Posted by Jason Greis on August 3, 2010 under Articles | 
The Centers for Medicare & Medicaid Services (“CMS”) has recently released various notices and final rules updating 2011 Medicare payment rates for post-acute care providers, including long-term acute care hospitals (“LTACHs”), inpatient rehabilitation facilities (“IRFs”), skilled nursing facilities (“SNFs”), home health agencies (“HHAs”) and hospices. These Medicare rate updates generally implement negative payment adjustments mandated by the Patient Protection and Affordable Care Act (Pub. L. No. 111-148), as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. No. 111-152) (together, “PPACA”). Yet in spite of these adjustments, SNFs, hospices, IRFs and LTACH have fared relatively well with collective Medicare payment increases totaling $919 million, with HHAs offsetting these reimbursement gains by suffering a proposed $900 million Medicare reimbursement cut for calendar year 2011. Read More...
Tags: adjust, cms, cy 2011, greisguide, greisguidetoltachs, hha, home health, hospice, hospital, inpatient rehabilitation facility, irf, jason greis, long term acute care hospital, long term care hospital, ltac, LTACH, LTCH, market basket, marketbasket, mcguirewoods, medicare, ppaca, ry 2011, skilled nursing, snf, standard federal rate
Posted by Jason Greis on June 23, 2010 under Articles |
Telemedicine consultations are often provided by physicians at large hospitals, often called “distant-site” hospitals (See § 1834(1)(m)(4)(A) of the Social Security Act), to patients at smaller ones, such as those in rural areas. Physicians providing these consultations are privileged and credentialed at their home institutions, but often not, at the outset, at the hospitals to which they provide their advice electronically, which for purposes of this discussion, we refer to as local hospitals. Read More...
Tags: cms, doctor, greisguide, greisguidetoltachs, joseph mcmenamin, ltac, LTACH, LTCH, mcguirewoods, melissa gilmore, physician, privilege, telemedicine
Posted by Jason Greis on April 30, 2010 under Articles |
The below CMS e-mail alert was distributed via grouplist on Thursday, April 22, 2010 and impacts LTACHs, among other institutional providers. Read More...
Tags: 0.25%, 3401, cms, greisguide, greisguidetoltachs, hospital, inpatient rehabilitation facility, irf, jason greis, ltac, LTACH, LTCH, market basket, Patient Protection and Affordable Care Act, ppaca, pps, prospective payment system
Posted by Jason Greis on March 28, 2010 under Articles |
On March 1, 2010, the Medicare Payment Advisory Commission (“MedPAC” or the “Commission”) released its 2010 Report to the Congress: Medicare Payment Policy (the “Final Report”) recommending annual Medicare payment updates for Medicare fee-for-service (“FFS”) payment systems, including among others, hospitals (including both general acute care and long term care hospitals) and physicians. MedPAC is an independent congressional agency established by the Balanced Budget Act of 1997 to formulate recommendations to Congress to address quality and cost-containment issues affecting the Medicare program and its beneficiaries. Two reports, issued in March and June each year, are the primary outlets for MedPAC’s policy and payment system updates, which change base rates paid by Medicare for a unit of service provided by a FFS provider—for example, a hospital admission or a physician visit or procedure. Recommended payment system updates are based on an assessment of payment adequacy that takes into account beneficiaries’ access to care, supply of providers, quality of care, providers’ access to capital and Medicare margins. Read More...
Tags: bundling, CBO, cms, doctor, equipment utilization assumption rate, ffs, grassley, greisguide, greisguidetoltachs, Health Care and Education Affordability Act of 2010, hhs, hr 4691, imaging, independent payment advisory board, ipab, jason greis, long term acute care hospital, long term care hospital, ltac, LTACH, LTCH, medicare, Medicare Payment Advisory Commission, MedPAC, obama, Patient Protection and Affordable Care Act, pha, physician, physician-owned hospital, primary care physician, radiologist, sgr, sustainable growth rate, tort reform
Posted by Jason Greis on July 14, 2009 under Articles, Industry News |
Section 114(b) of the Medicare, Medicaid and SCHIP Extension Act of 2007 (“MMSEA”) required the Secretary of Health and Human Services to conduct a study on the feasibility of establishing national LTACH facility and patient criteria for purposes of determining medical necessity, appropriateness of admission, and continued stay at, and discharge from, LTACHs. The Centers for Medicare and Medicaid Services (“CMS”) awarded a contract for this study to Research Triangle Institute International (“RTI”), which was previously awarded a contract in 2005 to evaluate the feasibility of developing patient and facility level characteristics for LTACHs that could distinguish LTACH patients from those treated in other acute care settings. RTI was scheduled to submit its most recent report required under the MMSEA to Congress by June 2009. According to an anonymous source within CMS, the agency is presently reviewing the report’s recommendations for legislation and administrative actions and CMS hopes to post the report on its website by the end of July 2009. Read More...
Tags: cms, greisguide, greisguidetoltachs, hospital, jason greis, ltac, LTACH, LTCH, Medicaid and SCHIP Extension Act, medicare, mmsea, post-acute, report, research triangle, RTI, study
Posted by Jason Greis on May 17, 2009 under Articles |
On April 29, 2009 the Senate Finance Committee (“Committee”) released the first of three health reform option papers exploring proposals for reducing costs and improving quality and efficiency in the country’s health care delivery system. The second option paper addressing potential solutions for reforming health coverage decisions was released on May 14, and the final option paper discussing solutions for financing health care reform is scheduled to be released on May 20. The policy options contained in the first option paper would shift Medicare payments to post-acute care providers from volume‐based to value‐based purchasing by providing new payment incentives for care that contributes to positive patient outcomes. The first option paper contains a number of proposals that, if enacted, would significantly affect Medicare payments to long-term acute care hospitals (“LTACH”). Read More...
Tags: altha, baucus, bundle, bundling, cms, greisguide, greisguidetoltachs, health information technology, hospital, irf, jason greis, ltac, LTACH, LTCH, nalth, Neleen Eisinger, option paper, payment, prevent, quality, readmission, senate finance committee, snf, value-based purchasing
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