Articles and Blogs

Inpatient-Only Procedures. Earlier this month, CMS quietly revised its billing policy related to inpatient-only procedures.  In a Transmittal issued on March 13, CMS included inpatient-only procedures provided in the outpatient setting as preadmission services subject to the Three-Day (One-Day) Payment Window Rule.  Effective April 1, hospitals can bill Medicare for inpatient-only procedures provided to... READ MORE

Summary of the Bill The United States House of Representatives overwhelmingly approved a measure this week to repeal the Sustainable Grow Rate (“SGR”), which has been used to determine Medicare physician payment rates for more than a decade.  The SGR was established as part of the Balanced Budget Act of 1997 as a method... READ MORE

With the last Sustainable Growth Rate (“SGR”) “patch” set to expire on March 31, 2015, lawmakers on Capitol Hill must soon decide whether to pass another “patch” or to finally tackle the issue of permanent SGR repeal and replacement. Just last week, House Majority Leader Kevin McCarthy (R-CA) and House Ways and Means Committee... READ MORE

President Obama introduced his fiscal year (“FY”) 2015 budget yesterday, and there are many proposed cuts to post-acute care providers.  Some of the highlights include a number of bundled payment initiatives, a $100 co-pay for home health patients not discharged from a hospital and re-admission penalties for skilled nursing facilities (“SNFs”) with high hospital... READ MORE