Reimbursement
The upcoming 2023 outpatient payment rule is expected to provide more on Medicare enrollment, payment and quality reporting.
Twenty-five states have restrictions on coverage of abortion, while in the others insurance carriers determine what their plans will include.
CMS is proposing to apply a permanent 5% cap on decreases in the wage index.
DaVita claims Marietta Memorial Hospital Employee Health Benefit Plan's limited coverage for outpatient dialysis violates the statute.
This decline reflects a recovery from the pandemic and the impact of the CMS wRVU changes implemented in 2021.
The rule proposes a permanent 5% cap on negative wage index changes, regardless of the underlying reason for the decrease.
Hospital are now left to question how they will be made whole and what HHS will set for future drug reimbursement.
Without action from Congress, the AHA estimates hospitals will lose at least $3 billion by the end of the year.
However, 15% of those say their claim was eventually paid by the insurer, according to eHealth.
The group supported predictable payment for radiation oncologists but said the model has been marred by payment cuts and administrative burdens.