Archive

New IPPS Proposed Rule Released

Comments due to CMS by June 25 The Centers for Medicare and Medicaid Services (CMS) released its FFY 2019 Inpatient Prospective Payment System (IPPS) proposed payment rule. While we’re working on our in-depth analysis, a few key points and issues have already emerged in our review. The proposed rule reflects the annual updates to the Medicare […]

Understanding the BPCI Advanced Targets

In February, CMS issued preliminary target specifications for the Bundled Payments for Care Improvement (BCPI) Advanced program.  The targets in CMS bundled payment programs have progressed from straightforward, provider-specific, historical performance-based targets in original BPCI, to regional historical targets stratified by patient diagnosis in the Comprehensive Care for Joint Replacement (CJR) program, to case mix-adjusted, […]

A Forced Reduction

Changes to Clinical Laboratory Medicare payments could have a major financial impact on hospitals. A series of payment adjustments enacted by Congress as part of the Protecting Access to Medicare Act of 2014 (PAMA) will change payments under the Medicare Clinical Laboratory Fee Schedule (CLFS) continuing through CY 2023. Hospital labs could see drastic cuts […]

Keeping Up with Changes in the CJR Regional Targets

Hospitals in the Medicare Comprehensive Care for Joint Replacement (CJR) program appear to be facing an uphill battle as their targets transition from their own hospital episode baseline experience to targets based on the Medicare episode spend of all hospitals in their region. During the first two performance years of CJR, targets were primarily (66%) […]

CMS Further Extends Deadline for S-10 Reporting Changes to January 2

CMS has extended the window for hospitals to amend uncompensated care, bad debt, and other Worksheet S-10 reporting on their fiscal year 2014 and 2015 Medicare cost reports, from October 31 to January 2. Proper reporting of S-10 data is critical, as it is now used for the distribution of the vast majority of Medicare […]

S-10 Update: CMS Issues Revised Reporting Instructions

CMS issued new and revised instructions for charity care and bad debt data reported by hospitals on worksheet S-10 of the Medicare Cost Report. Proper reporting of these data is critical, as it is now used for the distribution of Medicare Disproportionate Share Hospital (DSH) funding. To help with interpretation of the changes, CMS has […]

Time to Reconcile: Hospitals should complete their own S-10 reviews now

In an effort to balance funding distribution for Medicare Disproportionate Share Hospital (DSH) payments, the Centers for Medicare and Medicaid Services (CMS) is phasing in a changed approach to allocating those funds. Based around the S-10 worksheet, a tool used by hospitals to report charity care and non- Medicare bad debt expenses and collect uncompensated […]