Medicare & Medicaid
In response to increased mental health needs, CMS wants flexibility for hospitals to open and bill Medicare for a new inpatient psychiatric units.
The report also found that the more insurers, the lower the benchmark premiums, and vice versa.
Overall IRF payments for 2024 are expected to increase by 3.7%, or $335 million, relative to payments in 2023.
That's three years later than the prediction from the 2022 report, which projected a 2028 time frame for when the fund would evaporate.
The finalized risk adjustment model reflects revisions focused on conditions that are subject to more coding variation.
CMS says the rule takes initial steps in a larger effort to address what it sees as fraud, waste and abuse.
CMS released 2024 Medicare Advantage Program and Part D Payment policies on Friday.
The group issues recommendations to reduce health disparities and increase access to higher-quality care for underserved populations.
Senators Cassidy and Merkley contend that MA plans have a financial incentive to make beneficiaries appear sicker than they are.
The move is ahead of a final rule that is expected to reduce the time allowed for PA approval and require electronic FHIR API standards.