On October 21, 2019, U.S. District Judge Rosemary M. Collyer denied the government’s request to modify the Court’s previous ruling on September 17, 2019, that the Centers for Medicare & Medicaid Services (CMS) exceeded its statutory authority when it reduced
The Republican Party will soon be the party of health care. You watch.
-President Donald J. Trump, March 23, 2019
Opening with the above quote from President Trump, the Republican Study Committee (RSC) released the first part of its healthcare
On Monday, October 21, 2019, the Centers for Medicare & Medicaid Services (CMS) posted a request for information (RFI) soliciting comments on the use of new technologies in the Medicare and Medicaid programs. In a blog post accompanying the release
On Thursday, October 17, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) will publish in the Federal Register two proposals to implement major changes to
On October 9, 2019, the Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued two sweeping proposals aimed at revising the Stark Law and Anti-Kickback Statute (AKS)
Today, October 11, 2019, the United States Court of Appeals for the D.C. Circuit is hearing oral arguments in Stewart v. Azar (Case No. 19-5095), an appeal from the federal district court’s rulings invalidating three prior approvals of Section 1115 Waivers in Kentucky and Arkansas that would have implemented work and community engagement requirements as a condition of Medicaid eligibility. The three judge panel consists of Judges Pillard, Edwards, and Sentelle.
On Thursday, October 3, 2019, President Trump signed an executive order that aims to expand the Medicare Advantage program. Medicare Part C, commonly known as Medicare Advantage, is administered by private insurers in which CMS pays the health insurer on
On September 17, United States District Judge Rosemary M. Collyer, United States District Court for the District of Columbia, ruled that CMS in its CY 2019 OPPS final rule reducing Medicare payment rates for evaluation and management (E/M) services furnished
On August 14, 2019 The Joint Commission (TJC) released sentinel event statistics for the first half of 2019, which included 426 events. 83% of the events were voluntarily self-reported by an accredited or certified organization. The five most frequently reported
On August 2, 2019, the Centers for Medicare & Medicaid Services (CMS) published its Fiscal Year (FY) 2020 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long Term Acute Care Hospital (LTCH) Prospective Payment System (PPS) final rule (CMS-1716-F). The final rule is scheduled to be published in the Federal Register on August 16, 2019. CMS also published a fact sheet describing the proposed rule, which may be found here. This final rule is effective October 1, 2019.
CMS states that the final rule “reflects the agency’s efforts to transform the healthcare delivery system through competition and innovation to provide patients with better value and results.”
Medicare payments for inpatient hospital services are anticipated to increase by 3.0%, or $3.8 billion in FY 2020. CMS projects a market basket update of “3.0 percent reduced by a 0.4 percentage point productivity adjustment. This also reflects a +0.5 percentage point adjustment required by legislation.”
Medicare payments for LTCHs are estimated to increase by 1.0%, or $43 million, in FY 2020.
Below we address some of the policies CMS finalized for FY 2020.