Medicare

Latest Issue of OR Manager
April 2021

Hospital groups ask US Senate for $35B in COVID-19 relief funds

Editor's Note Nine hospital groups have asked the US Senate to add $35 billion to COVID-19 relief legislation to help them deal with financial effects of the COVID-19 pandemic, the February 25 Fierce Healthcare reports. The $1.9 trillion COVID-19 relief bill passed by the House does not include a provider…

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By: Judy Mathias
March 2, 2021
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More states report telehealth reimbursement laws

Editor's Note A Foley & Lardner survey finds that state telehealth reimbursement laws have significantly increased during the COVID-10 pandemic, but more can be done to address telehealth adoption barriers, the February 15 Revcycle Intelligence reports. More than 43 states and Washington, DC, have some telehealth statute for commercial payers,…

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By: Judy Mathias
February 18, 2021
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New year brings some changes to quality reporting criteria

The 2021 Medicare Hospital Outpatient Prospective Payment System (OPPS)/ASC Final Payment Rule was released on December 1, 2020, and became effective as of January 1, 2021. Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs, Ambulatory Surgery Center Association (ASCA), summarized the status of Medicare regulations and…

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By: Elizabeth Wood
January 19, 2021
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CMS releases final 2021 Medicare payment rule for ASCs, HOPDs

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on December 2 released its 2021 final payment rule for ASCs and hospital outpatient departments (HOPDs). CMS has finalized the addition of 11 procedures to the ASC covered procedures list, including total hip arthroplasty, autochondrocyte knee implant, and open complex…

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By: Judy Mathias
December 3, 2020
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Medicare to cover monoclonal antibody COVID-19 treatments

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on November 10 announced that Medicare will cover out-of-pocket costs for monoclonal antibody drugs for COVID-19 during the public health emergency. The agency’s coverage includes Eli Lilly’s bamlanivimab, which recently received an emergency use authorization from the Food and Drug…

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By: Judy Mathias
November 12, 2020
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CMS: How to prepare for COVID-19 vaccine

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on November 5 released a set of toolkits and enrollment actions to take to administer the COVID-19 vaccine when it’s available. Many Medicare-enrolled providers don’t have to take any actions until the vaccine is available. Some Medicare-enrolled providers must also…

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By: Judy Mathias
November 5, 2020
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CMS penalizes 2,545 hospitals for high readmissions

Editor's Note The Centers for Medicare and Medicaid Services (CMS) will penalize and reduce a year’s worth of payments to nearly half of the nation’s hospitals because of 30-day readmission rates, the November 2 Kaiser Health News reports. The penalties are part of the ninth year of the Hospital Readmissions…

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By: Judy Mathias
November 3, 2020
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Impact of COVID-19 on HAIs

Editor's Note To provide flexibility to healthcare workers responding to the COVID-19 crisis, the Centers for Medicare & Medicaid Services (CMS) waived reporting requirements for healthcare associated infections (HAIs) through June 2020. Using the experience of hospitals in New York City and St Louis, Missouri, the authors provide commentary on…

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By: Judy Mathias
October 21, 2020
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CMS threatens to withhold payments from hospitals not reporting COVID-19, flu data

Editor's Note The Centers for Medicare and Medicaid Services (CMS) on October 6 released guidance on how it will implement an interim final rule that requires hospitals and critical access hospitals to report data on COVID-19 and flu patients. CMS says failure to report specified data may lead to termination…

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By: Judy Mathias
October 8, 2020
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ASCs reduce Medicare costs $4 billion annually

Editor's Note A new analysis of Medicare payment data by KNG Health Consulting shows that ambulatory surgery centers (ASCs) reduced Medicare costs by $28.7 billion from 2011 to 2018, a savings of more than $4 billion each year. The analysis also shows that, without policy changes, performing procedures on Medicare…

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By: Judy Mathias
September 29, 2020
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