Editor's Note The Joint Commission reported on January 31 that it had confirmed with the Centers for Medicare & Medicaid Services (CMS) that organizations are required to have two exercises of their emergency operations plan annually. Among the organizations to which the requirement applies are: deemed hospitals critical access hospitals…
Uncertainty was the defining characteristic of the healthcare industry in 2017 as regulatory changes were proposed, rejected, revised, or tabled for now. The individual insurance mandate was repealed as part of a year-end tax reform bill—a victory for an administration that favors deregulation, but also a change that is projected…
Editor's Note The Centers for Medicare & Medicaid Services on January 11 issued a proposal to modify its national coverage determination for magnetic resonance imaging (MRI) to include patients who have implanted cardiac devices. Proposed changes include the expansion of coverage for patients with cardiac devices that are approved or…
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on January 9 announced a new voluntary bundled payment model called, “Bundled Payments for Care Improvement Advanced” (BPCI Advanced). Participants in BPCI Advanced will receive payments for performance on 32 (29 inpatient, 3 outpatient) different clinical episodes. The first cohort…
Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced on January 2 that physicians and other eligible clinicians participating in the Quality Payment Program can begin submitting their 2017 performance data using a new system on the Quality Payment Program website (qpp.cms.gov). The new system is an improvement…
Editor's Note The Centers for Medicare & Medicaid Services (CMS) announced December 21 that it updated data on its Hospital Compare website and will update the Overall Hospital Quality Star Rating using a new methodology that will give more hospitals one or five stars. CMS had postponed the release of…
When Medicare and Medicaid legislation was passed and signed into law in 1965, the US Congress formed the precursor federal agency to the Centers for Medicare & Medicaid Services (CMS) to write the rules and regulations spelling out the “Conditions of Participation” (CoPs) required to obtain federal funding under these…
Healthcare providers are straddling a variety of payment models while many regulatory changes remain in flux under the Trump Administration. Although the shift from fee-for-service to value-based payment began some years ago, not everyone is on board. Opinions about bundled payments also remain mixed, despite reports of improved outcomes and…
On November 1, 2017, the Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2018 Medicare Hospital Outpatient Prospective Payment System/ASC Payment System and Quality Reporting Programs. In summary, several ambulatory surgery center (ASC) measures (ASC-1 to ASC-14) are unaffected, except that three measures (ASC-5, -6,…
Editor's Note Hospitals with the largest reductions in serious complications after bariatric surgery had the greatest decrease in per-patient Medicare payments, this study finds. Analyzing 37,329 Medicare patients undergoing bariatric surgery from 2005 to 2006 and 2013 to 2014, researchers found a strong association between reductions in complications and decreased…