Tag: CMS

CMS issues proposed rule for hospital outpatient, ASC payment rates for CY 2023

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 15 released its Outpatient Prospective Payment System (OPPS) proposed rule that would raise rates by a net 2.7% in CY 2023. This update is based on the projected hospital market basket percentage increase of 3.1%, reduced by 0.4%…

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By: Judy Mathias
July 19, 2022
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Lawsuit filed against UnitedHealth for underpayment of telehealth services

Editor's Note A female patient in Chicago, Illinois, filed a lawsuit on July 7 against the multinational UnitedHealth Group for alleged underpayment of telehealth services, Becker’s Payer Issues July 8 reports. The lawsuit claims that the woman’s insurance plan covers telehealth services, including pay benefits for-out-network services. After receiving out-of-network…

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By: Lauren McCaffrey
July 12, 2022
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CMS physician fee schedule proposes 4.43% cut in 2023

Editor's Note The Centers for Medicare & Medicaid Services (CMS) released its Medicare physician fee schedule proposed rule for 2023, “which suggests further cuts to physician pay while inflation and the cost of running an independent practice continue to rise,” Becker’s ASC Review July 8 reports. The proposed rule would…

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By: Tarsilla Moura
July 8, 2022
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CMS updates ASC guidance, revisions for surveyors

Editor's Note The Centers for Medicare & Medicaid Services (CMS) has recently updated its State Operations Manual (SOM) Appendix L—Guidance for Surveyors: Ambulatory Surgical Centers (ASCs), making conforming revisions to the regulatory tags and interpretive guidelines, as well as clarifications and technical corrections to other guidance areas including medical history…

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By: Tarsilla Moura
July 6, 2022
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Most hospitals not providing price information for TJAs as required by CMS

Editor's Note This study from the Cleveland Clinic finds that less than one-third of US hospitals were fully compliant in 2021 with the transparency in pricing for total joint arthroplasty (TJA) rule mandated by the Centers for Medicare and Medicaid Services (CMS). Of 400 hospitals analyzed between December 1 and…

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By: Judy Mathias
June 27, 2022
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CMS citation trends show infection control in top 10 cited areas

Editor's Note According to the Centers for Medicare & Medicaid Services (CMS) Quality, Certification, and Oversight Reports (QCOR) page, which gives the public access to citation frequency reports, infection control was a top area of focus for CMS surveyors in 2021, the Ambulatory Surgery Center Association journal ASC Focus June…

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By: Tarsilla Moura
June 17, 2022
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The Joint Commission: Accelerate PI Dashboard Reports available

Editor's Note The Joint Commission on May 25 announced that refreshed Accelerate PI Dashboard Reports are available for accredited hospitals and critical access hospitals to provide updated performance measurement data on a select subset of quality measures. The Interim ORYX reports contain data through the second quarter of 2021, and…

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By: Judy Mathias
May 26, 2022
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Association of COVID-19 with disparities in access to major surgery

Editor's Note This study, led by researchers from the University of Rochester (NY) School of Medicine, finds that the early response to the COVID-19 pandemic did not increase disparities in access to major surgical procedures. Of 3,470,905 adults hospitalized for major surgical procedures at 719 facilities between January 1, 2018,…

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By: Judy Mathias
May 23, 2022
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Joint Commission approves COVID-19 vaccination standard for HCWs

Editor's Note In response to the Centers for Medicare & Medicaid Services (CMS) interim final rule regarding COVID-19 vaccinations for healthcare workers (HCWs), The Joint Commission has approved a new Infection Prevention and Control (IC) Standard IC.02.04.02 and new elements of performance, the regulator announced on April 27. The new…

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By: Tarsilla Moura
April 29, 2022
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CMS releases FY 2023 hospital IPPS proposed rule

Editor's Note The Centers for Medicare and Medicaid Services (CMS), on April 18, released the FY 2023 Medicare Hospital Inpatient Prospective Payment System (IPPS) proposed rule. The rule would increase payment rates by a net 3.2% for acute care hospitals that participate in the Hospital Inpatient Quality Reporting Program and…

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By: Judy Mathias
April 20, 2022
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