Medicare

Latest Issue of OR Manager
August 2020

ACS opposes proposed Medicare physician fee schedule

Editor's Note The American College of Surgeons (ACS) on August 4 announced that it is strongly opposed to the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule proposed rule for CY 2021. In the fee schedule, which is set to take place January 1, 2021, Medicare payments will…

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By: Judy Mathias
August 6, 2020
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CMS releases 2021 proposed payment rule for ASCs, HOPDs

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 4 released the 2021 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). Among the proposals in the rule: CMS proposes to expand the number of procedures that Medicare would pay for when performed…

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By: Judy Mathias
August 5, 2020
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Preoperative protocols enhance outpatient total joint outcomes

On January 1, 2020, the Centers for Medicare & Medicaid Services (CMS) began reimbursing healthcare providers for total hip arthroplasty performed in outpatient hospital settings and total knee arthroplasty in ambulatory surgery centers (ASCs), thereby opening the floodgates for explosive growth in outpatient total joint arthroplasty (TJA). About a million…

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By: Catherine Spader, RN
July 22, 2020
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US House of Representatives moves to expand the use of telehealth beyond COVID-19

Editor's Note Leaders of the US House of Representatives telehealth caucus introduced legislation on July 16 to permanently open up access to telehealth services for Medicare patients, the July 16 Fierce Healthcare reports. The bipartisan bill will eliminate restrictions on use in Medicare patients, and it will provide a bridge…

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By: Judy Mathias
July 20, 2020
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COVID-19 hospitalization costs could reach $17B this year

Editor's Note A new Avalere analysis estimates the cost of COVID-19 hospitalizations could range between $9.6 billion and nearly $17 billion this year, depending on infection and hospitalization trends, the June 23 Fierce Healthcare reports. The analysis considers the cost of hospitalizations in three scenarios: $9.6 billion, if there is…

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By: Judy Mathias
June 24, 2020
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ASC offsets some revenue loss through 'Hospital Without Walls' waiver

Far fewer cases of COVID-19 have been seen in rural areas of the US than in large urban populations. But even healthcare facilities not inundated with COVID-19 patients have sustained revenue losses and disruptions in standard procedures. One major advantage for Heartland Surgery Center in Kearney, Nebraska, was seeing the…

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By: Elizabeth Wood
June 17, 2020
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Proactive payment collection reduces bad debt risk

Establishing policies to collect payment before surgery has grown in importance as high-deductible health plans impose larger out-of-pocket costs on patients. To help manage patients’ expectations about costs and increase the likelihood of collecting payment, some experts believe a culture shift is in order. They say healthcare facilities should be…

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By: Jennifer Lubell
June 17, 2020
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CMS to make some pandemic telehealth provisions permanent

Editor's Note The Centers for Medicare & Medicaid Services (CMS) administrator Seema Verma says use of telehealth has grown dramatically during the COVID-19 pandemic, and some provisions that were extended temporarily will be made permanent, the June 2 Becker’s Hospital Review reports. During the pandemic, CMS expanded access to telehealth…

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By: Judy Mathias
June 3, 2020
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CMS releases proposed inpatient payment rule for FY 2021

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on May 11 released a proposed rule that increases Medicare inpatient prospective payment system (IPPS) rates by a net of 3.1% in FY 2021, compared to 2020, for acute care hospitals participating in the Hospital Inpatient Quality Reporting Program that…

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By: Judy Mathias
May 13, 2020
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CMS issues recommendations on reopening hospitals in areas with low COVID-19 incidence

Editor's Note: The Centers for Medicare & Medicaid Services (CMS) on April 19 issued recommendations on how hospitals and healthcare systems can protect their staff and patients as they reopen for nonemergent care. The new recommendations update earlier guidance on limiting nonessential surgical and medical procedures and are specifically targeted…

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By: Judy Mathias
April 20, 2020
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