Medicare & Medicaid
Long-term care hospitals cannot afford to absorb losses in outlier threshold calculation, says AHA.
Also, lung, breast, prostate and colorectal cancers were all more likely to be diagnosed in the first year of Medicare coverage.
Physicians who certify patient eligibility for hospice services must be enrolled in Medicare or have validly opted out.
CMS estimates the rule would result in a net increase of 4%, or about $1.4 billion, in Medicare Part A payments.
CMS also releases the 2024 Part D national average monthly bid amount to help Plan D sponsors finalize their premiums.
The GUIDE model is to support people with Medicare living with dementia and their unpaid caregivers.
For both, CMS is modifying the COVID-19 Vaccination Coverage Among Healthcare Personnel measure that will affect the 2025 payments.
More than 75% of the 4,654 hospitals in the Care Compare Dataset for 2023 received 2, 3 or 4 stars.
CMS last week cracked down on noncompliance by pausing the redetermination process in several states.
The managed care organizations in the review denied one out of every eight requests for prior authorization in 2019.