Skip to main content
Rural Health Information Hub
Rural Health Information Hub

Rural Healthcare Payment and Reimbursement – News

News stories from the past 60 days.

Nov 13, 2024 - Provides overview of recent research on rural medical debt. Notes that rural residents are more likely than urban residents to have problems paying medical bills, and identifies gender and racial disparities within rural survey respondents. Discusses the potential impacts of medical debt on the viability of rural hospitals.
Source: The Daily Yonder
Nov 12, 2024 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) updating and revising the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2025 and updates the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). This rule also updates the requirements for the Conditions for Coverage for ESRD facilities, the ESRD Quality Incentive Program, and the ESRD Treatment Choices Model. These regulations are effective January 1, 2025.
Source: Federal Register
Nov 1, 2024 - Pre-publication notice of final rule from the Centers for Medicare & Medicaid Services (CMS) addressing: 1) changes to the Physician Fee Schedule and Medicare Part B payment policies; 2) policies for the Medicare Prescription Drug Inflation Rebate program under the Inflation Reduction Act of 2022; 3) updates to the Medicare Diabetes Prevention Program expanded model; 4) payment for dental services inextricably linked to specific covered medical services; 5) updates to drugs and biological products paid under Part B including immunosuppressive drugs and clotting factors; 6) Medicare Shared Savings Program requirements; 7) updates to the Quality Payment Program; 8) Medicare coverage of opioid use disorder services furnished by opioid treatment programs; 9) updates to policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs); 10) electronic prescribing for controlled substances for a covered Part D drug under a prescription drug plan or an MA-PD plan; 11) updates to the Ambulance Fee Schedule regulations; 12) updates to Clinical Laboratory Fee Schedule regulations; 13) updates to the diabetes payment structure and COVID-19 public health emergency (PHE) flexibilities; 14) expansion of colorectal cancer screening and Hepatitis B vaccine coverage and payment; 15) establishing payment for drugs covered as additional preventive services; and 15) Medicare Parts A and B Overpayment Provisions of the Affordable Care Act and Medicare Parts C and D Overpayment Provisions of the Affordable Care Act. These regulations are effective January 1, 2025.
Source: Federal Register
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
Last Updated: 11/13/2024