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New Rule Aims to Reduce Fraud, Assess Risk of Medicare Providers
As the impact of the Affordable Care Act (ACA) on providers continues to unfold, the tools the legislation provides to reduce fraud, waste and abuse are being implemented. The Centers for Medicare...
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Proposed Rule for Accountable Care Organizations
On March 31, 2011, Centers for Medicare & Medicaid Services (CMS) released its proposed rule for implementing the provisions of the Patient Protection and Affordable Care Act relating to the...
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Proposed Changes to the Long-Term Care Hospital Prospective Payment System
The May 5, 2011, Federal Register includes the Centers for Medicare & Medicaid Services’ (CMS) proposed rule changes to the Long-Term Care Hospital Prospective Payment System (LTCH PPS) for...
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Proposed Changes to the Hospital Inpatient Prospective Payment System (IPPS)
On April 19, 2011, the Centers for Medicare & Medicaid Services (CMS) posted proposed rule changes to the hospital acute care prospective payment system for federal fiscal year 2012. In addition...
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Inpatient Rehabilitation Facility Prospective Payment System for FY2012
On April 25, 2011, the Centers for Medicare & Medicaid Services (CMS) issued its proposed rule for inpatient rehabilitation facility (IRF) prospective payments. Not only did the proposed rule...
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Inpatient Psychiatric Prospective Payment Final Rule Issued
The Centers for Medicare & Medicaid Services (CMS) issued the final rule related to payment updates for inpatient psychiatric facilities (IPF) for Rate Year (RY) 2012 on May 5, 2011. The final...
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Final Rule Streamlines Telemedicine Credentialing & Privileging Process
The Centers for Medicare & Medicaid Services (CMS) issued a final rule on May 5, 2011, offering hospitals and critical access hospitals (CAHs) the option to streamline the credentialing and...
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CMS Releases SNF PPS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) recently released proposed rules for the skilled nursing facility prospective payment system (SNF PPS) for fiscal year 2012. This proposal...
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New Reporting Requirements for Tax-Exempt Hospitals Optional for Tax Year 2010
As part of the Patient Protection and Affordable Care Act (PPACA), tax-exempt hospitals must meet new requirements to maintain exempt status. To document compliance with these new requirements, the...
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Value-Based Purchasing Final Rule Released
The Centers for Medicare & Medicaid Services (CMS) recently released the final regulations of the value-based purchasing (VBP) program, affirming much of what was proposed in January....
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Conditions of Medicare Participation for Community Mental Health Centers
The Centers for Medicare & Medicaid Services (CMS) has proposed a rule to establish, for the first time, conditions of participation (CoPs) required for community mental health centers (CMHCs) in...
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SNF Medicare Billing Changes Effective August 1, 2011
Two significant updates to Medicare Part A claims for skilled nursing facilities (SNFs) and hospital swing-bed providers will occur with dates of service beginning August 1, 2011. The Centers for...
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Guidance Issued on Community Health Needs Assessments for Exempt Hospitals
Recently issued IRS Notice 2011-52 addresses community health needs assessment (CHNA) requirements added to the Internal Revenue Code by the Patient Protection and Affordable Care Act (ACA). While...
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Effects of the Budget Control Act of 2011
The debt limit crisis was resolved with the enactment of the Budget Control Act of 2011. The good news for Medicare providers is there are no immediate cuts to provider payment. In a best-case...
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Proposed Physician Fee Schedule Rule for Calendar Year 2012
On July 19, 2011, the Centers for Medicare & Medicaid Services (CMS) published the Calendar Year 2012 Physician Fee Schedule (PFS) proposed rule. While the proposed rule includes significant...
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CMS Issues SNF PPS Final Rule for FY 2012
On July 29, 2011, the Centers for Medicare & Medicaid Services (CMS) issued its final rule for federal fiscal year 2012 to update payment rates under the prospective payment system (PPS) for...
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Medicare Provider Enrollment Revalidation
Have you received notification from your Medicare Administrative Contractor (MAC) to revalidate your Medicare enrollment information? If not, be prepared for it. Section 6401(a) of the Patient...
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CMS Issues ESRD Updates & Other Changes
The Centers for Medicare & Medicaid Services (CMS) issued proposed rules to update the End-Stage Renal Disease (ESRD) prospective payment rates and quality incentive program (QIP) and ambulance...
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Long-Term Care M&A Market Update – August 2011
Long-Term Care M&A Activity Accelerates With consecutive increases in transaction volume each of the last six quarters, long-term care (LTC) mergers and acquisitions (M&A) volume has been on a...
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Hospital Wage Index Pension Changes – FY 2012 Final IPPS Rule
On August 1, 2011, the Centers for Medicare & Medicaid Services (CMS) published the final rule for changes to the hospital acute care prospective payment system (PPS) for federal fiscal year (FY)...
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