Tag: CMS

CMS penalizes 2,273 hospitals for high readmission rates, lowest since 2014

Editor's Note  The Centers for Medicare & Medicaid Services (CMS), through the Hospital Readmissions Reduction Program, evaluated more than 2 years of readmission cases for Medicare patients and penalized 2,273 hospitals, Kaiser Health News November 1 reports. This is the lowest number of penalties since 2014. The Hospital Readmissions Reduction…

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By: Bridget Brown
November 1, 2022
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Session: ASC Leadership Roundtable Panel, Ask the Experts

Editor's Note The last day of the OR Manager Conference saw perhaps its most inventive breakout session yet. The ambulatory surgery center (ASC) leadership roundtable panel led attendees through an education-filled hour marked by games, interaction, and trivia. “Technology is the way of the future, it is here, and we…

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By: Tarsilla Moura
October 20, 2022
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CMS quality reporting update for ASCs

A lot has happened with ASC quality measure reporting in the last 2 years, especially this year, says Gina Throneberry, MBA, RN, CNOR, CASC, director, education and clinical affairs, Ambulatory Surgery Center Association (ASCA). Throneberry spoke at the ASCA annual conference in April. In the Centers for Medicare and Medicaid…

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By: Judith M. Mathias, MA, BS, RN
September 27, 2022
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The Joint Commission announces review of certain standards, requirements

Editor's Note The Joint Commission announced on September 13 that it is reviewing its standards and requirements that go beyond the Centers for Medicare & Medicaid Services (CMS) conditions of participation in the Medicare and Medicaid programs to determine whether some should be permanently retired. “As the [COVID-19 public health…

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By: Tarsilla Moura
September 15, 2022
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CMS updates Overall Hospital Quality Star Ratings for 2022

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 27 updated its Overall Hospital Quality Star Ratings for 2022—giving 429 hospitals a five-star rating, based on their performance across five quality categories, the July 27 Becker’s Hospital Review reports. There also were: 890 hospitals that received a…

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By: Judy Mathias
July 28, 2022
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CMS issues proposed rule for hospital outpatient, ASC payment rates for CY 2023

Editor's Note The Centers for Medicare & Medicaid Services (CMS) on July 15 released its Outpatient Prospective Payment System (OPPS) proposed rule that would raise rates by a net 2.7% in CY 2023. This update is based on the projected hospital market basket percentage increase of 3.1%, reduced by 0.4%…

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By: Judy Mathias
July 19, 2022
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Lawsuit filed against UnitedHealth for underpayment of telehealth services

Editor's Note A female patient in Chicago, Illinois, filed a lawsuit on July 7 against the multinational UnitedHealth Group for alleged underpayment of telehealth services, Becker’s Payer Issues July 8 reports. The lawsuit claims that the woman’s insurance plan covers telehealth services, including pay benefits for-out-network services. After receiving out-of-network…

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By: Lauren McCaffrey
July 12, 2022
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CMS physician fee schedule proposes 4.43% cut in 2023

Editor's Note The Centers for Medicare & Medicaid Services (CMS) released its Medicare physician fee schedule proposed rule for 2023, “which suggests further cuts to physician pay while inflation and the cost of running an independent practice continue to rise,” Becker’s ASC Review July 8 reports. The proposed rule would…

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By: Tarsilla Moura
July 8, 2022
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CMS updates ASC guidance, revisions for surveyors

Editor's Note The Centers for Medicare & Medicaid Services (CMS) has recently updated its State Operations Manual (SOM) Appendix L—Guidance for Surveyors: Ambulatory Surgical Centers (ASCs), making conforming revisions to the regulatory tags and interpretive guidelines, as well as clarifications and technical corrections to other guidance areas including medical history…

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By: Tarsilla Moura
July 6, 2022
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Most hospitals not providing price information for TJAs as required by CMS

Editor's Note This study from the Cleveland Clinic finds that less than one-third of US hospitals were fully compliant in 2021 with the transparency in pricing for total joint arthroplasty (TJA) rule mandated by the Centers for Medicare and Medicaid Services (CMS). Of 400 hospitals analyzed between December 1 and…

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By: Judy Mathias
June 27, 2022
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