Spotlight
Spotlights
- Inpatient and long-term care hospital: CMS issued an FY 2022 final rule and related files that update Medicare payment, quality reporting programs, and policies. See a summary of key provisions, effective October 1, 2021.
- Inpatient rehabilitation facility: CMS issued an FY 2022 final rule that updates Medicare payment, wage index, quality reporting program, and policies and finalized a DMEPOS payment provision. See a summary of key provisions , effective October 1.
- Inpatient psychiatric facility: CMS issued an FY 2022 final rule that updates Medicare payment, quality reporting program, and policies. See a summary of key provisions , effective October 1.
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CMS-1753-P: Proposed Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs
- Clinical Laboratory Data Reporting: Enforcement Discretion
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On March 30, CMS announced that it will exercise enforcement discretion until May 30, 2017, with respect to the data reporting period for reporting applicable information under the Clinical Laboratory fee Schedule (CLFS) and the application of the Secretary’s potential assessment of civil monetary penalties for failure to report applicable information.
View the announcement (PDF) and PAMA regulations page.
- Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions (PDF)
On August 19, 2013, in the FY2014 IPPS/LTCH final rule CMS clarified and revised the conditions of payment for hospital inpatient services under Medicare Part A related to patient status. On September 5, 2013, CMS released guidance (PDF) that discussed the provisions of the final rule regarding the physician order and physician certification of hospital inpatient services. This document includes further clarification of issues addressed in the previous guidance. - Prior Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions (PDF)
The guidance provided in this document has been further clarified in Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions. This version of the guidance document will remain online for comparison purposes. - On March 13, 2013, the Centers for Medicare & Medicaid Services (CMS) issued Ruling 1455-R which establishes an interim process for hospitals to bill Medicare for Part B services following a denial of a claim for an inpatient admission as not reasonable and necessary. CMS has issued temporary billing instructions (PDF) for affected providers to follow for both the Part B Types of Bills (TOB), TOB 12x and TOB 13x.
- Blood Clotting Factor Furnishing Fee
- Frequently Asked Questions Regarding Requirements for Hospitals To Make Public a List of Their Standard Charges via the Internet (PDF)
- Additional Frequently Asked Questions Regarding Requirements for Hospitals To Make Public a List of Their Standard Charges via the Internet (PDF)
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