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NAUH Comments on Proposed FY 2015 Medicare Inpatient Regulation: Part 1 of 7

Every year, the Centers for Medicare & Medicare Services (CMS) publishes in the Federal Register a draft regulation describing how it proposes paying hospitals for the inpatient care they provide to their Medicare patients in the coming fiscal year.  The proposed inpatient prospective payment system regulation for FY 2015 was published on May 15, and as always, CMS invited interested parties to submit written comments. The National Association of Urban Hospitals has always found CMS to be receptive and even responsive to its comments and therefore takes the opportunity to submit detailed comments and suggestions about the agency’s annual proposal. [&hellip

Steeper Penalties in Hospitals’ Future?

Hospitals could soon face larger penalties from the federal government for selected infractions. Under a new proposed regulation from U.S. Department of Health and Human Services’ Office of the Inspector General (OIG), the agency may soon impose larger fines for  … failure to grant OIG timely access to records; ordering or prescribing while excluded from a government program; making false statements, omissions, or misrepresentations in an enrollment application; failure to report and return an overpayment; and making or using a false record or fraudulent claim. The OIG’s authority to do so comes from a number of sources, including the Affordable [&hellip

NAUH Comments on Proposed Medicare Regulation

In a letter to the Centers for Medicare & Medicaid Services (CMS), the National Association of Urban Hospitals (NAUH) has commented on Medicare’s proposed FY 2014 inpatient prospective payment system regulation. NAUH’s letter addresses Medicare disproportionate share (Medicare DSH) payments, the coding adjustment for inpatient payments, the outlier threshold, the labor-related share adjustment, the value-based purchasing program, the hospital readmissions reduction program, and graduate medical education. NAUH also proposes its own, detailed formula for recalculating the size of the FY 2014 Medicare DSH pool based on the difference between the calendar year in which the Congressional Budget Office projected the [&hellip

New Rules to Limit Hospital Collection Practices

The federal government has released new proposed rules governing how hospitals may go about collecting payments from patients who owe them money. Under the new rules, hospitals would need to do more to explain to patients their policies governing charity care and reduced-cost care.  In addition, certain aggressive collection practices – like attempting to collect from patients waiting for care in emergency rooms – would be banned. The proposed rules include provisions governing how hospitals may charge uninsured patients. The new rules could have an especially significant impact on private, non-profit urban safety-net hospitals because of the especially large numbers [&hellip

Proposed Medicare Inpatient Regulation Released

The Centers for Medicare & Medicaid Services (CMS) has released its proposed annual Medicare inpatient prospective payment system regulation.  This regulation ultimately will dictate how Medicare pays hospitals when the 2013 fiscal year begins on October 1, 2012. As significant as what this year’s draft regulation says is what it does not say.  Even though eligible hospitals face cuts of as much as 75 percent in their Medicare disproportionate share hospital payments (Medicare DSH) beginning in FY 2014, the proposed regulation addresses neither how Medicare DSH payments might be calculated come 2014 nor how CMS will determine how much uncompensated [&hellip

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