CCH® Medicare — 5/17/11

Medicare and Medicaid Court action by one state agency against another allowed by Supreme Court A federal court may hear a lawsuit for prospective relief against state agency officials brought by another agency of the same state, the U.S. Supreme Court has held. The Virginia Office for Protection and Advocacy (VOPA) had filed a complaint […]

CCH® Medicare — 5/16/11

Medicare and Medicaid Court upholds denial of loss claims after merger The district court properly upheld the CMS Administrator’s denial of a hospital group’s reimbursement claims arising from the merger of two hospital corporations, according to the U.S. Court of Appeals for the D.C. Circuit. The hospital group argued unsuccessfully that the denial of their […]

CCH® Medicare — 5/13/11

Medicare and Medicaid Hospice wage index Proposed rule issued for fiscal year 2012 CMS has proposed the new hospice wage index for fiscal year (FY) 2012 which would increase Medicare payments to hospices by an estimated 2.3 percent for FY 2012, and CMS expects Medicare hospice payments to increase by $310 million overall in FY […]

Hospice wage index Proposed rule issued for fiscal year 2012

Medicare and Medicaid Hospice wage index Proposed rule issued for fiscal year 2012 CMS has proposed the new hospice wage index for fiscal year (FY) 2012 which would increase Medicare payments to hospices by an estimated 2.3 percent for FY 2012, and CMS expects Medicare hospice payments to increase by $310 million overall in FY […]

SNF PPS Proposed rule FY 2012

Medicare and Medicaid SNF PPS Proposed rule FY 2012 CMS has proposed several changes to the skilled nursing facility (SNF) prospective payment system (PPS) for fiscal year (FY) 2012. The most significant issue faced by CMS regarding the SNF PPS FY 2012 is how to set the FY 2012 payments rates. CMS is considering two […]

Value-based purchasing rule for hospitals published

Medicare and Medicaid Value-based purchasing rule for hospitals published CMS has issued a Final rule implementing an inpatient hospital Value-Based Purchasing (VBP) program starting October 1, 2012, under which value-based incentive payments will be made to hospitals that meet specific performance standards in a given year. The VBP program was authorized under Soc. Sec. Act […]

Hospital unreasonably relied on advice on FTEs

Medicare and Medicaid Hospital unreasonably relied on advice on FTEs A hospital unreasonably relied on the fiscal intermediary’s (FI) faulty advice regarding how to count full time equivalent (FTE) residents. A hospital had to repay several million dollars to the Medicare program for training its medical residents. In fiscal years (FY) 1995 and 1996 the […]

Challenge to physician self-referral amendment rejected

Medicare and Medicaid Challenge to physician self-referral amendment rejected The Secretary of Health and Human Services was granted summary judgment on a challenge to an amendment to the Medicare Act from a group of physician-owned hospitals (POHs). The amendment, Section 6001 of the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148), prohibits new or […]

Proposed rule modifies DMEPOS supplier standards adopted in 2010

Medicare and Medicaid Proposed rule modifies DMEPOS supplier standards adopted in 2010 CMS has issued a Proposed rule, applicable to all durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers, that would revise and clarify several DMEPOS supplier standards set forth in 42 C.F.R. §424.57(c)that were adopted in the Final rule published in the Federal […]

New HAC link from CMS’ Hospital Compare website launched

Medicare and Medicaid New HAC link from CMS’ Hospital Compare website launched Medicare patients can now see important data about eight hospital acquired conditions (HACs) in America’s hospitals through a link from CMS’ Hospital Compare website. Since 2005, Hospital Compare has been providing information about the quality of care in over 4,700 acute-care, critical access, […]