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CMS Finalizes FY 2021 Payments to Hospitals

Medicare has announced how it will pay hospitals for inpatient care in FY 2021 with publication of its annual inpatient prospective payment system regulation last week.

Among the changes announced by the Centers for Medicare & Medicaid Services:

  • A 2.9 percent increase in fee-for-service inpatient rates.
  • A compromise on its proposal to require hospitals to report their payer-specific negotiated rates with Medicare Advantage plans.
  • Changes in how Medicare will calculate Medicare disproportionate share (Medicare DSH) uncompensated care payments.
  • A much smaller cut than originally proposed in the pool of funds for Medicare DSH uncompensated care payments.  Medicare DSH uncompensated care payments are especially important to private safety-net hospitals.
  • Minor adjustments in the Medicare area wage index system.
  • Refinements in the Medicare graduate medical education program.
  • A new DRG for CAR T-cell payments and a new pathway to Medicare add-on payments for FDA-approved antimicrobial products.

Learn more from CMS’s fact sheet or see the final regulation itself.

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s January agenda were:

  • The Medicare prescription drug program (Part D):  status report and options for restructuring
  • Redesigning the Medicare Advantage quality program:  initial modeling of a value incentive program
  • Hospital inpatient and outpatient payments
  • Physician payments
  • Outpatient dialysis payments
  • Skilled nursing facility, home health, inpatient rehabilitation facility, and long-term-care hospital payments
  • Hospice and ambulatory surgery center payments
  • The 340B program
  • ACO beneficiary assignment

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.

MedPAC Meeting Transcript Now Available

Last week the Medicare Payment Advisory Commission met in Washington, D.C.  Among the Medicare payment issues on its agenda of interest to private safety-net hospitals were:

  • Assessing payment adequacy and updating payments: Physician and other health professional services
  • Assessing payment adequacy and updating payments: Ambulatory surgical center services
  • Assessing payment adequacy and updating payments: Hospital inpatient and outpatient services;
  • Assessing payment adequacy and updating payments: Skilled nursing facility services
  • Assessing payment adequacy and updating payments: Home health care services
  • Assessing payment adequacy and updating payments: Inpatient rehabilitation facility services
  • Assessing payment adequacy and updating payments: Long-term care hospital services

A transcript of that MedPAC meeting is now available.  Find it here.

MedPAC to Meet Tomorrow

The Medicare Payment Advisory Commission meets this Thursday and Friday in Washington, D.C.

MedPAC’s December agenda is dominated by Medicare payment issues:  how much Medicare should pay for different types of services in calendar year 2021 and FY 2021.  The services to be addressed during the December 5-6 meetings are physician and other health professional services, ambulatory surgical center services, hospital inpatient and outpatient services, skilling nursing facility services, home health services, inpatient rehabilitation facility services, long-term care hospital services, outpatient dialysis services, and hospice services.

In addition, MedPAC commissioners will discuss their mandated report on expanding Medicare’s post-acute care transfer policy to hospice and hear a status report on the Medicare Advantage program.

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.  Those recommendations, in turn, can have a major impact on the nation’s private safety-net hospitals.

Learn more here.

MedPAC Weighs in on Proposed Medicare Payment Changes

The Medicare Payment Advisory Commission has submitted formal comments to the Centers for Medicare & Medicaid Services in response to the latter’s publication of a proposed regulation that would govern how Medicare will pay for acute-care hospital inpatient services and long-term hospital care in the coming 2020 fiscal year.

The 14-page MedPAC report addresses four aspects of the proposed Medicare payment regulation:

  • inpatient- and outpatient drug- and device related payment proposals
  • proposed changes in the hospital area wage index
  • the reporting of hospitals’ uncompensated care on the Medicare cost report’s S-10 worksheet
  • the long-term hospital prospective payment system

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

See MedPAC’s letter to CMS here.

See NASH’s reponse to the same CMS proposed regulation here.

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues.

The issues on MedPAC’s December agenda were:

  • Medicare payments for physician and other health professionals services
  • payments for ambulatory surgical centers
  • payments for hospital inpatient and outpatient care
  • Medicare’s hospital quality incentive program
  • payments for skilled nursing facilities
  • payments for long-term care hospitals
  • payments for inpatient rehabilitation facilities
  • the Medicare Advantage program

MedPAC is an independent congressional agency that advises Congress on issues involving the Medicare program.  While its recommendations are not binding on either Congress or the administration, MedPAC is highly influential in governing circles and its recommendations often find their way into legislation, regulations, and new public policy.

Go here for links to the policy briefs and presentations that supported MedPAC’s discussion of these issues.

MedPAC Meets

The Medicare Payment Advisory Commission met in Washington, D.C. last week.

Among the issues on the agenda of the independent agency that advises Congress on Medicare payment issues were:

  • payment adequacy for physicians and other health professional services
  • An alternative to the merit-based incentive payment system (MIPS)
  • payment adequacy for hospital inpatient and outpatient services
  • payment adequacy for ambulatory surgical center services
  • the status of the Medicare Advantage program

Find links to issue briefs on these subjects and the presentations offered at the meeting by going here, to the MedPAC web site.