Southwest Consulting Associates Blog

FY 2020 Hospice Final Rule Update

Posted by Stacie Snider on Sep 9, 2019 9:48:53 AM

The 2020 Hospice Final Rule was published in the Federal Register August 6, 2019, and will affect hospital discharges on or after October 1, 2019. Each year, CMS publishes updates to the regulations for inflation factors, wage adjustments, etc. For FY 2020, CMS has updated the following Hospice rates which are contained in the final rule:

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Topics: Industry Updates, regulations, final rule, hospice

CY 2020 End-Stage Renal Disease Proposed Rule Update

Posted by Stacie Snider on Sep 5, 2019 7:55:00 AM

The End-Stage Renal Disease (ESRD) 2020 proposed rule was published in the Federal Register August 6, 2019, and affects discharges on or after January 1, 2020. Each year, CMS publishes updates to the regulations for inflation factors, wage adjustments, etc., and for calendar year (CY) 2020, CMS has proposed the following updates to the End-Stage Renal Disease rates:

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Topics: Industry Updates, proposed rule

Medicare Cost Report Supporting Documentation Requirements

Posted by Jamie Pennington on Aug 29, 2019 3:32:00 PM

As you will recall from the FY 2019 IPPS final rule-making cycle, CMS issued new requirements for supporting documentation that must be submitted along with the Medicare cost report.  While that final rule was posted a little over a year ago, hospitals will soon be in the midst of filing the first affected cost reports. The new Medicare cost report supporting documentation is required for cost reporting periods beginning on or after October 1, 2018.

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Topics: DSH Reimbursement, Medicare DSH Reimbursement, Industry Updates, S-10, regulations, final rule, worksheet s-10, Medicare Cost Report

2020 Inpatient Skilled Nursing Facility Final Rule Update

Posted by Stacie Snider on Aug 16, 2019 9:13:30 AM

The 2020 Inpatient Skilled Nursing Facility Final Rule was published in the Federal Register August 7, 2019. The rule can be found through the CMS website or you can view the Federal Register version here. This SNF rule affects discharges on or after October 1, 2019. 

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Topics: Industry Updates, regulations, final rule, provider reimbursement, inpatient SNF

2020 Inpatient Rehab Final Rule Update

Posted by Stacie Snider on Aug 14, 2019 9:05:00 AM

The 2020 Inpatient Rehab Final Rule was published in the Federal Register August 8, 2019, and will affect discharges on or after October 1, 2019. The 2020 Rehab (IRF) Final Rule can be viewed here.

 

Each year, CMS publishes updates to the regulations for inflation factors, wage adjustments, etc. and for FFY 2020, CMS has finalized the following updates to the Rehab rates:

 

 

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Topics: Industry Updates, regulations, final rule, provider reimbursement, inpatient rehab

2020 Inpatient Psych Final Rule Update

Posted by Stacie Snider on Aug 13, 2019 4:53:34 PM

The FY 2020 Inpatient Psych Final Rule was put on display for public inspection on July 30, 2019, and was published in the Federal Register August 6, 2019. The FY 2020 Psych Final Rule can be viewed here. As a reminder, this IPF rule affects discharges on or after October 1, 2019.

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Topics: Industry Updates, regulations, final rule, provider reimbursement, inpatient psych

2020 Hospital OPPS Proposed Rule Update

Posted by Stacie Snider on Aug 12, 2019 3:39:39 PM

The Hospital Outpatient Prospective Payment System (OPPS) FY 2020 proposed rule was put on display for public inspection on July 29, 2019 and published in the Federal Register on August 9, 2019. The 247-page FY 2020 OPPS proposed rule can be viewed in its entirety here. This proposed rule will affect discharges on or after January 1, 2020. 

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Topics: Industry Updates, regulations, proposed rule, OPPS

FY 2020 IPPS Final Rule Posted

Posted by Jamie Pennington on Aug 2, 2019 4:40:07 PM

The FY 2020 Inpatient Prospective Payment System (IPPS) Final Rule was put on display for public inspection on August 2, 2019, and is scheduled to be published in the Federal Register on August 16, 2019.  The pre-publication version can be viewed HERE or on the FY 2020 IPPS Final Rule homepageThese changes will go into effect October 1, 2019.  

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Topics: Medicare DSH Reimbursement, Industry Updates, S-10, regulations, proposed rule, worksheet s-10, factor 3, uncompensated care payment, ipps rule, provider reimbursement

Worksheet S-10 2017 Audit Letter

Posted by Jamie Pennington on Aug 1, 2019 10:48:20 AM

We began hearing from our client hospitals a few weeks ago that the MAC audits of Worksheet S-10 were starting for FFY 2017. Yes, that’s right, reviews of FFY 2015 data are over and we are onto round 2. We've heard that roughly 600 hospitals will be audited this time around, although we suspect that number is higher based on the audit count we've seen on behalf of our clients and other providers that have contacted SCA. Several hospitals that were selected for FFY 2015 S-10 audits were also selected for FFY 2017 but there have also been a good amount of first-timers in the 2017 S-10 audit pool. So far, the 32 S-10 MAC audit letter requests we’ve seen (5 different MACs) essentially mirror the initial requests for data for FFY 2015, with a few exceptions. This post will review the elements of the S-10 2017 audit letter but to get everyone up to speed on how we got here, we will start with a brief review.

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Topics: worksheet s-10, S-10 audit

FY 2020 IPPS Proposed Rule Review Part 2: Medicare DSH

Posted by Michael Newell on Jul 30, 2019 5:12:51 PM

In part 2 of our FY 2020 IPPS Proposed Rule Review series, we will take a look at the one DSH item included in the proposed rule that may be of some interest to you. It appears this item stems from the fact that there are a large number of PRRB appeals involving Medicaid eligible days and the agency is struggling for ways to deal with that issue. It appears that the agency recognizes that there is a legitimate issue to be addressed in terms of including all identified Medicaid eligible days in a hospital’s cost report, but that there might be a better way to proceed and alleviate the backlog of appeals on this issue at the Provider Reimbursement Review Board.

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Topics: Medicare DSH Reimbursement, appeals, ipps rule, PRRB rules

About This Blog

The climate of provider reimbursement is ever-changing and this blog is intended to keep you up-to-date on the latest information regarding:

  • DSH Reimbursement
  • 340B Pharmacy Drug Discount Program
  • Compliance Issues
  • Litigation Surrounding Provider Reimbursement

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