Search Results for: "Continuity Planning"

Showing 391 - 400 of 402 results

FFY 2019 Uncompensated Care Payments to Come From 2014, 2015 Worksheet S-10 Data

This post has been archived and contains information that may be out of date.

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.

Gov. Newsom Releases State Budget Proposal

This post has been archived and contains information that may be out of date.

Yesterday, Gov. Newsom released his first proposed state budget, totaling $209 billion for 2019-20. CHA was pleased to see health care as a primary focus of the budget. Other clear priorities are early childhood development, housing and paying down debt. 

CHA Releases Draft Model of 2017-19 Hospital Fee Program

This post has been archived and contains information that may be out of date.

As reported in CHA News last week, the Department of Health Care Services (DHCS) recently sent hospitals invoices covering the first six fee-for-service cycles of the 2017-19 Hospital Fee Program. The attached draft model incorporates those invoiced amounts, as well as the supplemental fee-for-service payment amounts approved last month by the Centers for Medicare & Medicaid (CMS) services. Notably, the “Gain.Contribute” tab in the model includes a summary, by state fiscal year, of the estimated fee and payment amounts for the 30-month program period. CHA is in the process of creating hospital-specific fee and payment schedules, which will be distributed within the next week.  

CHA Provides Update on 2017-19 Hospital Fee Program

This post has been archived and contains information that may be out of date.

As reported in CHA News last month, the Centers for Medicare & Medicaid Services approved the supplemental fee-for-service payments and overall tax structure of the 2017-19 hospital fee program. CHA is working with the Department of Health Care Services (DHCS) to update the draft model so hospital-specific implementation schedules can be distributed by the end of this month. DHCS expects the first round of invoices will be sent to hospitals within the next month, with a due date in late February. As soon as the exact timing is finalized, CHA will notify members via CHA News.

Now that the fee-for-service component of the program has been approved, DHCS has turned its attention to the managed care components of the program. As previously reported in CHA News, the new federal Medicaid managed care rules require significant changes to how supplemental Medi-Cal managed care payments are made through the hospital fee program. Effective July 1, 2017, roughly half of the supplemental Medi-Cal managed care payments must be transitioned to a directed payment methodology. Under the directed payment method, supplemental payments can be made only to network providers based on utilization in the encounter data file from the current rate year.

EMTALA — Essentials and Trouble Spots Webinar: Participant Information

This post has been archived and contains information that may be out of date.

Despite being on the books for nearly 30 years, the Emergency Medical Treatment and Labor Act (EMTALA) continues to be a source of confusion for staff and a public relations nightmare. Fines have recently doubled, and may result in sanctions – recently for one hospital in excess of $1 million. 

CMS Provides Updates for Post-Acute Care Quality Reporting

This post has been archived and contains information that may be out of date.

The Centers for Medicare & Medicaid Services (CMS) regularly provides important updates about post-acute care quality reporting programs, including training opportunities, public reporting, and reminders of data submission and review deadlines.  

Inpatient Rehabilitation Facilities 

Data Submission Deadline Approaching Assessment data for the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF PAI) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.  

Long-Term Acute Care Hospitals 

Data Submission Deadline Approaching Assessment data for the Long-Term Care Hospital Continuity Assessment Record and Evaluation (LTCH CARE) and data submitted to CMS via the Center for Disease Control and Prevention National Healthcare Safety Network for July-September (Q3) of calendar year 2017 are due no later than 11:59 (PT) on Feb. 15.  

Training Materials from the December 2017 Long-Term Care Hospital Quality Reporting Program provider training are now available under “Related Links” on CMS’ dedicated long-term care hospital web page.  

CHA Meets With CMS on Medicare Managed Care Rules

This post has been archived and contains information that may be out of date.

Yesterday, CHA met with representatives from the Centers for Medicare & Medicaid Services (CMS) at its headquarters in Baltimore to discuss the Medicaid managed care rules finalized in May 2016 and January 2017 and, specifically, their impact on the Quality Assurance Fee (QAF) program.

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 Issues Final Rule With Comment Period on Access to Covered Medicaid Services

This post has been archived and contains information that may be out of date.

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule with comment period that aims to allow states and CMS to make better informed, data-driven decisions when considering whether proposed changes to Medicaid fee-for-service payment rates are sufficient to ensure that Medicaid beneficiaries have access to covered Medicaid services. The final rule also intends to strengthen CMS’ ability to review Medicaid payment rates to ensure they are consistent with efficiency, economy and quality of care, as well as ensure sufficient beneficiary access to care under the Medicaid program. CMS also issued a Request for Information (RFI) to gather input into additional approaches that it and states may consider to better ensure compliance with Medicaid access requirements. The RFI asks for comments on the potential development of standardized core set measures of access, access measures for long-term care and home and community-based services, national access to care thresholds, and resolution processes that beneficiaries could use when they have problems accessing essential health care services.