Finance News

Finance News web alerts provide timely updates on federal and state reimbursement policies and procedures for hospitals and health systems.

CMS Value in Opioid Use Disorder Treatment Demonstration Accepting Applications through Jan. 3

Hospital outpatient departments, critical access hospitals, rural health clinics and other eligible providers may apply through Jan. 3 to participate in the CMS Value in Opioid Use Disorder Treatment demonstration. The demonstration will offer participating providers a per-beneficiary care management fee and performance-based incentive...

CMS Will Not Update Hospital Star Ratings, Quality Data in Jan. 2021

CMS announced last week it will not update the overall hospital quality star ratings at Hospital Compare in January to allow time to review public comment and finalize proposed changes to the star ratings methodology. The proposed changes to the star ratings methodology, many of which are supported by AHA and OHA, were included in the CY 2021...

CMS Releases FAQ on CHART Rural Payment Model

CMS yesterday released a FAQ on the Community Health Access and Rural Transformation Model. Announced in August, the two-track model seeks to provide up-front funding and predictable payments, reduce regulatory burden and increase flexibilities for rural participants. Applications to participate in the Community Transformation Track are due Feb...

CMS Launches Price Transparency Website

CMS last week launched a website on the final hospital price transparency rule that requires hospitals to disclose their negotiated rates. The website includes information and resources for hospitals and consumers to better understand the new requirements, including a compliance checklist, a new set of frequently asked questions and...

OHA Comments on CY 2021 OPPS Proposed Rule

The Ohio Hospital Association today submitted comments on the Centers for Medicare & Medicaid Services' outpatient prospective payment system proposed rule for calendar year 2021, offering recommendations to:The proposed elimination of the inpatient only listFurther reduction in payment for certain drugs purchased under the 340B...

Continuing Resolution Changes Repayment Terms for Medicare Advance and Accelerated Payments Program

President Trump signed into law late Wednesday a short-term government funding bill that includes changes to repayment terms for certain providers who have received COVID-19 loans. The bill gives hospitals one year before Medicare can offset payments to recoup advancements received under Medicare's Advance and Accelerated...

CMS Change Request Recalculates NAH, GME Payments

CMS late August announced a change to their Medicare Advantage payment policy which impacts Nursing Allied Health and Graduate Medical Education programs. CMS' Change Request 11642 instructs MACs to recalculate the Medicare Part C components of NAH and GME payments to hospitals for calendar years 2002 though 2018. These adjustments are...

CMS to Withdraw Medicaid Fiscal Accountability Proposed Rule

The Centers for Medicare & Medicaid Services late today announced its decision to withdraw its Medicaid Fiscal Accountability Rule from its regulatory agenda. CMS will formally withdraw the rule through a notice published in the Federal Register. OHA earlier this year submitted comments to CMS detailing the profound impact the proposed MFAR...

Recoupment of Accelerated/Advance Payments Pending CMS Guidance, Providers May Pay Early

As of Sept. 4, CGS is still waiting on additional guidance from CMS related to the recoupment of Medicare accelerated/advance payments.    Any provider who does not want to wait for the offsets to occur may send a repayment by check to CGS' Overpayments & Refunds department, along with the following information...