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*  CMS Releases Home Health Prospective Payment System Final Rule for CY 2013
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2013. The rule finalizes a reduction in rates of 1.32%, which is approximately a $10 million decrease to payments for the home health 60-day episode for CY 2013. Of specific importance to physical therapy, CMS finalizes 3 revisions regarding the requirement that a qualified therapist complete a functional reassessment of the patient at the 14th and the 20th visit, and every 30 days. First, CMS finalized its proposal that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment, not the visit after the therapist completed the late reassessment. Second, CMS finalized ...
  http://www.apta.org/PTinMotion/NewsNow/2012/11/2/HHPPS2013/?blogid=10737418615&category=Health%20Care%20Headlines
*  CMS Releases Home Health Prospective Payment System Final Rule for CY 2013
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2013. The rule finalizes a reduction in rates of 1.32%, which is approximately a $10 million decrease to payments for the home health 60-day episode for CY 2013. Of specific importance to physical therapy, CMS finalizes 3 revisions regarding the requirement that a qualified therapist complete a functional reassessment of the patient at the 14th and the 20th visit, and every 30 days. First, CMS finalized its proposal that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment, not the visit after the therapist completed the late reassessment. Second, CMS finalized ...
  http://www.apta.org/PTinMotion/NewsNow/2012/11/2/HHPPS2013/?blogmonth=1&blogday=17&blogyear=2013&blogid=10737418615
*  CMS Releases Home Health Prospective Payment System Final Rule for CY 2013
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2013. The rule finalizes a reduction in rates of 1.32%, which is approximately a $10 million decrease to payments for the home health 60-day episode for CY 2013. Of specific importance to physical therapy, CMS finalizes 3 revisions regarding the requirement that a qualified therapist complete a functional reassessment of the patient at the 14th and the 20th visit, and every 30 days. First, CMS finalized its proposal that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment, not the visit after the therapist completed the late reassessment. Second, CMS finalized ...
  http://www.apta.org/PTinMotion/NewsNow/2012/11/2/HHPPS2013/?blogmonth=4&blogday=11&blogyear=2013&blogid=10737418615
*  CMS Releases Home Health Prospective Payment System Final Rule for CY 2013
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2013. The rule finalizes a reduction in rates of 1.32%, which is approximately a $10 million decrease to payments for the home health 60-day episode for CY 2013. Of specific importance to physical therapy, CMS finalizes 3 revisions regarding the requirement that a qualified therapist complete a functional reassessment of the patient at the 14th and the 20th visit, and every 30 days. First, CMS finalized its proposal that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment, not the visit after the therapist completed the late reassessment. Second, CMS finalized ...
  http://www.apta.org/PTinMotion/NewsNow/2012/11/9/FunctionalLimitationsWebpage/?blogid=10737418615&id=10737428463
*  CMS Releases Home Health Prospective Payment System Final Rule for CY 2013
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2013. The rule finalizes a reduction in rates of 1.32%, which is approximately a $10 million decrease to payments for the home health 60-day episode for CY 2013. Of specific importance to physical therapy, CMS finalizes 3 revisions regarding the requirement that a qualified therapist complete a functional reassessment of the patient at the 14th and the 20th visit, and every 30 days. First, CMS finalized its proposal that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment, not the visit after the therapist completed the late reassessment. Second, CMS finalized ...
  http://www.apta.org/PTinMotion/NewsNow/2012/6/14/Beattie/?blogid=10737418615&id=10737428463
*  CMS Releases Home Health Prospective Payment System Final Rule for CY 2013
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2013. The rule finalizes a reduction in rates of 1.32%, which is approximately a $10 million decrease to payments for the home health 60-day episode for CY 2013. Of specific importance to physical therapy, CMS finalizes 3 revisions regarding the requirement that a qualified therapist complete a functional reassessment of the patient at the 14th and the 20th visit, and every 30 days. First, CMS finalized its proposal that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment, not the visit after the therapist completed the late reassessment. Second, CMS finalized ...
  http://www.apta.org/PTinMotion/NewsNow/2012/8/28/CosponsorDrive/?blogid=10737418615&id=10737428463
*  CMS Releases Home Health Prospective Payment System Final Rule for CY 2013
On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule for the Home Health Prospective Payment System (HH PPS) for Calendar Year (CY) 2013. The rule finalizes a reduction in rates of 1.32%, which is approximately a $10 million decrease to payments for the home health 60-day episode for CY 2013. Of specific importance to physical therapy, CMS finalizes 3 revisions regarding the requirement that a qualified therapist complete a functional reassessment of the patient at the 14th and the 20th visit, and every 30 days. First, CMS finalized its proposal that if a qualified therapist missed a reassessment visit, therapy coverage would resume with the visit during which the qualified therapist completed the late reassessment, not the visit after the therapist completed the late reassessment. Second, CMS finalized ...
