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10.30.23
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Past issues are available in the Media Library.
CMS Releases CY 2024 Medicare ESRD PPS Final Payment And Policy Updates
Agencies Release Proposed Rules To Improve The Surprise Billing Payment Dispute Process
MHD Updates Provider Policy On Physical Therapy
HRSA Reminds 340B Hospitals About Child Site Registration
FMT Releases MBQIP Quality Measures Annual Report
Staff Contact: Andrew Wheeler
CMS released the final CY 2024 Medicare End-Stage Renal Disease payment and policy updates. CMS estimates that hospital-based ESRD facilities will receive an estimated 3.1% increase in Medicare payments while freestanding ESRD facilities will receive an estimated 2% increase. CMS estimates that ESRD PPS expenditures will increase by $190 million in 2024 as compared to 2023. MHA published an issue brief with additional details.
Staff Contact: Andrew Wheeler
The Departments of Health and Human Services, Labor, and Treasury released a proposed rule to improve the federal Independent Dispute Resolution process. As part of the No Surprises Act, the IDR is designed to create protections against out-of-network balance billing practices. The newly proposed rule “addresses specific issues critical to improving the functioning of the federal IDR process in response to feedback and challenges noted by interested parties.” If finalized, the rule would improve communications between payers, providers and certified IDR entities; establish new batching provisions; and change the administrative fee structure. Comments to the agencies will be due 60 days following publication in the Federal Register.
Staff Contact: Brian Kinkade or Sarah Willson
The MO HealthNet Division issued an updated provider bulletin on physical therapy prescription requirements. The bulletin outlines circumstances when a qualified enrolled physical therapist can provide services to eligible participants without a prescription from the participant’s physician.
Staff Contact: Andrew Wheeler or Brian Kinkade
HRSA is reinstating a requirement for hospitals in the 340B Drug Pricing Program to register their off-site outpatient departments, known as child sites, with the 340B Office of Pharmacy Affairs to access 340B pricing. HRSA previously provided flexibility regarding the registration of child sites during the COVID-19 PHE. The notice includes the following instructions.
“To be registered and continue to be listed in OPAIS as participating in the 340B Program, a hospital covered entity’s off-site, outpatient facility must (1) be listed as reimbursable on the hospital’s most recently filed Medicare Cost Report and (2) have associated outpatient costs and charges on the most recently filed Medicare Cost Report.”
Hospitals will have 90 days from the publication date to meet the notice requirements.
Staff Contact: Bryant McNally or Stephen Njenga
The Flex Monitoring Team released its national and state MBQIP Quality Measures Annual Reports based on 2022 data from CAHs. These reports feature MBQIP quality data, including measures in all four MBQIP domains: patient safety/inpatient, outpatient, patient engagement and care transitions.
ATTEND: CMS is hosting a webinar, “FY 2024 Review of IPF-Specific Reports for Claims-Based Measures,” at 1 p.m. Thursday, Nov. 9, for hospitals participating in the IPFQR program. Registration is required.
