Articles and Blogs

IPPS

OMB Census Recommendations Could Have Huge Downstream Impacts on Medicare Payments

[03/08/21]

Posted on March 8, 2021 in Health Law News

Published by: Hall Render

The Office of Management and Budget (“OMB”) is requesting comments on the recommendations it has received from the Metropolitan and Micropolitan Statistical Area Standards Review Committee for changes to OMB’s 2010 metropolitan and micropolitan statistical area standards. Among other changes, one proposal would change nearly 150 areas from urban to rural for purposes of... READ MORE

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FFY 2021 Inpatient PPS Final Rule Released by CMS

[09/04/20]

Posted on September 4, 2020 in COVID-19 Daily Updates, Health Law News

Published by: Hall Render

On September 2, 2020, CMS published the delayed Final Rule for the FFY 2021 Inpatient Prospective Payment System (“PPS”). This Final Rule will appear in the Federal Register on September 18, 2020 and will still become effective on October 1, 2020, despite its delays. Payments for inpatient hospital services for hospitals that are EHR... READ MORE

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CMS Proposes Major Overhaul to Incorporate Payer Pricing into Medicare Cost Report Data and MS-DRG System

[05/19/20]

Posted on May 19, 2020 in Health Law News

Published by: Hall Render

On May 11, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). One of the most significant updates is the proposed addition of a new requirement to the Medicare cost report submission process. Specifically, hospitals would be required to provide the median... READ MORE

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Did the Ground Just Shift? CMS Proposes Changes to Hospital Wage Index Areas

[05/13/20]

Posted on May 13, 2020 in COVID-19 Daily Updates, Health Law News

Published by: Hall Render

On May 11, 2020, CMS released the 2021 Inpatient Prospective Payment System (“IPPS”) Proposed Rule (“Proposed Rule”). Among other changes in the Proposed Rule, CMS is adopting updated labor market area delineations to take effect on October 1, 2020. Hospitals should review whether they are in a county that is affected by the updated... READ MORE

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The Price May Not Be Right, But It Will Be Public: CMS Finalizes Price Transparency Rule Requiring Hospitals to Publish Payer-Specific Rates

[11/18/19]

Posted on November 18, 2019 in Health Law News

Published by: Hall Render

On November 15, 2019, the Centers for Medicare & Medicaid Services (“CMS”) released the final rule on Price Transparency Requirements for Hospitals to Make Standard Charges Public (“Final Rule”) (available here). Despite broad opposition from the industry, CMS finalized the rule largely as proposed. CMS did delay the effective date until January 1, 2021,... READ MORE

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Graduate Medical Education: Insights About the 2020 IPPS Proposed Rule and Medical Record Documentation

[06/11/19]

Posted on June 11, 2019 in Health Law News

Published by: Hall Render

The Centers for Medicare & Medicaid Services (“CMS”) recently made several announcements regarding graduate medical education (“GME”). This article discusses three matters that are particularly significant for teaching hospitals, teaching physicians and other GME stakeholders. First, CMS issued its inpatient prospective payment system (“IPPS”) proposed rule (“Proposed Rule”) for fiscal year 2020 and announced... READ MORE

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Wage Index Fix? CMS Proposes Changes for Low Wage Hospitals and Rural Floor

[04/30/19]

Posted on April 30, 2019 in Health Law News

Published by: Hall Render

On April 23, 2019, the Centers for Medicare & Medicaid Services (“CMS”) released the Federal Fiscal Year (“FFY”) 2020 Medicare Inpatient Prospective Payment System (“IPPS”) proposed rule (“IPPS Proposed Rule”). Among many other changes, CMS proposed several changes to address disparities between high and low wage index areas and fixing the so-called “rural floor.”... READ MORE

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Hospital Wage Index Reform Deja Vu? OIG Releases Report on Vulnerabilities of Wage Index System, Recommends Overhaul of System

[11/30/18]

Posted on November 30, 2018 in Health Law News

Published by: Hall Render

On November 21, 2018, the Department of Health and Human Services Office of Inspector General (“OIG”) released a report (“Report”) outlining what it believes are multiple deficiencies in the Medicare wage index system. OIG recommended several changes, including revisiting the possibility of comprehensive reform and seeking authority to penalize hospitals that submit inaccurate wage... READ MORE

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CMS Releases FFY 2019 Proposed Rule, Triggers Wage Index and Reclassification Deadlines

[05/03/18]

Posted on May 3, 2018 in Health Law News

Published by: Hall Render

The FFY 2019 IPPS Proposed Rule (“Proposed Rule”) was released on April 24, 2018, and CMS published the associated tables on its website. It is expected that the Proposed Rule will be published in the Federal Register on May 7. The release of the Proposed Rule and the accompanying tables triggers the start to... READ MORE

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