Noteworthy News

Archive for September, 2018

 

New Approach to Readmissions Program to Take Effect October 1

Medicare’s hospital readmissions reduction program will move in a new direction beginning in FY 2019 after Congress directed the Centers of Medicare & Medicaid Services to compare hospitals’ performance on readmissions to similar hospitals instead of to all hospitals. The policy change, driven by a belief that safety-net hospitals were harmed by the program and excessive penalties because their patients are more challenging to serve, results in all hospitals being divided into peer groups based on the proportion of low-income patients they serve.  The readmissions performance of hospitals is then compared only to other hospitals within each peer group. As [&hellip

States Pursuing Medicaid Reforms

A new Commonwealth Fund report looks at some of the changes states are pursuing in how they deliver and pay for care for their Medicaid recipients. The review groups the reforms into three categories: Managed care reforms – demanding more data to support bids for Medicaid managed care contracts and favoring bidders that include strong value components in their bids and that seek to address recipients’ social needs. Focusing on beneficiaries with complex health and social needs – working with Medicaid managed care plans to address both the medical problems of members with complex medical conditions and the social determinants [&hellip

NAUH Opposes Proposed Medicare Outpatient Regulation

In a letter to the Centers for Medicare & Medicaid Services, NAUH has conveyed its opposition to aspects of CMS’s proposed Medicare outpatient prospective payment system regulation for 2019.  Once adopted, this regulation will determine how the federal government pays hospitals and some physicians for Medicare-covered outpatient services in calendar year 2019. Aspects of the proposed regulation that NAUH opposes include: reducing outpatient payments to exempted off-campus provider-based departments to site-neutral rates; reversing a recent policy that permitted hospital-based outpatient facilities to be paid outpatient fee system rates rather than physician fee schedule rates for new services provided within clinical [&hellip

CMS Proposes Easing Regulatory Requirements

In a newly proposed rule, the Centers for Medicare & Medicaid Services proposes easing the regulatory burden on health care providers. The proposed regulation, which weighs in at 285 pages, covers a broad range of government regulation of health care providers and would, CMS projects, save hospitals more than $1 billion a year while cutting millions of hours of administrative work. Learn more about what CMS proposes by reading its fact sheet on the proposed regulation or going here to see the proposed regulation itself. &nbsp

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. to review a number of Medicaid- and CHIP-related issues. MACPAC members heard presentations on and discussed the following issues: Multistate Collaboration: Panel on State Perspectives Themes from Interviews on the Development of Hospital Payment Policies DSH Payments: Policy Changes and Policy Options Operational Considerations for Work and Community Engagement Requirements Medicaid Coverage of New and High Cost Drugs Managed Care Oversight Oversight of UPL Payments: Additional Analyses and Policy Options Mandated Report: Therapeutic Foster Care Find outlines of these subjects and additional materials by clicking the links [&hellip

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