CMS Outlines Improvements in RAC Audit Processes
In the face of complaints from hospitals about backlogs, time-consuming procedures, and lengthy appeals processes involving Medicare Recovery Audit Contractor audits, the Centers for Medicare & Medicaid Services recently outlined changes it has implemented in the RAC audit process to [...]
CMS Adopts Rule to Protect Medicaid Payments
A new Medicaid provider reassignment regulation eliminates the ability of states to divert any portion of Medicaid payments to third parties. Such diversion was authorized, in a limited manner, in 2014, when CMS created an exception to the existing prohibition [...]
Senate Finance Committee Reports on Supplemental Medicaid Payments
The majority members of the Senate Finance Committee have published a report on supplemental Medicaid payments. According to the new document, This report seeks to increase educational understanding of Medicaid supplemental payments, as well as outline the reporting mechanisms for [...]
Uninsured ED and Inpatient Visits Down Since ACA
Uninsured hospital admissions and emergency department visits are down since passage of the Affordable Care Act. And Medicaid-covered admissions and ER visits are up, according to a new analysis. The report, published on the JAMA Network Open, found that ER [...]
Bureaucratic Requirements May Be Driving Medicaid Enrollment Decline
State eligibility redetermination processes may be pushing down Medicaid enrollment nation-wide. Last year, national Medicaid enrollment fell 1.5 million, more than half of them children, and according to a new report from Families USA, much of that decline may be [...]
Safety-Net Hospitals, Others Benefit From Changes in Medicare Readmissions Program
Safety-net hospitals are among the leading beneficiaries of changes implemented this year in Medicare’s hospital readmissions reduction program. According to a new study, safety-net, academic, and rural hospitals have enjoyed improved performance under the program since Medicare began organizing hospitals [...]
CMS Posts Proposed FY 2020 Inpatient Regulation
Medicare would change its wage index system, raise inpatient fees, increase funding for Medicare disproportionate share hospital payments (Medicare DSH), enhance payments for new technologies, and make minor modifications in its hospital readmissions reduction, value-based purchasing, and hospital-acquired condition program [...]
MACPAC Recommends Changes in Medicaid Shortfall Definition
Hospitals’ calculation of their Medicaid shortfall would change under a recommendation that MACPAC voted to make to Congress. That change, in turn, could affect hospitals’ future Medicaid disproportionate share payments. Last week the Medicaid and CHIP Payment and Access Commission [...]
MACPAC Meets
The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. The Commission wrapped up its work on the June 2019 Report to Congress on [...]
Delay Medicaid DSH Cuts, Pelosi Says
Medicaid DSH cuts should be delayed, House Speaker Nancy Pelosi (D-CA) told a gathering of hospital officials. According to Speaker Pelosi, DSH cuts threaten to erode the health of community hospitals, safety-net hospitals and rural hospitals, [affecting] the health of [...]
