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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.

Good News and Bad for Hospitals on Outpatient Payments

A federal court has provided relief to hospitals that saw reduced Medicare payments for some outpatient services in 2019.

But that relief is only partial.

In response to a suit filed by several hospital groups, a federal court ruled that the Centers for Medicare & Medicaid services had illegally reduced Medicare payments for services provided in some hospital off-campus outpatient departments beginning on January 1, 2019 and ordered the federal government to repay the hospitals for the Medicare revenue they lost.  The reduced payments were part of a new Medicare site-neutral payment policy for outpatient services, and CMS has announced a plan for reimbursing affected hospitals for their losses.

At the same time, however, CMS announced that despite the court’s ruling, it will implement the same policy of reduced payments for outpatient care provided in some hospitals’ off-campus outpatient departments in 2020, and an effort by hospitals to persuade the court to ban this payment reduction was rejected by the same court that ruled against CMS on the 2019 payments.

Learn more about the ruling that CMS must reimburse  hospitals for lost payments in the Healthcare Dive article “Hospital group cheers CMS move to pay back outpatient payment cuts.”  Learn about the court decision not to impose the same decision on 2020 payments in the Fierce Healthcare article “Judge strikes down AHA’s bid to halt CMS’ site-neutral payment cuts for 2020.”

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 Talks Payments

At public meetings in Washington, D.C. last week, members of the Medicare Payment Advisory Commission discussed the adequacy of current Medicare payments and whether they need updating in the next fiscal year.

Among the payment areas MedPAC reviewed were inpatient services, outpatient services, physician and health professional services, ambulatory surgical center services, skilled nursing facilities, home health services, inpatient rehabilitation hospitals, long-term-care facilitiies, outpatient dialysis services, and hospices.

Find the issue briefs and presentations used to guide these discussions here, on MedPAC’s web site.

MedPAC Meets, Talks Alternative Payment Models, Medicare Advantage Star Ratings, More

The agency that advises Congress on Medicare payment issues met last week in Washington, D.C.

new medpacDuring two days of public meetings the Medicare Payment Advisory Commission (MedPAC) heard presentations about and discussed a number of issues of interest to private safety-net hospitals, including alternative payment models and merit-based incentive payment systems and factors affecting variation in Medicare Advantage plan star ratings.

For links to policy briefs and presentations on these and other subjects, go here.

To see a transcript of the two days of meetings, go here.

Members of Congress Seek Increased Medicare Rates

US Capitol DomeMembers of Congress have written to Centers for Medicare & Medicaid Services (CMS) acting administrator Andrew Slavitt asking him to reconsider his agency’s proposal to reduce the rates Medicare will pay providers for outpatient services.

In July, CMS proposed reducing those outpatient rates 0.2 percent in calendar year 2016.

The letter notes that

According to MedPAC, Medicare already pays hospitals less than 88 cents on the dollar for outpatient services and this rule will make that situation worse for our constituents – both hospitals and patients alike.

The letter also states that

Medicare already pays providers less than the cost of care. Prescribing a negative update to OPPS [note: outpatient prospective payment system] payment rates will only make it more difficult for hospitals to serve their patients and their communities, particularly as they move to adopt delivery system reforms.

To see the letter, including the names of the 95 Democrats and Republicans who signed it, go here.