HHS Issues Rule on DSH Payments

On May 13, CMS released a proposed rule on the health reform law’s reductions to Disproportionate Share Hospital (“DSH”) payments. The rule would temporarily shield states that have decided to expand Medicaid from deeper DSH cuts in fiscal years 2014 and 2015. The rule comes a month after the White House’s fiscal year 2014 budget proposed delaying the cuts until 2015 in order to get a better sense of uncompensated care levels. (more…)

HHS Releases Hospital Price Information for Common Procedures

On May 8, HHS released publicly available information about hospital charges. The data set includes information on the 100 most common inpatient procedures. The data shows that hospital fees vary widely – sometimes 10 to 20 times what Medicare normally reimburses, for the same procedure.  The release of this data is expected to intensify the debate in Congress about how hospitals determine prices and why they differ so widely.

(more…)

CMS Releases IPPS Proposed Rule for FY 2014

On April 26, CMS issued its Fiscal Year (“FY”) 2014 proposed rule for hospitals paid under the inpatient prospective payment system (“IPPS”).  The rule would update FY 2014 Medicare payment policies and rates for inpatient stays at general acute care and long-term care hospitals (“LTCHs”).

(more…)

PCORI Offers Funding to Develop Research Network

On April 23, the Patient-Centered Outcomes Research Institute (“PCORI”) announced funding up to $68 million in efforts to build a research network to support comparative effectiveness studies.

(more…)

HHS Inspector General Revises Self-Disclosure Protocol

On April 17, the HHS Office of Inspector General (“OIG”) released a revised self-disclosure protocol (PDF) called the OIG Provider Self-Disclosure Protocol.  The protocol describes what a hospital must confide to the government in order to avoid prosecution or get a possible reduction in penalties.

(more…)

Obama Releases HHS Budget for FY 2014

On April 10, HHS posted a 126-page summary of President Obama’s fiscal year (“FY”) 2014 budget for the agency. The budget proposes $5.6 billion in Medicare payment cuts for FY 2014. Hospital-related cutbacks were proposed for graduate medical education, critical access hospitals and bad debt payments.

(more…)

Proposed Reporting Rule for Charity Hospitals Released

On April 3, the Internal Revenue Service and Department of Treasury published a proposed rule on the health care law’s community health needs assessment requirements for charitable hospitals, related excise tax and reporting requirements, and the consequences for failing to complete them.

(more…)

Senate Passes FY 2014 Budget Resolution

On March 23, the U.S. Senate voted 50-49 to pass a fiscal year 2014 budget resolution that would reduce Medicare spending by $275 billion over 10 years but does not include structural entitlement reforms.  The $275 billion in cuts to Medicare were unspecified reductions aimed at cutting waste and fraud across the health care system.

(more…)

Congress Avoids Government Shutdown, Continues Work on Budget

On March 20, the U.S. Senate approved a $984 billion continuing resolution (“CR”) that will fund the government through September 30, 2013, the end of the 2013 Fiscal Year.  The bill is similar to the bill that passed the House earlier in the week and is expected to reach the President’s desk before federal agencies are set to close on March 28, when current funding expires.

(more…)

CMS Releases Part B Inpatient Billing Proposed Rule and Administrator’s Ruling

On March 13, CMS released an administrative ruling and a proposed rule allowing Medicare to pay for additional hospital inpatient services under Medicare Part B. Specifically, the proposed rule would allow additional Part B payment when a Medicare Part A claim is denied because the beneficiary should have been treated as an outpatient rather than being admitted to the hospital as an inpatient. However, hospitals will only be able to rebill CMS within one year of when the services in question were furnished.

(more…)