Prospective Payment

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August 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 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 proposes giving Medicare patients better access to cutting-edge devices

Editor's Note In its proposed rule, the Centers for Medicare & Medicaid Services (CMS) would give Medicare patients better access to innovative devices beginning next year, the July 30 MassDevice reports. CMS also says it might pay more for “certain transformative new devices” for inpatients, using a new technology add-on…

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By: Judy Mathias
August 1, 2019
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CMS maintains site-neutral cuts in 2020 proposed rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 29 issued the 2020 proposed payment rule for ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs), which would increase Medicare hospital outpatient prospective payment system rates by 2.7%. CMS is also proposing to add eight codes to…

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By: Judy Mathias
July 31, 2019
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ASCs react to 2019 regulatory changes

Each year, ambulatory surgery centers (ASCs) adapt to numerous federal regulatory policy reforms. As an example, since 2012, when the Centers for Medicare & Medicaid Services (CMS) launched the Ambulatory Surgery Center Quality Reporting (ASCQR) Program ASCs had been asking for, ASCs have reported data for a changing set of…

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By: Judith M. Mathias, MA, RN
February 20, 2019
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Editorial

The Centers for Medicare & Medicaid Services (CMS) on July 12 issued a proposed rule with potential changes to the Medicare Physician Fee Schedule on or after January 1, 2019. According to CMS, the changes would increase the time available for physicians and other clinicians to spend with their patients…

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By: Elizabeth Wood
August 21, 2018
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CMS: Changes in IPPS, LTCH PPS final rule empower patients, reduce administrative burden

Editor's Note On August 2, the Centers for Medicare & Medicaid Services (CMS) finalized its Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) rule for FY 2019. The rule will empower patients and advance the White House “MyHealthData” initiative and the CMS “Patients…

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By: Judy Mathias
August 3, 2018
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CMS releases outpatient prospective payment rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 25 released its 2019 outpatient prospective payment rule, which includes cutting payments for hospital outpatient clinic visits as part of a site neutral payment policy. CMS estimated this would save patients about $150 in lower copayments for clinic…

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By: Judy Mathias
July 26, 2018
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CMS issues FY 2019 hospital IPPS proposed rule

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on April 24 issued its hospital inpatient prospective payment system (IPPS) proposed rule for FY 2019. The proposed rule increases rates by 1.75%, which reflects the projected market-basket update of 2.8% for hospitals that were meaningful users of electronic health…

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By: Judy Mathias
April 25, 2018
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