September 2, 2021

Study Finds CMS MIPS Scores Not Correlated With Reductions in Readmissions or Complications

Study Finds CMS MIPS Scores Not Correlated With Reductions in Readmissions or Complications Better MIPS quality scores may be rarely associated with lower rates of hospital complications in the first year of implementation, study finds. RevCycle Intelligence (8/9, McKeon) reported on research indicating that “better Merit-based Incentive Payment System (MIPS) quality scores were rarely associated with lower rates of hospital complications during the first year of program implementation.” The study included “over 38,000 specialty physicians using CMS’s Physician Compare and Hospital Compare data from 2017, the first year of MIPS.” It found that “MIPS quality scores for vascular surgeons in the 11th to 25th percentile were associated with a 0.55-percentage point higher rate of failure to rescue, compared to physicians in […]
September 2, 2021

Federal Government Agencies Accelerate Review of COVID-19 Provider Relief Fund Expenditures

Federal Government Agencies Accelerate Review of COVID-19 Provider Relief Fund Expenditures On August 27, 2021, the Biden administration announced it has hired several separate outside contractors to police the billions in COVID-19 grants it sent to hospitals and health care providers. The contracts, which have not previously been reported, are a sign that the federal government is beefing up enforcement on the grants that were intended to help health care providers recover from the pandemic. The Trump administration faced criticism for initially sending money out to health care providers based on past income, and not on need, and punted a difficult oversight process to the Biden team. As the Biden administration starts to crack down on its bookkeeping, the pace […]
September 2, 2021

Senate Passes Massive Infrastructure Bill That Includes Several Health Care Provisions

Senate Passes Massive Infrastructure Bill That Includes Several Health Care Provisions On August 10, 2021, the U.S. Senate, by a vote of 69-31, passed the Infrastructure Investment and Jobs Act, H.R. 3684. The 2,702-page legislation contains several relevant health care–related provisions, including a delay of the implementation of the rule eliminating the Anti-Kickback Statute safe harbor protection for Medicare Part D rebates. Rebate for Discarded Amounts of Medicare Part B Single-Dose Container or Single-Use Package Drugs First, the legislation requires manufacturers of single-dose container or single-use package drugs payable under Medicare Part B to provide a rebate to the government for any discarded portion of that drug. The rebates will be charged each quarter, beginning with the first quarter of 2023, and […]
September 2, 2021

CMS Releases 2022 Medicare Inpatient Prospective Payment System (IPPS) Final Rule

CMS Releases 2022 Medicare Inpatient Prospective Payment System (IPPS) Final Rule On August 2, 2021, CMS published a final rule for the 2022 Calendar Year Inpatient Prospective Payment System (IPPS) The final rule, effective October 1, 2021, authorizes additional payments for diagnostics and therapies to treat COVID-19 during the current public health emergency, and beyond. The rule revises payment policies, as well as policies under certain quality and value-based purchasing programs, for hospitals to lessen the adverse impacts of the pandemic. Some of these changes will incentivize the meaningful use of certified electronic health record (EHR) technology that will help public health officials monitor for future public health emergencies. CMS also finalized a number of other Medicare payment rules, including […]