Noteworthy News

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CMS Requires States to Monitor Medicaid Access

A new federal regulation requires states to monitor access to Medicaid services. According to a new regulation issued by the Centers for Medicare & Medicaid Services (CMS), states must submit to CMS plans for monitoring Medicaid beneficiary access to care in five service areas: primary care, physician specialists, behavioral care; pre- and post-natal care; and home health services. State monitoring plans must address the extent to which Medicaid is meeting beneficiaries’ needs; the availability of care; changes in service utilization; and comparisons between Medicaid rates and rates paid by other public and private payers. Interested parties have 60 days to [&hellip

IRS Finalizes Standards for Non-Profit Hospitals

The Internal Revenue Service has issued guidance for non-profit hospitals on selected issues that could jeopardize their non-profit status. As described in a commentary by the U.S. Treasury Department, non-profit hospitals must: Limit charges.  Hospitals may not charge individuals eligible for financial assistance more for emergency or other medically necessary care than the amounts generally billed to patients with insurance (including Medicare, Medicaid, or private commercial insurance).  Establish and disclose financial assistance policies.  Each hospital must establish and widely publicize a financial assistance policy that clearly describes to patients the eligibility criteria for obtaining financial assistance and the method for [&hellip

Feds Release Medicaid DSH “Uninsured” Definition

The Centers for Medicare & Medicaid Services (CMS) has published a new regulation that defines “uninsured” for the purpose of calculating the limit for how much individual hospitals may receive in Medicaid disproportionate share hospital payments (Medicaid DSH). Under federal law, Medicaid DSH payments to hospitals cannot exceed the uncompensated costs of the services those hospitals provide to Medicaid recipients and the uninsured.  In calculating hospital-specific limits, according to the new regulation, … the calculation of uncompensated care for purposes of the hospital-specific DSH limit will include the cost of each service furnished to an individual by that hospital for [&hellip

Suit Against Medicare Rate Cut Continues

Hospital groups are suing the Centers for Medicare & Medicaid Services (CMS) over the 0.2 percent rate cut in Medicare inpatient payments during the 2014 fiscal year. According to the hospital groups, CMS failed to provide a rationale for the rate cut and denied interested parties access to the data and analysis underlying its rate cut decision. At the heart of the cut was CMS’s expectation that implementation of Medicare’s controversial “two-midnight rule” would result in an increase in admissions.  The rule was never fully implemented. CMS has asked the court to dismiss the suit. Learn more about the suit [&hellip

NAUH Comments on Proposed FY 2015 Medicare Inpatient Regulation: Part 6 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

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