he United States has been in a state of Public Health Emergency (PHE) due to the coronavirus pandemic since January 2020. Section 319 of the Public Health Services (PHS) Act grants the authority to declare and re-evaluate the need for the PHE to the Secretary of Health and Human Services, who reviews the emergency declaration every 90-days and determines whether an extension is warranted.
Blog
2022 Medicare Sequestration Considerations
Overview In a late 2021...
CMS Doubles Down on Their Expectation for Price Transparency
On November 2, 2021, CMS released the anticipated CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule (CMS-1753-FC), finalizing this year’s Medicare payment rates for hospital outpatient and ASC as well including regulatory guidance regarding several high profile policies for hospitals providing outpatient services. CMS evaluated industry feedback to the proposed modifications, including halting the elimination of the Inpatient Only list (IPO), broadening the impact of the Hospital Price Transparency Rule, and other updates.
COVID-19 Provider Relief Fund Updates
Additional Funds, Delay...
Don’t Use Denial Rate to Measure a Payer’s Performance
By Jerilyn Morrissey,...
What Your Denial Rate Is Not Telling You
Let’s talk about...
Will Medicare Beneficiaries pay more for a procedure no longer on the Inpatient-Only List?
There is still a lot of...
Do More Denials Mean More Revenue?
By Joseph Zebrowitz, MD...
Hospital Price Transparency: Penalties Potentially Much Higher Than Hospitals Anticipate
Within the IPPS policy...
The Addition of Total Knee Arthroplasty (TKA) to the PEPPER Will Be of Little Use to Hospitals
Much ado is being made...
1135 Waivers: When do they expire?
These waivers, known as...
Medicare Update: Prior Authorization Request Process for Certain Hospital Outpatient Services
Five hospital...
COVID-19: Additional $25 Billion CARES Act Fund Allocation & CMS Re-opening Guidelines
The U.S. Department of...