Medicare
The Centers for Medicare & Medicaid Services Oct. 11 issued a final rule establishing appeals processes for certain Medicare beneficiaries who are initially admitted as hospital inpatients but subsequently reclassified as outpatients receiving observation services.
The Department of Health and Human Services Oct. 2 released final guidance detailing the process for the second cycle of negotiations under the Medicare Drug Price Negotiation Program.
The Department of Health and Human Services’ Office of Inspector General Sept. 24 recommended that additional oversight is needed to ensure that remote patient monitoring in Medicare is being used and billed appropriately, according to a report.
The Centers for Medicare & Medicaid Services Sept. 24 issued a final rule that would carve out significant, anomalous, and highly suspect (SAHS) billing from Medicare Shared Savings Program financial calculations for calendar year 2023.
The Centers for Medicare & Medicaid (CMS) Aug. 1 finalized a new mandatory payment model that will bundle payment to acute care hospitals for five types of surgical episodes.
The Centers for Medicare & Medicaid Aug. 15 announced it negotiated lower prices with drug makers for 10 high-cost, sole-source drugs, with the new prices becoming effective in 2026 for individuals with Medicare Part D coverage.
The AHA, joined by five other national hospital associations, Aug. 14 filed an amicus brief urging the Supreme Court to correct the Department of Health and Human Services’ misinterpretation of the formula set by Congress to calculate Disproportionate Share Hospital (DSH) payments, which includes a…
The AHA Aug. 13 commented to the Medicare Payment Advisory Commission in anticipation of the commission’s 2024-2025 cycle.
In this webinar, AHA staff discussed the recently released CY 2025 Physician Fee Schedule proposed rule. This rule proposes updates to physician fee schedule rates, changes to telehealth services, updates for behavioral health and opioid use disorder, and other aspects of physician…
Congressional action is needed to ensure greater oversight of MA plans as these rules are implemented and to enable CMS to enforce existing regulations designed to protect beneficiary access to medically necessary services.