Laboratories are pleased that CMS is opening the process of setting reimbursement for laboratory services, just as it is doing for physician services, which will give labs more say over pay rates. The change, which is part of the annual Physician Fee Schedule rule unveiled late last week, adds to the run of positive developments for labs that started when Congress replaced CMS' plan to change clinical lab fees based on technological changes in the patch to the Sustainable Growth...
Patients who receive chemotherapy in hospital outpatient departments cost Medicare more than those who receive the same care in cancer clinics, according to a Moran Company report for the US Oncology Network and Community Oncology Alliance. The oncologists are using the report to fight CMS' proposal to pay the same rates for cancer care in physician offices and outpatient departments. The Moran report finds that outpatient chemotherapy spending per beneficiary was 25 percent to 47 percent higher than physician clinic...
The Medicare Trustees Report unveiled Friday (March 31) pushes the insolvency date for the trust fund to 2031 -- similar to what the actuary projected earlier this month, and two years earlier than the Congressional Budget Office’s 2033 projection -- and pointed in part to lower Part A spending due to the movement of dually eligible beneficiaries to Medicare Advantage, lingering effects of the COVID-19 pandemic, and the movement of joint replacements to outpatient settings. While some said the extension...
CMS is proposing a 2.8% increase in Medicare hospice payments for next year, but hospices that don’t meet quality reporting requirements will see a 1.2% decrease under the proposed rule released Friday (March 31). The administration also wants to extend telehealth flexibilities for providing hospice care through the end of 2024. The proposed 2024 hospice pay rule would provide a $720 million bump in Medicare payments compared to 2023, upping reimbursements from $32,486.92 to $33,396.55. CMS also proposes doubling last...
Five states are scheduled to begin dropping Medicaid and Children’s Health Insurance Program enrollees Saturday (April 1), which is the first day after nearly three years states can begin normal redeterminations and drop beneficiaries from coverage when they’re found ineligible for various reasons, like their income is too high or they did not respond to a renewal form. Two of those states plan to complete their redeterminations in eight months. States kept Medicaid beneficiaries continuously enrolled during COVID-19 in order...
HHS on Transgender Day of Visibility (March 31) released a new report and policy recommendations on access to health care for LGBTQIA+ young people and providers who care for them -- marking the department’s latest step to curb a raging mental health crisis among queer youths. HHS’ report comes as states increasingly move to ban access to gender-affirming care for trans children, a policy 12 states have implemented and several others are considering. In its new report, HHS recommends policymakers...
