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*  MedPAC Makes Recommendations to Increase Efficiency of Medicare
MedPAC suggests that Congress eliminate the market basket update for 2013 and revise the prospective payment system (PPS). ... Recommendations for HHA payment include a 2-year rebasing of home health rates in 2013 and eliminating the market basket update ... Specifically, MedPAC calls for raising SNF Medicare Part A payments for medically complex care and lowering SNF Medicare Part A ... In its March report, MedPAC calls on Congress to repeal the sustainable growth rate and replace it with a 10-year path of ...
  http://www.apta.org/PTinMotion/NewsNow/2012/2/23/ACOList/?blogid=10737418615&id=10737426555
*  GAO-16-375SP
Medicare Payments by Place of Service Medicare could save billions of dollars if Congress were to equalize the rates Medicare ... off-campus hospital outpatient departments from reimbursement under Medicare's hospital outpatient prospective payment system, ... effectively limits certain providers from billing at the higher hospital outpatient department rates. Specifically, the ... For example, the total Medicare payment rate for one common service-a mid-level evaluation and management office visit for an ...
  https://www.gao.gov/modules/ereport/handler.php?m=1&p=1&path=/ereport/GAO-16-375SP/data_center_savings/Health/30._Medicare_Payments_by_Place_of_Service
*  Medicare Long-Term Care Hospital Prospective Payment System - PDF
2015 Payment Rule Brief PROPOSED RULE Program Year: FFY 2016 Overview, Resources, and Comment Submission On May 17, the Centers ... Medicare Long-Term Care Hospital Prospective Payment System May 5, ... sequester will continue unless Congress intervenes. Sequester is not applied to the payment rate; instead, it is applied to ... proposed in FFY Effect of Sequestration FR page reference not available While the proposed rule does not specifically address ...
  http://docplayer.net/19350952-Medicare-long-term-care-hospital-prospective-payment-system.html
*  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 ... MedPAC s June 2000 Recommendations for Updating PPS In its June 2000 report to Congress, MedPAC specifically outlined ... 11 The Prospective Payment System In response to payment growth, Congress adopted a prospective payment system to curtail the ... Florida Medicaid Inpatient Prospective Payment System Florida Medicaid Inpatient Prospective Payment System Justin Senior ...
  http://docplayer.net/12714973-Medicare-hospital-prospective-payment-system-how-drg-rates-are-calculated-and-updated.html
*  The FY 2018 Inpatient Proposed Rule: Early insights for CV leaders | Advisory Board
Here's our initial take on which provisions of the FY 2018 Inpatient Prospective Payment System proposed rule would have the ... April showers bring May flowers and-this year, at least-CMS's FY 2018 Inpatient Prospective Payment System (IPPS) proposed rule ... A healthy inpatient payment update for FY 2018. CMS foresees a 1.6% increase in overall operating payment rates for FY 2018, a ... This change was mandated by the 21st Century Cures Act, which Congress passed in December 2016. Per the law, beginning in FY ...
  https://www.advisory.com/research/cardiovascular-roundtable/cardiovascular-rounds/2017/04/2018-ipps
*  CMS Releases CY 2018 Medicare Physician Fee Schedule Final Rule - Lexology
... final policy will change the PFS payment rates for these services from 50 percent of the Outpatient Prospective Payment System ... Specifically, physical/occupational therapy shifted from a 1 percent increase to a 2 percent cut from the proposed to the Final ... In response to stakeholder feedback, Congress used the 21st Century Cures Act to exempt hospital outpatient departments that ... CMS issues proposed CY 2013 Medicare Outpatient Prospective Payment System and Medicare Physician Fee Schedule rules * ...
