Federal regulatory agencies can impact hospital and health system operations. IHA plays an influential role with healthcare-related policy proposals.
On Nov. 2, the Centers for Medicare & Medicaid Services (CMS) released its calendar year (CY) 2024 physician fee schedule (PFS) final rule.
On Nov. 2, CMS posted the calendar year 2024 Medicare Outpatient Prospective Payment System final rule effective Jan. 1, 2024 through Dec. 31, 2024.
On Aug. 1, CMS posted the fiscal year 2024 (FY24) Medicare Inpatient Prospective Payment System (IPPS) final rule effective Oct. 1, 2023 through Sept. 30, 2024.
On July 31, the Centers for Medicare & Medicaid Services (CMS) published its calendar year 2024 (CY24) outpatient prospective payment system (OPPS) proposed rule.
CMS proposed several changes to hospital price transparency requirements in the CY24 OPPS proposed rule.
CMS published its annual proposed rule updating the Medicare Home Health prospective payment system effective Jan. 1, 2024 through Dec. 31, 2024.
Details on CMS’ proposed payment remedy in response to its unlawful 340B payment policy implemented in CY 2018.
CMS published its annual proposed rule updating the Medicare inpatient prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
CMS published its annual proposed rule updating the Medicare inpatient rehabilitation facility prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
CMS published its annual proposed rule updating the Medicare inpatient psychiatric facility prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
CMS published its annual proposed rule updating the Medicare skilled nursing facility prospective payment system effective Oct. 1, 2023 through Sept. 30, 2024.
CMS finalized outpatient prospective payment system updates, effective Jan. 1, 2023 through Dec. 31, 2023.
CMS finalized Medicare Conditions of Participation for rural emergency hospitals, effective Jan. 1, 2023.
CMS finalized policies and procedures specific to rural emergency hospitals, effective Jan. 1, 2023.
CMS restored the 340B reimbursement to average sales price plus 6% for calendar year 2023.
CMS published the home health prospective payment system final rule effective Jan. 1, 2023 through Dec. 31, 2023.
CMS published the inpatient prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
CMS published the long term care hospital prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
CMS published the skilled nursing facility prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
CMS published the inpatient rehabilitation facility prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
CMS published the Medicare hospice payment final rule effective Oct. 1, 2022 through Sept. 31, 2023.
CMS published the inpatient psychiatric facility prospective payment system final rule effective Oct. 1, 2022 through Sept. 31, 2023.
CMS published its annual proposed rule updating the Medicare outpatient prospective payment system effective Jan. 1, 2023 through Dec. 31, 2023.
CMS published its annual proposed rule updating the Medicare Home Health prospective payment system effective Jan. 1, 2023 through Dec. 31, 2023.
CMS published its annual proposed rule updating the Medicare Long-Term Care Hospital prospective payment system effective Oct. 1, 2022 through Sept. 30, 2023.
CMS published its annual proposed rule updating the Medicare Skilled Nursing Facility Prospective Payment System, effective Oct. 1, 2022 through Sept. 30, 2023.
CMS published its annual proposed rule update the Medicare Inpatient Prospective Payment System, effective Oct. 1, 2022 through Sept. 30, 2023.
CMS published its annual proposed rule updating the Medicare Hospice payment system effective Oct. 1, 2022 through Sept. 30, 2023.
CMS published its annual proposed rule updating the Medicare Inpatient Psychiatric Facility prospective payment system effective Oct. 1, 2022 through Sept. 30, 2023.
CMS published its annual proposed rule updating the Medicare Inpatient Rehabilitation Facility prospective payment system effective Oct. 1, 2022 through Sept. 30, 2023.
CMS published its annual final rule updating the Medicare outpatient prospective payment system effective Jan. 1, 2022 through Dec. 31, 2022. See IHA's fact sheet on the final rule.
CMS published its annual final rule updating the Medicare home health prospective payment system effective Jan. 1, 2022 through Dec. 31, 2022.
CMS published its annual final rule updating the Medicare Hospice prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS published its annual final rule updating the Medicare Long Term Care Hospital (LTCH) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS published its federal fiscal year 2022 final rule updating the Medicare inpatient prospective payment system. Additional rulemaking is forthcoming.
CMS published its federal fiscal year 2022 final rule updating the Medicare inpatient psychiatric facility PPS, including required reporting of COVID-19 healthcare personnel vaccination rates.
CMS published its FFY 2022 final rule updating the Medicare inpatient rehabilitation facility prospective payment system including required reporting of COVID healthcare personnel vaccination rates.
CMS published its federal FY 2022 final rule updating the Medicare skilled nursing facility prospective payment system, including required reporting of COVID healthcare personnel vaccination rates.
