10 data for calculating Medicare disproportionate share hospital (DSH) payments beginning in FY 2018. CMS states that amended cost reports received on or before Oct. 31 must be accepted by the MAC. If amended cost reports are submitted after Oct. 31, the MAC should follow normal timelines and procedures, including rejection of the cost report.
CHA urges members that wish to revise Worksheet S-10 of their FY 2015 cost report to do so before the Oct. 31 deadline, as the IPPS final rule is expected to be released in early August. While CHA continues to oppose the use of Worksheet S-10 data in Medicare DSH calculations, members should note that revisions to the cost report will be time-sensitive should CMS finalize its proposed policy.
MedPAC Issues June 2017 Report to Congress
This post has been archived and contains information that may be out of date.
The Medicare Payment Advisory Commission (MedPAC) released its June 2017 Report to the Congress: Medicare and the Health Care Delivery System. The document includes 10 chapters covering key issues facing the Medicare program and offers solutions to ensure the program’s continued viability.
In its June report the commission continues its work, required by the Improving Medicare Post-Acute Care Transformation (IMPACT) Act, evaluating the feasibility of a unified prospective payment system (PPS) spanning post-acute care (PAC) settings (e.g., skilled-nursing facility, inpatient rehabilitation facility, long-term care hospital and home health agency). After determining a unified PPS is feasible in its 2016 report, the commission studied three implementation issues: a transition period with blended setting-specific and unified PPS rates, appropriate levels of aggregate PAC payments, and ways to address ongoing refinements to the system after implementation. MedPAC recommends that a unified PAC PPS be implemented beginning in 2021 with a three-year transition, and that aggregate payments should be reduced by 5 percent.
CHA Provides Summary of Proposed SNF PPS Case-Mix Changes
This post has been archived and contains information that may be out of date.
CHA has issued the attached summary, prepared by Health Policy Alternatives, of a recent Centers for Medicare & Medicaid Services (CMS) advance notice of proposed rule-making (ANPRM) outlining potential revisions to the skilled-nursing facility (SNF) prospective payment system (PPS) case-mix methodology. CMS seeks feedback on the changes, which it is considering including in federal fiscal year (FFY) 2019 rulemaking.
CMS proposes to replace the current resource utilization groups (RUGs) case-mix system with a new methodology, the Resident Classification System, Version l (RCS-I). RCS-I would aim to pay SNFs accurately based on beneficiary complexity and required care, and avoid incentivizing therapy delivery by payment policy. Notably, the therapy component would be case-mix adjusted based on resident performance on selected functional status measures, rather than on documented therapy utilization. Additionally, CMS proposes to create a non-therapy ancillary services component, separate from the nursing component.
CMS Further Delays Implementation of Cardiac EPMs, CJR Expansion
This post has been archived and contains information that may be out of date.
The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rule delaying until Jan. 1, 2018, implementation of its new mandatory episode-based payment model (EPM) for cardiac care and expansion of the current Comprehensive Care for Joint Replacement (CJR) model to include surgical hip/femur fracture treatment (SHFFT) excluding lower extremity joint replacement. Previously, CMS issued an interim final rule with comment period that delayed implementation until Oct. 1, 2017. In comments on the interim final rule, CHA urged CMS to further delay implementation of the cardiac EPM and CJR SHFFT episodes until Jan. 1, 2018, and is pleased CMS has responded to stakeholder concerns. CHA also offered a number of other policy issues to consider as the agency proceeds in testing EPMs. In the final rule, CMS notes that it will not respond to comments outside the scope of the delay, but may address these comments in future rulemaking. Additional resources on EPMs are available on CHA’s dedicated resource page.
CMS Proposes Revisions to SNF PPS Case-Mix
This post has been archived and contains information that may be out of date.
The Centers for Medicare & Medicaid Services (CMS) requests comments on the attached advanced notice of proposed rulemaking addressing revisions to the skilled-nursing facility (SNF) prospective payment system (PPS) methodology. Specifically, CMS seeks feedback on replacing the existing case-mix classification model — the Resource Utilization Groups, Version 4 — with a new model, the Resident Classification System, Version I. The proposal is based on recent CMS payment models research and is designed to address concerns that incentives in the current SNF PPS have led to overutilization of therapy services and resulting classification of patients into higher payment categories. Comments are due August 25.
CHA Submits Comments on Delay of Cardiac EPMs, CJR Model Expansion
This post has been archived and contains information that may be out of date.
CHA has submitted the attached comment letter on the Centers for Medicare & Medicaid Services’ (CMS) interim final rule delaying implementation of certain episode payment models (EPMs) from July 1 to Oct. 1. The EPMs delayed by the interim final rule include those focused on episodes of care for acute myocardial infarction, coronary artery bypass graft and surgical hip/femur fracture treatment (SHFFT) excluding lower extremity joint replacement, as well as the Cardiac Rehabilitation Incentive Payment Model. CHA supports the delay and offers CMS a number of other policy issues to consider as the agency proceeds in testing EPMs.