  https://www.lexology.com/library/detail.aspx?g=4392e0ea-5649-4f19-a20d-b765d78176ed
*  Comments to the CY 2009 Outpatient Prospective Payment System (OPPS) Proposed Rule - BIO
Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates) Dear Acting Administrator Weems: ... Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; ... Congress enacted these provisions because it disagreed with CMS's use of claims data to set payment rates for these drug and ... Specifically, CMS noted that its methodology produced a payment rate for both drug acquisition and pharmacy service costs (ASP ...
  https://www.bio.org/advocacy/letters/comments-cy-2009-outpatient-prospective-payment-system-opps-proposed-rule
*  tenet healthcare 2ndQTR 0310QFY032d - English
DRG PAYMENTS Medicare payments for general hospital inpatient services are based on a prospective payment system utilizing what ... The IME payment formula is currently being reviewed and recommendations may be made to Congress that the payment level be ... and per-case-rate payments combined with pass-through payments for high cost devices and pharmaceutical costs, and stop-loss ... Specifically, our proposal would involve utilizing current filed cost reports for our hospitals and eliminating the SWA from ...
  https://www.slideshare.net/finance42/tenet-healthcare-2ndqtr0310qfy032d
*  Group purchasing organization - Wikipedia
The institution of the Medicare Prospective Payment System (PPS) in 1983 focused greater scrutiny on costs and fostered further ... Congress did not specify any limit on contract administration fees, but required the United States Department of Health and ... These fees can be set as a percentage of the purchase or set as an annual flat rate. Some GPOs set mandatory participation ... In specifically exempting GPOs from the Federal Anti-Kickback Law, many healthcare providers interpreted the act as an ...
  https://en.wikipedia.org/wiki/Group_purchasing_organization
*  CMS Grants New Technology Add-On Payment to Vyxeos® (daunorubicin and cytarabine) Liposome for Injection | BioSpace
CMS Grants New Technology Add-On Payment to Vyxeos® (daunorubicin and cytarabine) Liposome for Injection - read this article ... based reimbursement that hospitals receive under the Medicare Hospital Inpatient Prospective Payment System (IPPS). The NTAP ... effect for a period of two to three years until the cost of Vyxeos is included in CMS's recalibration of the DRG payment rate. ... Introduced in 2001, NTAP was created by Congress to help facilitate access to new, innovative technologies used to treat ...
  https://www.biospace.com/article/releases/cms-grants-new-technology-add-on-payment-to-vyxeos-daunorubicin-and-cytarabine-liposome-for-injection/
*  MEDICARE COULD HAVE SAVED BILLIONS AT CRITICAL ACCESS HOSPITALS IF SWING-BED SERVICES WERE REIMBURSED USING - PDF
... reasonable costs for providing services to beneficiaries rather than at rates set by Medicare s prospective payment system (PPS ... 8 In a 2005 report to Congress, the Medicare Payment Advisory Commission stated that cost-based reimbursement has led to more ... Specifically, we reviewed FY 2010 cost Medicare Could Have Saved Billions on Swing-Bed Services at Critical Access Hospitals (A ... Review of Hospital Wage Data Used To Calculate Inpatient Prospective Payment System Wage Indexes (A-0 1-05-00504) DEPARTMENT OF ...
  http://docplayer.net/69356-Medicare-could-have-saved-billions-at-critical-access-hospitals-if-swing-bed-services-were-reimbursed-using.html
*  News from the ESC Congress 2013 | The British Journal of Cardiology
UK doctor payment system linked to good lipid results. More patients in the UK are achieving cholesterol goals than in Germany ... The discharge rate from the emergency department was 66% in the co-peptin group versus 12% in those given standard care. ... strategies to reduce blood pressure via sodium restriction are best targeted specifically at those groups. Whereas in China ... Prospective Urban Rural Epidemiological) study suggest. ... with the UK's incentive system where GPs receive payment linked ...
