The government is starting a trial program in the District of Columbia that aims to improve treatment for Medicaid beneficiaries struggling with serious mental illness or substance use disorders.
In the 2020 Medicare Physician Fee Schedule (MPFS) final rule, CMS put a stamp of approval on its previous proposals to overhaul how medical practices will report office and outpatient E/M services in 2021.
CMS recently announced that the Medicare Fee for Service (FFS) improper payment rate is at its lowest level since fiscal year (FY) 2010. The FY 2019 improper payment rate is 7.25%, according to the U.S. Department of Health and Human Services’ (HHS) annual Agency Financial Report.
Expanded price transparency requirements are set to become reality for hospitals effective January 1, 2021. On November 15, CMS released a final rule that pushed ahead with many of the requirements originally included in the 2020 OPPS proposed rule.
Along with its annual updates to the inpatient-only list, the 2020 Outpatient Prospective Payment System (OPPS) final rule finalized a proposal that will give hospitals a grace period to adjust internal policies for procedures recently removed from the inpatient-only list.
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1. However, the agency pushed its controversial price transparency proposals to a separate, yet-to-be released final rule.
A federal judge rejected CMS’ motion to reconsider or issue a stay on her September order to vacate cuts to reimbursement to grandfathered off-campus provider-based departments.
Approximately 25% of the $3.8 trillion spent annually in the U.S. on healthcare can be characterized as waste, according to an analysis recently published in the Journal of the American Medical Association.
While the calendar year 2020 OPPS proposed rule is shorter than in prior years (819 pages for the display version), the proposed policies therein pack a punch and may be thought of as a new day dawning for the future of hospital services.
