Rural Healthcare Payment and Reimbursement – News
News stories from the past 60 days.
Jul 1, 2024 - Pre-publication notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) proposing 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, rule proposes benchmarks for ACOs starting agreement periods in 2024, 2025, and 2026; and 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. Comments are due by July 29, 2024.
Source: Federal Register
Jun 28, 2024 - Pre-publication notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) making changes related to End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2025 and proposing updates to the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). Among other things, this rule also proposes updated requirements for the Conditions for Coverage for ESRD facilities, the ESRD Quality Incentive Program, and the ESRD Treatment Choices Model. Comments are due by August 26, 2024.
Source: Federal Register
Jun 17, 2024 - Announces the conclusion of the Center for Medicare & Medicaid Services (CMS) Accelerated and Advance Payment (AAP) Program, which launched in March to address payment disruptions resulting from the Change Healthcare cyberattack. Notes that over $2.55 billion has been distributed to Part A providers as a result of the program, which will conclude on July 12.
Source: Center for Medicare & Medicaid Services
GAO: Request for Nominations for the Physician-Focused Payment Model Technical Advisory Committee (PTAC)
Federal Register
Jun 12, 2024 - The Government Accountability Office (GAO) is accepting nominations for appointment to the Physician-Focused Payment Model Technical Advisory Committee (PTAC), which provides comments and recommendations to the Secretary of Health and Human Services on physician payment models. Nominations are due by July 10, 2024.
Source: Federal Register
Jun 4, 2024 - Notice from the Centers for Medicare & Medicaid Services (CMS) making technical and typographical corrections to the May 2, 2024, proposed rule regarding changes to the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2025.
Source: Federal Register
CMS: Medicare Program: Alternative Payment Model Updates and the Increasing Organ Transplant Access Model
Federal Register
May 17, 2024 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) describing a new mandatory Medicare payment model, the Increasing Organ Transplant Access Model (IOTA Model). The IOTA Model would test whether performance-based incentive payments paid to or owed by participating kidney transplant hospitals increase access to kidney transplants for patients with end-stage renal disease (ESRD) while preserving or enhancing the quality of care and reducing Medicare expenditures. This proposed rule also describes standard provisions for CMS Innovation Center (CMMI) models relating to beneficiary protections, cooperation in model evaluation and monitoring, audits and records retention, rights in data and intellectual property, monitoring and compliance, and more. These standard provisions would apply to any CMMI model whose first performance period begins on or after January 1, 2025, and in whole or in part to any CMMI model whose first performance period began before January 1, 2025. Comments are due by July 16, 2024.
Source: Federal Register
Last Updated: 7/1/2024