  https://bjcardio.co.uk/2013/10/news-from-the-esc-congress-2013/
*  Federal Register :: TRICARE; Outpatient Hospital Prospective Payment System (OPPS)
This interim final rule implements a prospective payment system for hospital outpatient services similar to that furnished to ... V. Packaging and Special Payment Provisions Under OPPS The prospective payment system establishes a national payment rate, ... Since transitional corridor payments were specifically designed to supplement the losses experienced under the OPPS (i.e., to ... Congress also-in section 707 of NDAA-02-changed the statutory authorization (in 10 U.S.C. 1079(j)(2)) that TRICARE payment ...
  https://www.federalregister.gov/documents/2007/08/14/E7-15924/tricare-outpatient-hospital-prospective-payment-system-opps
*  Lessons Learned in Length of Stay (LOS) | FTI Consulting
... "prospective payment system" (PPS). Under this diagnosis-related groups (DRG) system, Medicare pays hospitals a flat rate per ... In 1982, noting the success of several state rate regulation programs in controlling costs, Congress mandated the creation of a ... and specifically reducing length of stay (LOS). In this article, we will address how LOS improvements result in reduced costs, ... Prospective Payment System (DRGs) - as detailed above.. *Changes in Cost Sharing - Medicare's inpatient hospital deductible has ...
  http://www.fticonsulting.com/insights/white-papers/lessons-learned-in-length-of-stay-los
*  Highlights from the 2016 OIG Work Plan - Lexology
... to conduct a compliance review related to Medicare program payments made pursuant to the home health prospective payment system ... which will require most laboratories to report to CMS payment rates of private payors for certain tests. CMS will aggregate the ... The OIG specifically indicated that it will examine whether the U.S. Food and Drug Administration (FDA) is providing sufficient ... These concerns led Congress to exclude such off-campus facilities from receiving enhanced reimbursement starting January 1, ...
  https://www.lexology.com/library/detail.aspx?g=9389e9a4-c576-4d5f-a6e6-6a92711a6db9
*  National Flood Insurance Act of 1968 - Wikipedia
The National Flood Insurance Reform Act of 1994 codified the Community Rating System (an incentive program that encourages ... "losses to properties for which repetitive flood insurance claim payments have been made." More specifically, FIRA authorized ... "S. 1926 - Summary". United States Congress. Retrieved 31 January 2014. "H.R. 3370 - Summary". United States Congress. Retrieved ... Act of 1968 to prohibit the Federal Emergency Management Agency from providing flood insurance to prospective insureds at rates ...
  https://en.wikipedia.org/wiki/National_Flood_Insurance_Act_of_1968
*  Dodd-Frank Wall Street Reform and Consumer Protection Act - Wikipedia
The Council is required to report to Congress on the state of the financial system, and may direct the Office of Financial ... The Act bans the payment of yield spread premiums or other originator compensation that is based on the interest rate or other ... However, it is specifically authorized under the Act.[119]. *SEC is specifically authorized to issue "point-of-sale disclosure ... is constituted to handle the oversight of existing and prospective carbon markets to ensure an efficient, secure, and ...
  https://en.wikipedia.org/wiki/Dodd-Frank_Wall_Street_Reform_and_Consumer_Protection_Act
*  CMS Releases Proposed 2016 IPPS
2016 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital ... Specifically, the rule proposes to add a care coordination measure to the FY 2018 program year and a 30-day mortality measure ... In response to hospital concerns about medical review, CMS and Congress have prohibited Recovery Auditor review of patient ... standard LTCH PPS payment rates, and new, lower site neutral LTCH PPS payment rates that are generally based on the IPPS rates ...
  https://www.aapc.com/blog/30282-cms-releases-proposed-2016-ipps/
*  Home Health Agency (HHA) Center - Centers for Medicare & Medicaid Services
Updating the Medicare Home Health Payment Rates - CY 2014 Home Health Prospective Payment System Final Rule" Technical Report [ ... Report to Congress on the Medicare Home Health Study: An Investigation on Access to Care and Payment for Vulnerable Patient ... and from the Medicare Payment Advisory Commission. The report specifically discusses one potential model called the Home Health ... Updating the Medicare Home Health Payment Rates - CY 2014 Home Health Prospective Payment System Proposed Rule" Technical ...