CMS published its calendar year 2022 proposed rule updating the Medicare outpatient prospective payment system, including updates to the hospital price transparency rule.
CMS published its annual proposed rule updating the Medicare home health prospective payment system effective Jan. 1, 2022 through Dec. 31, 2022.
CMS published its annual proposed rule updating the Medicare long-term acute care hospital prospective payment system effective Oct. 1, 2021 through September 30, 2022.
CMS published its annual proposed rule updating the Medicare inpatient prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS published its annual proposed rule updating the Medicare hospice prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS published its annual proposed rule updating the Medicare skilled nursing facility (SNF) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS published its annual proposed rule updating the Medicare inpatient psychiatric facility (IPF) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS published its annual proposed rule updating the Medicare inpatient rehabilitation facility (IRF) prospective payment system effective Oct. 1, 2021 through Sept. 30, 2022.
CMS will begin reprocessing and recouping reimbursement made for certain 2019 outpatient services provided at excepted off-campus Provider-Based Departments.
CMS published its annual final rule updating the Outpatient Prospective Payment System, effective Jan. 1, 2021. The final rule includes new COVID-19 hospital reporting requirements.
CMS published its annual final rule updating the Medicare Physician Fee Schedule, effective Jan. 1, 2021, including changes to Medicare telehealth policy.
CMS published its annual final rule updating the Medicare Home Health Prospective Payment System, effective Jan. 1, 2021 to Dec. 31, 2021.
On Sept. 3, CMS published its annual final rule updating the LTCH Prospective Payment System effective Oct. 1, 2020 through Sept. 30, 2021.
On Sept. 3, CMS published its annual final rule updating the Inpatient Prospective Payment System effective Oct. 1, 2020 through Sept. 30, 2021.
CMS published its annual final rule updating the Medicare inpatient psychiatric facility prospective payment system effective Oct. 1, 2021. See IHA’s fact sheet for important details on the rule.
CMS published its annual final rule updating the Medicare inpatient rehabilitation facility prospective payment system effective Oct. 1, 2021. See IHA's fact sheet for important details on the rule.
CMS published its annual final rule updating the Medicare skilled nursing facility prospective payment system effective Oct. 1, 2021. IHA's fact sheet provides detailed information on the rule.
On Nov.12, CMS published the final annual update regarding the Medicare outpatient prospective payment system (OPPS) and ambulatory surgical center payment system (ASC) for calendar year (CY) 2020.
CMS finalized a payment remedy in response to underpayments to 340B hospitals from 2018 through 2022.
The American Hospital Association developed this implementation guide to help equip hospitals and health systems with tools to better advocate for MA plan compliance with regulatory requirements.
This fact sheet summarizes several behavioral health and telehealth policies implemented via CY 2023 Medicare payment rules.
This reference guide includes details for the 2023, 2024, and 2025 Medicare Value-Based Purchasing, Readmissions Reduction, and Hospital-Acquired Condition Reduction programs.
An IHA webinar on June 9 provided an overview of the Medicare Readmissions Reduction Program (RRP) and Hospital Acquired Condition (HAC) Program. A recording of the webinar is available here.
An IHA webinar on May 17 identified strategies to enhance Medicare reimbursement. Access the webinar recording here (password Ehc6efgf). Click "Read More" below for the program slides.
An IHA webinar on May 16 provided an overview of the Medicare Value Based Purchasing (VBP) Program, which is the only Medicare quality program to recognize improvement as well as achievement.
IHA shares concerns on the No Surprises Act, which outlined new patient protections from surprise medical bills and requirements for healthcare providers and health plans.
OSHA issued a final emergency rule requiring healthcare employers to protect workers against on-the-job COVID-19 infection. The emergency temporary standard applies only to the healthcare sector.
CMS issued interpretative guidance concerning the Interoperability and Patient Access final rule electronic admission, discharge and transfer notification Conditions of Participation.
The implementation and enforcement deadline for new electronic admission, discharge and transfer notifications tied to Medicare Conditions of Participation is May 1, 2021.
As part of Medicare Conditions of Participation, hospitals, psychiatric hospitals and critical access hospitals must send electronic patient admission, discharge and transfer information by May 1.
Teaching hospitals have until March 29 to apply for IME and DGME slots made available by the recent closure of two teaching hospitals.
Hospitals and clinicians may apply for quality data reporting exceptions due to COVID-19. See an IHA memo with deadlines and additional information.
CMS clarified and codified longstanding Medicare bad debt policy via the FFY 2021 IPPS final rule. See IHA's fact sheet on the recent policy changes.
CMS delays the due date for several upcoming cost report submissions.
