The Improper Payments Information Act of 2002 (IPIA), as amended by the Improper Payments Elimination and Recovery Act of 2010 and the Improper Payments Elimination and Recovery Improvement Act of 2012, requires CMS to periodically review programs it administers, identify programs that may be susceptible to significant improper payments, estimate the amount of improper payments, and report on the improper payment estimates and the Agency’s actions to reduce improper payments in the Department of Health & Human Services (HHS) annual Agency Financial Report (AFR)
On February 28, 2018, the United States District Court for the District of New Mexico issued a decision invalidating use of the statewide average premium by the Center for Medicare & Medicaid Services (CMS) in the risk adjustment transfer formula established under section 1343 of the Patient Protection and Affordable Care Act for the 2014 – 2018 benefit years, pending further explanation of CMS’s reasons for operating the program in a budget neutral manner in those years.
Today, the Centers for Medicare & Medicaid Services (CMS) announced the agency’s first Data Element Library (DEL). The DEL is a new CMS database that supports the exchange of electronic health information. Using this free, centralized resource, the public for the first time can view the specific types of data that CMS requires post-acute care facilities (such as nursing homes and rehabilitation hospitals) to collect as part of the health assessment of their patients.
Today, the Centers for Medicare & Medicaid Services proposed transformative changes to the payment systems for services furnished by a range of medical facilities. The agency’s proposed payment rules also set out to continue to modernize Medicare through innovation in skilled nursing facility payment.
On April 27, 2018, the Centers for Medicare & Medicaid Services issued a proposed rule (CMS-1692-P) that would update fiscal year 2019 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries.
On April 27, 2018, the Centers for Medicare & Medicaid Services proposed changes on how Medicare pays inpatient rehabilitation facilities to make it easier for providers to spend more time with their patients, and improve the use of electronic health records.
The HHS Notice of Benefit and Payment Parameters for 2019 final rule released on April 9th, 2018 includes CMS standards for issuers and Exchanges, generally for plan years beginning on or after January 1, 2019.
On July 13, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2018.