  http://www.apta.org/PTinMotion/NewsNow/2012/8/9/PPSSummariesforSNFsIRFS/?blogid=10737418615&id=10737428463
*  CMS Proposes Update to 2015 Home Health Prospective Payment System for Comment | McDermott Will & Emery - JDSupra
The Centers for Medicare & Medicaid Services (CMS) published its proposed update of the Medicare home health prospective payment system (HH PPS) rates for calendar year (CY) 2015 in the...
  http://www.jdsupra.com/legalnews/cms-proposes-update-to-2015-home-health-03692/
*  Stark Provisions in 2009 Inpatient Prospective Payment System Rule Will Lead to Major Changes for Physician Joint Ventures |...
On July 31, 2008, the 2009 final Hospital Inpatient Prospective Payment System (IPPS) rules were put on display at the Federal Register and on the CMS web site. These rules will be...
  http://www.jdsupra.com/post/documentViewer.aspx?fid=946701e3-d255-473b-996a-94ba91f281a6
*  2013 Inpatient Prospective Payment System Medicare Proposed Rule Released - American College of Cardiology
On April 24, 2012, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule for the 2013 Inpatient Prospective Payment System (IPPS) rule, which covers payment and quality issues for services performed in an inpatient hospital between Oct. 1, 2012 and Sept. 30, 2013. The ACC will submit comments on the proposed rule by June 25 and CMS will issue a final rule covering these policies towards the end of the summer. The following are areas of interest for cardiovascular medicine. Surgical site infection for cardiac devices The Medicare payment system for hospitals pays more for a discharge if certain complicating conditions are present in addition to the primary diagnosis for which the ...
  http://www.acc.org/latest-in-cardiology/articles/2012/05/04/16/11/hosptial-rate-proposed-rule
*  Definition of Coinsurance (Outpatient Prospective Payment System)
The term 'Coinsurance (Outpatient Prospective Payment System) ' as it applies to the area of Medicare in the United States can be defined as ' The percentage of the Medicare payment rate or a hospital's billed charge that you have to pay after you pay the deductible for Medicare Part B services'. ...
  http://www.teachmefinance.com/Scientific_Terms/Coinsurance%20
*  Inpatient Prospective Payment System Rule
Medicare payment for acute care hospital inpatient stays is based on set rates under Medicare Part A. The system for payment, known as the Inpatient Prospective Payment System (IPPS), categorizes cases into diagnoses-related groups (DRGs) that are weighted based on resources used to treat Medicare beneficiaries in those groups. The Centers for Medicare & Medicaid Services (CMS) updates the IPPS regulations annually, with comment periods open prior to implementation of the final rule. AAPM&R IPPS Comment Letters. ...
  http://www.aapmr.org/advocacy/reimbursement-advocacy/inpatient-prospective-payment-system-rule
*  Comment Letter: Outpatient Prospective Payment System Final Rule
On behalf of our nearly 5,000 member hospitals, health care systems, networks and other providers of ambulatory care, the American Hospital Association (AHA) is writing to express serious concern regarding the outpatient prospective payment system final rule published on March 1, 2002, for implementation beginning April 1, 2002.
  http://www.aha.org/advocacy-issues/letter/2002/020314-cl-67fr9556.shtml
*  Changes in the Location of Death After Passage of Medicare's Prospective Payment System
The proportion of deaths occurring in the nation's nursing homes increased significantly after the implementation of Medicare's prospective payment system (PPS) while hospital deaths declined, suggesting that Medicare patients ...
  https://repository.library.georgetown.edu/handle/10822/830250
*  CMS Issues Outpatient Hospital Prospective Payment System Rule
The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule today that would update payment policies and payment rates for services furnished to Medicare beneficiaries in hospital outpatient departments (HOPDs) and ambulatory surgical centers (ASCs) beginning January 1, 2013. CMS projects that total payments to hospitals under the Outpatient Prospective Payment System (OPPS) in calendar year 2013 will be approximately $48.1 billion.. The OPPS proposed rule includes several proposals that would affect the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. Specifically, the proposed rule would allow updates to the IRF quality reporting program measures based on changes that ...
  http://www.apta.org/PTinMotion/NewsNow/2012/7/6/HospitalRule/?blogmonth=11&blogday=15&blogyear=2012&blogid=10737418615
*  Medicare Hospital Prospective Payment System How DRG Rates Are Calculated and Updated - PDF
Medicare Hospital Prospective Payment System How DRG Rates Are Calculated and Updated August 2001 OEI Office of Inspector General Office of Evaluation and Inspections Region IX This white paper
  http://docplayer.net/12714973-Medicare-hospital-prospective-payment-system-how-drg-rates-are-calculated-and-updated.html
*  Federal Register :: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and...
