IPPS and LTCH Proposed Rule FY2019

On April 25, 2018, in Industry News, by AQ-IQ LLC

On April 24, 2018 CMS  issued a proposed rule for FY2019 expected to empower patients through better access to hospital price information, improve patients’ access to their electronic health records, and make it easier for providers to spend time with their patients. The rule proposes updates to Medicare payment policies and rates under the Inpatient […]

FY2018 IPPS and LTCH Final Rule

On August 8, 2017, in Announcements, Industry News, by AQ-IQ LLC

In this final rule, CMS is increasing the amount of uncompensated care payments made to acute care hospitals by $800 million to approximately $6.8 billion for fiscal year 2018. Uncompensated care represents healthcare services provided by hospitals or providers for which they don’t get reimbursed. Often uncompensated care arises when people don’t have insurance and […]

FY2018 IRF Final Rule

On August 5, 2017, in Announcements, Industry News, by AQ-IQ LLC

The FY 2018 final policies are summarized below. Update to the payment rates under the IRF PPS. For FY 2018, CMS is finalizing an update to the IRF PPS payments to reflect a 1.0 percent increase factor, in accordance with section 1886(j)(3)(C)(iii) of the Social Security Act, as added by section 411(b) of the Medicare […]

LTC Proposed Rule FY2018

On June 8, 2017, in Industry News, by AQ-IQ LLC

This proposed rule would revise the requirements that Long-Term Care (LTC) facilities must meet to participate in the Medicare and Medicaid programs. Specifically, it would remove provisions prohibiting binding pre-dispute arbitration and strengthen requirements regarding the transparency of arbitration agreements in LTC facilities. This proposal would support the resident’s right to make informed choices about […]

Proposed Rule FY2018 SNF PPS

On May 4, 2017, in Industry News, by AQ-IQ LLC

This proposed rule would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2018. It also proposes to revise and rebase the market basket index by updating the base year from 2010 to 2014, and by adding a new cost category for Installation, Maintenance, […]

Final Rule (with Comment Period) MIPS and APM Incentive under the Physician Fee Schedule

On October 14, 2016, in Industry News, by AQ-IQ LLC

CMS today issued this Final Rule (with comment period). SUMMARY: The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of […]

Reducing Medical Record Reviews (New Pilot Program)

On October 14, 2016, in Industry News, by AQ-IQ LLC

CMS announced an 18-month pilot program to reduce medical record review for certain physicians while continuing to protect program integrity. Under the program, providers practicing within certain Advanced Alternative Payment Models (Advanced APMs) will be relieved of additional scrutiny under certain Medicare medical review programs. CMS has a statutory duty to protect the Medicare Trust […]

IPPS Final Rule FY2017

On August 2, 2016, in Announcements, Documents, Industry News, by AQ-IQ LLC

CMS issued a final rule to update fiscal year (FY) 2017 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The final rule, which would apply to approximately 3,330 acute care hospitals and approximately 430 LTCHs, applies for discharges occurring on or […]

CMS Moratoria and Demonstration Project

On August 2, 2016, in Announcements, Industry News, by AQ-IQ LLC

CMS announced an extension and statewide expansion of fraud-fighting temporary provider enrollment moratoria efforts in six states, along with a new related demonstration project to allow for certain exceptions to the moratoria and heightened screening requirements for new providers.  CMS also announced it is immediately lifting the current temporary moratoria on all Medicare Part B, […]