Hospitals that serve as Medicare providers must adhere to various rules and regulations for patient care and reimbursement.
The following offers guidance to hospitals to ensure their compliance with Medicare.
Medicare utilizes several mechanisms to pay for services provided to its beneficiaries. Throughout the last few years, the Centers for Medicare & Medicaid Services has begun tying payments to certain quality metrics. The following series of on-demand webinars serve as an educational instrument that will help the listener gain a high level of understanding about the programs, as well as have the opportunity to listen and see simulations about how the pay-for-performance calculations affect payment. Each session is designed to be short in nature, typically lasting 10 minutes. The exception is the value-based purchasing 201 session, which is about 30 minutes.
MHA Issue Briefs — Final PPS Regulations
The Centers for Medicare & Medicaid Services has issued final versions of its regulatory changes for Medicare’s fiscal year 2019 PPS. MHA has published issue briefs on the following rules.
- Inpatient Psychiatric Facility PPS
- Skilled Nursing Facility PPS
- Inpatient Rehabilitation Facility PPS
- Acute Inpatient and Long-Term Care Hospital PPS
- End-Stage Renal Disease PPS
- Home Health PPS
- Hospital Outpatient PPS
- Ambulatory Surgical Centers
MHA Quality Reporting Guides
- Medicare Administrative Contractor Wisconsin Physicians Service Government Health Administrators
- Centers for Medicare & Medicaid Services
- Medicare Payment Advisory Commission
- At this site, users can search for Medicare information in the “Documents” section.
Recovery Audit Contractor Program
The Medicare Recovery Audit Contractor Program was established by the Centers for Medicare & Medicaid Services to correct Medicare fee-for-service payments made to providers. CMS awarded new FFS RAC contracts as of Oct. 31, 2016. The RAC covering Region 2, which includes the entire state of Missouri, is now Cotiviti, LLC.