Southwest Consulting Associates Blog

Proposed 2020 IPPS Rule: Update to Standardized Rates

Posted by Stacie Snider on May 14, 2019 10:18:50 AM

The 2020 IPPS Proposed Rule was put on display for public inspection on April 23, 2019, and subsequently published in the Federal Register May 3, 2019.  You can view the rule in its entirety here.  If finalized, the proposed 2020 IPPS rule will affect discharges on or after October 1, 2019. Each year, CMS publishes updates to the regulations for inflation factors, wage adjustments, etc.  The rates that are reviewed in this post are the non-wage index adjusted rates for specific Core-Based Statistical Areas (CBSAs) as well as other updates made to the standardized rates.  

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Topics: proposed rule, wage index, ipps rule, provider reimbursement

FY 2020 Hospice Proposed Rule Update

Posted by Stacie Snider on May 1, 2019 9:15:00 AM

The FY 2020 Hospice Proposed Rule was put on display for public inspection on April 19, 2019. The proposed rule is scheduled to be published in the Federal Register on April 25, 2019. In the meantime, the pre-publication version can be viewed here. If finalized, this Hospice proposed rule will be effective October 1, 2019.

 

Each year, CMS publishes updates to the regulations for inflation factors, wage adjustments, etc. For FY 2020, CMS has proposed the following updates to the Medicare Hospice payment rates:

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Topics: Industry Updates, regulations, proposed rule, provider reimbursement, hospice

FY 2020 Inpatient Skilled Nursing (SNF) Proposed Rule Update

Posted by Stacie Snider on Apr 26, 2019 11:25:38 AM

The FY 2020 Inpatient Skilled Nursing Facility Proposed Rule was put on display for public inspection on April 19, 2019. The proposed rule is scheduled to be published in the Federal Register April 25, 2019, however, the pre-publication can be viewed here. If finalized, this SNF rule will affect discharges on or after October 1, 2019.

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

FY 2020 IPPS Proposed Rule

Posted by Jamie Pennington on Apr 24, 2019 3:23:43 PM

The FY 2020 Inpatient Prospective Payment System (IPPS) Proposed Rule was put on display for public inspection on April 23, 2019, and is scheduled to be published in the Federal Register on May 3, 2019.  The pre-publication version can be viewed HERE or on the FY 2020 IPPS Proposed Rule homepage.  If finalized, these changes will go into effect October 1, 2019.  All public comments to the proposed rule are to be received by 5 pm EST on Monday, June 24, 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

FY 2020 Inpatient Rehab Proposed Rule Update

Posted by Stacie Snider on Apr 22, 2019 3:57:59 PM

The Inpatient Rehab FY 2020 Proposed Rule was put on display for public inspection on April 17, 2019. The proposed rule is scheduled to be published in the Federal Register on April 24, 2019, however, the pre-publication version can be viewed here. This IRF rule will affect discharges on or after October 1, 2019.

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Topics: proposed rule, provider reimbursement, inpatient rehab

FFY 2017 MAC Letters & Aberrant Worksheet S-10 Data

Posted by Jeff Norman on Apr 10, 2019 11:20:14 AM

On April 8, 2019, SCA was provided multiple copies of a MAC letter informing hospitals of potentially aberrant data reported on Worksheet S-10 for federal FY 2017.  While we have only seen a few letters to date, it is our understanding that this is a CMS initiative affecting many hospitals. Here is what we have been told at this point:

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Topics: uncompensated care, S-10, worksheet s-10, factor 3, uncompensated care payment, cost to charge ratio, Medicare Cost Report, S-10 audit, provider reimbursement

PODCAST: Worksheet S-10 Scope, Uses and Implications

Posted by Jamie Pennington on Mar 12, 2019 11:46:52 AM

 

Southwest Consulting Associates recently participated in a segment of the THA SOLUTIONS Podcast where SCA President Michael Newell discussed the Medicare cost report Worksheet S-10 with Texas Hospital Association's Lance Lunsford. The sixteen minute conversation was part of the podcast segment titled, "Maintain Compliance to Maximize Hospital Funding" and can be heard in its entirety by selecting the play button located at the end of this post.

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Topics: uncompensated care, S-10, worksheet s-10, uncompensated care payment, Medicare Cost Report, S-10 audit, provider reimbursement

PRRB Rules and Electronic System

Posted by Stacie Snider on Feb 28, 2019 10:28:03 AM

In January, CMS issued a MLN Matters newsletter reviewing the new electronic system for Provider Reimbursement Review Board (PRRB) Medicare cost report appeals. The electronic system, referred to as OH CDMS (Office of Hearings Case and Document Management System), is a web-based portal that allows providers to submit all necessary appeals documents electronically.

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Topics: PRRB, appeals, Medicare Cost Report, provider reimbursement, 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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