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Rural Health
News by Topic: Reimbursement and payment models

CMS: Medicare Program; Cancellation of Advancing Care Coordination Through Episode Payment and Cardiac Rehabilitation Incentive Payment Models; Changes to Comprehensive Care for Joint Replacement Payment Model: Extreme and Uncontrollable Circumstances Policy for the Comprehensive Care for Joint Replacement Payment Model Federal Register
Dec 1, 2017 - Final rule from the Centers for Medicare and Medicaid Services (CMS) cancelling the Episode Payment Models (EPMs) and Cardiac Rehabilitation (CR) Incentive Payment Model. The rule also finalizes revisions to the Comprehensive Care for Joint Replacement (CJR) Model, making participation in CJR voluntary for all low-volume and rural hospitals, regardless of geographic location. Additionally, the included interim final rule provides flexibility when determining episode costs for providers located in areas affected by extreme circumstances, such as hurricanes, in 2017. Comments regarding provisions of the interim final rule must be submitted no later than 5:00 p.m. Eastern on January 30, 2018. Additional information is available on the November 30, 2017, CMS fact sheet.
Source: Federal Register
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CMS Finalizes Changes to the Comprehensive Care for Joint Replacement Model, Cancels Episode Payment Models and Cardiac Rehabilitation Incentive Payment Model
Nov 30, 2017 - The Centers for Medicare and Medicaid Services (CMS) implemented changes to the Comprehensive Care for Joint Replacement (CJR) Model. CMS also finalized the cancellation of the mandatory hip fracture and cardiac bundled payment models that were to be operated by the CMS Innovation Center. A fact sheet is available.
Source: Centers for Medicare and Medicaid Services
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2 Kansas Hospitals Join Experiment Aimed At Bolstering Rural Health Care
Nov 22, 2017 - Two rural Kansas hospitals have joined a demonstration project being conducted by the Centers for Medicare and Medicaid Services (CMS) which begin in 2004 and has since been extended twice. Under this program, hospitals are reimbursed at cost for their in-patient services. This boost in revenue can help counteract low patient volumes and other rural-specific challenges.
Source: KCUR
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'Deeply Saddened': Another Rural Alabama Hospital Closing
Nov 18, 2017 - Details the upcoming closure of a rural hospital in Winston County, Alabama. Lakeland Community Hospital, a 59-bed facility, announced that it will cease operations by the end of the year, citing drastic reductions in reimbursements. This will be the seventh hospital closure in Alabama in eight years.
Source: AL.com
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Administrator’s Blog: National Rural Health Day (November 16, 2017)
Nov 16, 2017 - Blog post from the Centers for Medicare and Medicaid Services (CMS) from CMS Administrator Seema Verma on the topic of National Rural Health Day. Touches on challenges faced by rural communities like physician recruitment and what CMS will do to mitigate those challenges and help improve rural health.
Source: Centers for Medicare & Medicaid Services Blog
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CMS: Medicare Program; CY 2018 Updates to the Quality Payment Program; and Quality Payment Program: Extreme and Uncontrollable Circumstance Policy for the Transition Year Federal Register
Nov 16, 2017 - Final rule and interim final rule providing updates for the second and future years of the Quality Payment Program (QPP), and establishing guidelines for MIPS-eligible clinicians who may face uncontrollable circumstances due to widespread catastrophic events, such as hurricanes, during calendar year 2017. Also finalizes the low-volume threshold, which exempts clinicians and groups providing care to fewer than 200 Medicare Part B beneficiaries annually, or submitting $90,000 or less to Medicare Part B annually. Comments regarding provisions of the rule, which take effect January 1, 2018, must be submitted no later than 5:00 p.m. Eastern on January 1, 2018.
Source: Federal Register
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CMS: Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2018; Medicare Shared Savings Program Requirements; and Medicare Diabetes Prevention Program Federal Register
Nov 15, 2017 - Final rule from the Centers for Medicare and Medicaid Services (CMS) addressing changes to the Medicare physician fee schedule (PFS) and other Medicare Part B payment policies. Also includes policies necessary to begin offering the expanded Medicare Diabetes Prevention Program model, and information about new care coordination services and payments for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQCHs). Provisions of the rule take effect January 1, 2018. Additional information is available on the November 2, 2017, CMS fact sheet.
Source: Federal Register
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HHS: Meetings Announcement for the Physician-Focused Payment Model Technical Advisory Committee Required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Federal Register
Nov 15, 2017 - Announces the next meeting of the Physician-Focused Payment Model Technical Advisory Committee, which will be held on December 18-20, 2017, from 9:00 a.m. to 5:00 p.m. Eastern each day at the Hubert H. Humphrey Building in Washington, D.C. The meeting is open to the public and will include deliberations and voting on proposals for physician-focused payment models submitted by members of the public. Those wishing to participate may attend in person, over teleconference, or via livestream. Pre-registration is requested.
Source: Federal Register
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Ways & Means Committee Leaders Announce Bipartisan Medicare Extenders Package
Nov 15, 2017 - The U.S. House of Representatives Committee on Ways and Means announced a bipartisan agreement to extend several expiring Medicare payment policies, including the Medicare Dependent Hospital Program and the Low-Volume Adjustment Program. The agreement includes offsetting the cost of these extensions with funding from other programs, including payments for Critical Access Hospital swing beds.
Source: U.S. House of Representatives Committee on Ways and Means
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CMS: Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs Federal Register
Nov 13, 2017 - Final rule from the Centers for Medicare and Medicaid Services (CMS) revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System for calendar year 2018. Included in the rule is a provision that reduces Medicare Part B payments to Disproportionate Share Hospitals (DSHs) and Rural Referral Centers (RRCs) for drugs acquired through the 340B Drug Pricing Program. Effective January 1, 2018, payments to affected facilities will be reduced from average sales price (ASP) plus 6 percent, to ASP minus 22.5 percent. Among others, Critical Access Hospitals (CAHs) and rural Sole Community Hospitals (SCHs) are excluded from this payment adjustment. Comments regarding provisions of the rule must be submitted no later than 5:00 p.m. Eastern on December 31, 2017.
Source: Federal Register
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