  https://www.cms.gov/center/provider-Type/home-Health-Agency-HHA-Center.html
*  Medical care quality facts, information, pictures | Encyclopedia.com articles about Medical care quality
Some Web sites use a report card grading system; others use stars, akin to restaurant and hotel rating systems. While these ... The capitation method of payment, as contrasted with a payment for services rendered, is considered not only to be a good ... "Report to Congress: Appropriateness of Minimum Nurse Staffing Ratios in Nursing Homes." World Wide Web document, www.hcfa.gov ... Before focusing on nursing homes specifically, a good starting point is to understand the array of options called long-term ...
  https://www.encyclopedia.com/history/modern-europe/british-and-irish-history/medical-care-quality
*  Meet the Sacklers: The Family That's Killing Millions
Industry, Distributors and Congress Have Much to Answer For. In a recent episode of 60 Minutes,38 whistleblower Joe Rannazzisi ... At all the meetings, that was a constant source of discussion - 'What else can we use the Contin system [editor's note: a slow- ... A 3-year prospective observational study of more than 69,000 postmenopausal women with recurrent pain conditions showed that ... The top 1 percent of physicians received nearly 83 percent of the payments, and the drug fentanyl, a synthetic opioid that can ...
  https://articles.mercola.com/sites/articles/archive/2017/11/22/meet-sackler-family-making-billions-from-opioid-crisis.aspx
*  https://www.thefreelibrary.com/State+labor+legislation+enacted+in+1984.-a03579386
Among changes in the wage-payment law, the labor department was specifically authorized to collect judgments for unpaid wages ... Among changes made in the prevailing wage law, the prevailing rate of wages was defined as the single rate paid to a majority ... Members of the State Retirement System may now take up to 1 year of maternity leave provided they pay the full actuarial cost. ... By resolution, the President, the Congress, and the U.S. Secretary of Labor were urged to take action to rescind the orders and ...
  https://www.thefreelibrary.com/State+labor+legislation+enacted+in+1984.-a03579386
*  soverreigh bancorp 2002 annual report
... including interest rate policies of the Board of Governors of the Federal Reserve System; • inflation, interest rate, market ... Sovereign expensed such payments ratably from the completion of the acquisition until final payment in September 2001. (7) ... Specifically, against Sovereign's vision, it states: mission, values and critical success factors "We achieve our mission and ... We support efforts by the Securities and Exchange Commission ("SEC"), the United States Congress (with the passage of the ...
  https://www.slideshare.net/finance47/soverreigh-bancorp-2002annualreport
*  Maintaining balance : the physical therapy workforce in North Carolina in the year 2000 : report of the Technical Panel on the...
15 percent cut in payment for home health services until one year after the implementation of a prospective payment system (PPS ... During the 1980s the average annual rate of growth in PTA supply was approximately 9 percent per year. The growth rate during ... Specifically, according to an employment survey released in December, 1999 by the American Physical Therapy Association (APTA ... On November 9, 1999, Congress passed the Balanced Budget Refinement Act (BBRA) that mandates a two-year moratorium on the $ ...
  http://digital.ncdcr.gov/cdm/singleitem/collection/p249901coll22/id/650260/rec/21
*  Medicare's Big Changes | Managed Care magazine
The original payment DRG system, known as CMS-DRG, was adopted in 1983 as a prospective system. Payments to hospitals were made ... Specifically, hospitals "will not receive additional payment for cases in which one of the selected conditions was not present ... Hospitals now report 27 quality-related measures to CMS in order to receive the full annual update to Medicare's payment rates. ... In a November 2007 report to Congress, the Department of Health and Human Services moved that idea a step further by stating ...
  http://managedcaremag.com/archives/2008/5/medicare%E2%80%99s-big-changes?page=358