This document corrects technical errors in the correcting document that appeared in the October 3, 2012 Federal Register entitled ``Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Fiscal Year...
  https://www.federalregister.gov/documents/2013/03/13/2013-05724/medicare-program-hospital-inpatient-prospective-payment-systems-for-acute-care-hospitals-and-the
*  APTA Recommends Interim Revisions to HH PPS; Calls for Alternative Payment System
APTA illustrates several ways that the home health prospective payment system (HH PPS) can be revised to better reflect the role of physical therapists in home health, as well as bolster clinically appropriate practice patterns that improve quality of care and lower growth in expenditures, in comments submitted on September 4 to the Centers for Medicare and Medicaid Services (CMS). APTA's remarks focus heavily on therapy coverage requirements. While calling on CMS to begin the work of developing an alternative payment system for therapy services under the Medicare home health benefit, the association makes specific interim recommendations to alleviate the burdens associated with missed reassessment visits and alter provisions regarding coverage of compliant therapy disciplines and visit ranges.. In response to CMS' quality reporting ...
  http://www.apta.org/PTinMotion/NewsNow/2012/9/5/HHPPSComments/?blogmonth=6&blogday=17&blogyear=2013&blogid=10737418615
*  Effects of Medicare payment reform: Evidence from the home health interim and prospective payment systems | RCMAR/UCLA
Huckfeldt PJ, Sood N, Escarce JJ, Grabowski DC, Newhouse JP. Effects of Medicare payment reform: Evidence from the home health interim and prospective payment systems. J Health Econ. Mar 1, 2014; 34: --: 1-18: PubMed PMID24395018 ; PubMed Central PMCID: PMC4255717 ...
  http://www.rcmar.ucla.edu/node/674
*  Federal Register :: Medicare Program; Hospital Inpatient Prospective Payment Systems Implementation of the Fiscal...
This proposed rule would revise the methodology for calculating the occupational mix adjustment announced in the Fiscal Year (FY) 2007 Hospital Inpatient Prospective Payment System (IPPS) proposed rule by applying the occupational mix adjustment to 100 percent of the wage index using the new...
  https://www.federalregister.gov/documents/2006/05/17/06-4608/medicare-program-hospital-inpatient-prospective-payment-systems-implementation-of-the-fiscal-year
*  Medicare Home Health Care: Prospective Payment System Could Reverse Recent Declines in Spending - Digital Library
A letter report issued by the General Accounting Office with an abstract that begins 'Pursuant to a congressional request, GAO provided information on Medicare home health care's recent declines in spending, focusing on: (1) the declines in service use underlying the changes in spending; (2) the extent of the changes in use across beneficiaries, home health agencies (HHA), and locations; and (3) identify any implications these new patterns of home health use have for the impact of the prospective payment system (PPS).'
  https://digital.library.unt.edu/ark:/67531/metadc292875/
*  A risk-based prospective payment system that integrates patient, hospital and national costs. Implications of basing health...
A risk-based prospective payment system that integrates patient, hospital and national costs. Implications of basing health-care resource allocations on cost-utility analysis in the presence of externalities
  http://www.readabstracts.com/Health-care-industry/A-risk-based-prospective-payment-system-that-integrates-patient-hospital-and-national-costs.html
*  Federal Register :: TRICARE; Hospital Outpatient Prospective Payment System (OPPS)
This final rule implements a prospective payment system for hospital outpatient services similar to that furnished to Medicare beneficiaries, as set forth in Section 1833(t) of the Social Security Act. The rule also recognizes applicable statutory requirements and changes arising from Medicare's...
  https://www.federalregister.gov/documents/2008/12/10/E8-29251/tricare-hospital-outpatient-prospective-payment-system-opps
*  Payment Matters: CY 2013 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed ...
CMS has released its Calendar Year (CY) 2013 Proposed Rule for outpatient services furnished in hospitals and ASCs. CMS anticipates that total payments under the OPPS for CY 2013 will...
  https://www.jdsupra.com/legalnews/payment-matters-cy-2013-outpatient-pros-13199/
*  Inpatient Prospective Payment System (IPPS) | JD Supra
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  https://www.jdsupra.com/topics/inpatient-prospective-payment-system-ipps