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MedPAC Comments on Proposed Medicare Outpatient Payment Rule

The Medicare Payment Advisory Commission has weighed in with the Centers for Medicare & Medicaid Services on its proposed regulation governing the 2018 hospital outpatient prospective payment system and ambulatory surgical center payment systems and quality reporting programs. Among the issues MedPAC addresses in its comment letter to CMS are the proposal to reduce Medicare reimbursement for 340B-covered prescription drugs; how to reinvest the savings such a payment cut would produce; the ability of hospitals to expand the services they offer at hospital-based outpatient departments; proposed changes in the Medicare hospital outpatient quality reporting program and ambulatory surgery center quality [&hellip

Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs. Or so says one of CMS’s own advisory panels. The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options. The panel’s recommendation [&hellip

NAUH Asks House to Block S-10 Data in Medicare DSH Calculation

In response to a request from the House Ways and Means Committee’s Health Subcommittee for suggestions from stakeholders on ways to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery, NAUH has asked the committee to require the Centers for Medicare & Medicaid Services to continue using the low-income days proxy for 2013 in the calculation of Medicare disproportionate share payments (Medicare DSH) and not use S-10 uncompensated care data in that calculation until the S-10 form’s instructions have been improved and until the quality of the data hospitals report on an [&hellip

NAUH Urges Ways and Means to Block 340B Changes

In response to a request from the House Ways and Means Committee’s Health Subcommittee for suggestions from stakeholders on ways to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery, NAUH has urged the committee to compel CMS to withdraw its proposed changes in reimbursement for prescription drugs purchased by hospitals under the federal government’s 340B prescription drug discount program. The Centers for Medicare & Medicaid Services’ proposed outpatient prospective payment system rule for 2018, published in July, calls for significant reductions in federal reimbursement for drugs purchased by hospitals for low-income [&hellip

Improvements Inspired by Readmissions Reduction Program Level Off

After major improvements during the early years of Medicare’s hospital readmissions reduction program, the program is no longer showing significant new gains. While Medicare readmissions have fallen from 21.5 percent to 17.8 percent since 2007, there has been very little improvement since 2012, suggesting that most of the benefits from the program have already been achieved. And in FY 2018, Medicare will penalize almost the same number of hospitals it penalized in FY 2017:  approximately 80 percent of the hospitals subject to the program. In FY 2018, the average penalty will be 0.73 percent of affected hospitals’ Medicare payments.  Forty-eight [&hellip

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