Hospital Payments and Operations

IHA summarizes and analyzes federal policies impacting hospital payments and operations. 

May 10, 2024

Recording: Hospital Wage Index: Maximizing Medicare Reimbursement (5.9.24)

This webinar walks IHA members through the wage index development process, the impact of recent court cases and policy changes, and the opportunities before hospitals. Password: pDtV3mRA

Apr 30, 2024

340B ADR Final Rule

HRSA published a final rule revising the 340B ADR process required under the Affordable Care Act.

Apr 03, 2024

Recording: CMS Interoperability and Prior Authorization Final Rule (4.3.24)

CMS provided IHA members with an overview of the interoperability and prior authorization final rule (CMS-0057-F). Password: pMtq3rug

Nov 21, 2023

CMS Final 340B Payment Remedy

CMS finalized a payment remedy in response to underpayments to 340B hospitals from 2018 through 2022.

Nov 15, 2023

Medicare Advantage Final Rule Implementation Handbook

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.

Dec 02, 2022

2023 Medicare Behavioral Health and Telehealth Fact Sheet

This fact sheet summarizes several behavioral health and telehealth policies implemented via CY 2023 Medicare payment rules.

Nov 22, 2022

Medicare Quality Programs Reference Guide

This reference guide includes details for the 2023, 2024, and 2025 Medicare Value-Based Purchasing, Readmissions Reduction, and Hospital-Acquired Condition Reduction programs.

Jun 09, 2022

Overview of Medicare RRP and HAC 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.

May 20, 2022

Webinar: Top Medicare Reimbursement Opportunities Post COVID

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.

May 18, 2022

Overview of Medicare VBP Program

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.

Nov 10, 2021

Federal No Surprises Act Implementation

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.

May 12, 2021

CMS Releases Guidance for Electronic ADT Notification CoP

CMS issued interpretative guidance concerning the Interoperability and Patient Access final rule electronic admission, discharge and transfer notification Conditions of Participation.

Mar 29, 2021

Updated Electronic ADT Enforcement Date and ONC Information

The implementation and enforcement deadline for new electronic admission, discharge and transfer notifications tied to Medicare Conditions of Participation is May 1, 2021.

Mar 22, 2021

May 1 Implementation Deadline: Electronic Exchange of Patient ADTs as Medicare CoP

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.

Feb 25, 2021

March 29 Deadline: Apply for IME and DGME FTE Slots

Teaching hospitals have until March 29 to apply for IME and DGME slots made available by the recent closure of two teaching hospitals.

Dec 10, 2020

Upcoming Deadlines: Medicare Quality Program Reporting and Reweighting Extensions

Hospitals and clinicians may apply for quality data reporting exceptions due to COVID-19. See an IHA memo with deadlines and additional information.

Dec 03, 2020

FFY 2021 Medicare Bad Debt Policy Changes

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.

Jun 26, 2020

Delayed Due Dates for Medicare Cost Reports

CMS delays the due date for several upcoming cost report submissions.

Feb 26, 2020

HHS OIG Work Plan, 2020

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.

Jan 14, 2020

CLFS PAMA Reporting Period Changes

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.

Oct 25, 2019

Final Rule: Changes to Medicare Conditions of Participation

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).

Oct 25, 2019

Final Rule: Revised Discharge Planning Requirements for Hospitals

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).

Sep 12, 2019

Proposed Specialty Care Models: Radiation Oncology and End-Stage Renal

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).