IHA closely monitors the OIG Work Plan to keep our members informed about potential changes to the healthcare landscape. This document summarizes current OIG studies members may find most pertinent.
CMS delayed the private payer data reporting period for CDLTs from applicable laboratories, including hospital outreach laboratories, as required under the Protecting Access to Medicare Act of 2014.
On Sept. 30, the Centers for Medicare & Medicaid Services (CMS) published in the Federal Register (FR) a final rulemaking a series of changes to the Medicare conditions of participatio n(CoP).
On Sept. 30, CMS published a final rule modifying discharge process requirements as a condition of participation for hospitals, critical access hospitals (CAHs) and home health agencies (HHAs).
On July 18, CMS published in the Federal Register (FR) two proposed specialty care models specific to radiation oncology and end-stage renal disease (ESRD).
IHA submitted comments on the proposed 300% increase in IDR administrative fees for 2024.
IHA comments on the Draft Merger Guidelines (Draft Guidelines) issued on July 18, 2023 by the Department of Justice (DOJ) and the Federal Trade Commission (FTC).
IHA comments on the calendar year 2024 (CY24) Outpatient Prospective Payment System (OPPS) proposed rule.
IHA supports CMS’ proposed lump sum repayment, but urges the Agency not to pursue budget neutrality.
In a letter on the calendar year 2024 (CY24) Home Health prospective payment system (PPS) proposed rule, IHA urges CMS to recalculate the proposed negative rate update to support these services.
In comments to CMS' director, IHA applauds the agency for authorizing State Directed Payments for Medicaid and urges that no further restrictions be placed on their use.
In a letter on the fiscal year (FY) 2024 inpatient prospective payment system (IPPS) proposed rule, IHA urges CMS to recalculate the proposed rate update to better reflect hospital costs.
IHA comments urge further standardization of prior authorization processes and shortened decision timelines across payers.
IHA urges CMS to increase the CY 2023 OPPS rate update and promptly repay hospitals impacted by its unlawful 340B reimbursement policy.
IHA urges CMS to increase its proposed rate update for the CY 2023 HH PPS and reconsider its proposed PDGM behavior adjustment.
In a letter on the fiscal year (FY) 2023 inpatient prospective payment system (IPPS) proposed rule, IHA urges CMS to recalculate the proposed rate update to better reflect hospital costs.
In a letter on the fiscal year (FY) 2023 skilled nursing facility (SNF) payment proposed rule, IHA urges CMS to improve several proposed payment policies to better support SNFs in the coming year.
In a letter on the Inpatient Rehabilitation Facility proposed rule, IHA urges CMS to improve the proposed rate update to better reflect economic realities hospitals face.
IHA urges CMS to postpone proposed increases to civil monetary penalties for price transparency noncompliance and support making permanent certain COVID-19 telehealth and supervision waivers.
IHA sent a comment letter to CMS on the CY22 Medicare PFS proposed rule, expressing disappointment that CMS declined to permanently add new telehealth services to Medicare under the CY 2022 PFS.
IHA comments focus on proposed home health quality changes, urging the administration to maintain current measurement selection processes to enhance transparency.
IHA comments urge collaboration on measuring health equity, delaying changes to Medicare organ transplantation payments, and expanding the cap on residency positions available under the CAA.
IHA submitted comments urging CMS to pursue National Quality Forum endorsement of proposed quality program measures.
IHA submitted comments requesting CMS continue monitoring public reporting of quality data impacted by COVID and ensure adequate resources for PAC providers transitioning to electronic standards.
IHA submitted comments urging CMS to delay and phase-in recoupment of overpayments made to SNF providers in FFY 2020, and explore revisions to the SNF VBP.
IHA submitted comments urging CMS to use its authority and influence to indefinitely maintain and expand telehealth access granted during the public health emergency.
IHA submitted comments objecting to his proposed rule, as it retroactively imposes a rule that the Supreme Court of the United States determined invalid.
IHA submitted comments addressing supervision levels, 340B payments, prior authorization policies, discontinuation of the inpatient only list, and Overall Star Ratings changes.
IHA submitted comments addressing CMS’ proposed utilization of hospital price transparency rule data, certain proposed changes to Medicare bad debt policies, and worksheet S-10 audits.
IHA submitted comments urging CMS to forgo proposals that would allow MA plans to assemble narrower provider networks.
IHA commented on the proposed collection of 340B provider acquisition costs.
IHA commented on on the proposed rule that would establish new price transparency requirements.
IHA submitted comments to CMS on the the proposed rule establishing two new specialty care models specific to radiation oncology and end-stage renal disease.
Comment letter to the Health Resources and Services Administration encouraging the agency to publish its final rule in time to meet the Jan. 1, 2019 proposed date.
Comments due to HRSA by Nov. 23