The Centers for Medicare & Medicaid Services (CMS) has released its much-anticipated Calendar Year (CY) 2018 Quality Payment Program (QPP) Final Rule. In this final rule, CMS details changes to both the Advanced Alternative Payment Models (APMs) track and the Merit-Based Incentives Payment System (MIPS) track of the QPP. CMS says it expects this program to, “Modernize […]
Read MoreTonight, CMS released the final Medicare Physician Fee Schedule (MPFS) payment rule for 2018. CMS is finalizing an overall update to physician payments of +0.41%, and the 2018 conversion factor will increase by $0.10, to $35.99 from 2017’s $35.89. Read on for more news…. Coding Policy Change for Biosimilars In 2016, CMS finalized a policy […]
Read MoreIn what is likely the first major Medicare policy change of the Trump Administration, Medicare payment for 340B drugs administered in the hospital outpatient department will be cut from 106% of average sales price (ASP, or ASP+6%) to average sales price less 22% (ASP-22%). Those who have been following President Trump’s statements on health care […]
Read MoreThis evening, CMS also released the CY 2018 Home Health Prospective Payment System (HH PPS) Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements final rule which will be effective on January 1, 2018. Within this rule, CMS announces an overall payment adjustment of -0.4 […]
Read MoreThis afternoon, the Trump Administration released the first proposed rule under regular order concerning the Affordable Care Act’s Marketplaces (or Exchanges). The rule, which covers benefit and payment parameters for qualified health plans (QHPs) operating on and off the Marketplaces, would impact plans offered in 2019. This is another signal that despite the uncertainty surrounding […]
Read MoreOn Wednesday, August 2, 2017, the Centers for Medicare & Medicaid Services (CMS) issued its final Inpatient Prospective Payment System (IPPS) rule for Fiscal Year 2018. The rule outlines how hospitals are paid for inpatient Medicare stays, starting October 1, 2017. This rule finalizes a number of changes proposed in the IPPS proposed rule issued in April, but does […]
Read MoreCMS Finalizes Payment Increases for SNFs and IRFs Both Seeing a 1% Bump, Advances Move from Volume to Value within SNF VBP Program On Monday, July 31, 2017 the Centers for Medicare and Medicaid Services (CMS) issued two final rules updating the following payment systems for federal fiscal year (FY) 2018: the Inpatient Rehabilitation Facility […]
Read MoreOn July 25, 2017, CMS released the CY 2018 Home Health Prospective Payment System Rate Update and Proposed CY 2010 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. CMS is projecting that Medicare payments to Home Health Agencies in CY 2018 will be reduced by 0.4 percent, estimated […]
Read MoreOn July 13, 2017, the Centers for Medicare and Medicaid Services (CMS) released the Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2018 proposed rule. The proposed rule updates payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule on […]
Read MoreOn Monday, April 3, 2017, the Centers for Medicare and Medicaid Services (CMS) issued the final Call Letter for the 2018 Medicare Advantage and Medicare Part D Prescription Drug Benefit plan year. The Call Letter establishes requirements for Medicare Advantage (MA) and Medicare Part D plan sponsors for the 2018 benefit year. The draft call […]
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