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Rural Healthcare Payment and Reimbursement – News

News stories from the past 60 days.

Oct 3, 2024 - Notice of interim final action with comment period from the Centers for Medicare & Medicaid Services (CMS) revising Medicare wage index values for fiscal year (FY) 2025, establishes a transitional payment exception for low-wage hospitals significantly impacted by those revisions, and makes conforming changes to the hospital inpatient prospective payment system (IPPS) payment rates for FY 2025. These changes reflect the removal of the low wage index hospital policy following the appellate court decision in Bridgeport Hosp. v. Becerra. This rule also makes conforming changes to IPPS rates and factors used to determine certain payments under the long-term care hospital prospective payment system (LTCH PPS). This action is effective on September 30, 2024. Comments are due by November 29, 2024.
Source: Federal Register
Oct 2, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical and typographical corrections to the August 28, 2024, final rule. This correction is effective October 1, 2024.
Source: Federal Register
Oct 2, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical corrections to the August 7, 2024, final action. This correction in effective October 1, 2024.
Source: Federal Register
Oct 2, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical corrections to the August 6, 2024, final rule. This correction is effective October 1, 2024.
Source: Federal Register
Oct 2, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical and typographical corrections to the August 6, 2024, final rule. This correction is effective October 1, 2024.
Source: Federal Register
Sep 27, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) addressing policies for assessing performance year (PY) 2023 financial performance of Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) in light of significant, anomalous, and highly suspect (SAHS) billing activity for selected intermittent urinary catheters on Medicare Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) claims. Among other things, this rule establishes benchmarks for ACOs starting agreement periods in 2024, 2025, and 2026, financial calculations used in the application cycle for ACOs applying to enter a new agreement period beginning on January 1, 2025, and the change request cycle for ACOs continuing their participation in the program for PY 2025. These regulations are effective October 15, 2024.
Source: Federal Register
Aug 28, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) revising the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2025. This rule also makes changes to Medicare graduate medical education (GME) for teaching hospitals and updates payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals. Among other things, this rule also finalizes the proposal of a separate IPPS payment for establishing and maintaining access to essential medicines; finalizes a new mandatory alternative payment model called the Transforming Episode Accountability Model (TEAM), which will test whether financial accountability for selected episode categories reduces Medicare expenditures while preserving or enhancing the quality of care for Medicare beneficiaries; and finalizes the proposal requiring respiratory illness reporting for hospitals and Critical Access Hospitals (CAHs) as a condition of participation following the expiration of the COVID-19 public health emergency requirements. With three exceptions, this final rule is effective October 1, 2024. Instruction 2 (§ 405.1845) is effective January 1, 2025. Instructions 29 and 31 (§ 482.42(e) and § 485.640(d)) are effective November 1, 2024.
Source: Federal Register
Last Updated: 10/1/2024