Hospital Payments and Operations
IHA summarizes and analyzes federal policies impacting hospital payments and operations.
Telehealth Coverage and Practice Waiver Updates
This document provides updates to IHA members on federal and state telehealth coverage and practice waivers.
Proposed Rule Seeks to Strengthen Federal Oversight of Organ Procurement
On Jan. 30, CMS issued a proposed rule that updates conditions of coverage for Organ Procurement Organizations, strengthening federal oversight of these organizations.
CMS Proposed Rules Banning Gender-Affirming Care for Children
CMS proposed new hospital conditions of participation that would ban the provision of and federal payment for most gender-affirming care services for children.
Medicare Advantage Provider Complaint Submission Form
Organizations representing Medicare providers and seeking assistance from CMS in resolving Medicare Advantage claims issues must complete this form by following these instructions.
Recording: Hospital Wage Index: Maximizing Medicare Reimbursement (5.9.24)
This webinar walks IHA members through the wage index development process, the impact of recent court cases and policy changes, and the opportunities before hospitals. Password: pDtV3mRA
Recording: CMS Interoperability and Prior Authorization Final Rule (4.3.24)
CMS provided IHA members with an overview of the interoperability and prior authorization final rule (CMS-0057-F). Password: pMtq3rug
Medicare Advantage Final Rule Implementation Handbook
The American Hospital Association developed this implementation guide to help equip hospitals and health systems with tools to better advocate for MA plan compliance with regulatory requirements.
Medicare Quality Programs Reference Guide
This reference guide includes details for the 2023, 2024, and 2025 Medicare Value-Based Purchasing, Readmissions Reduction, and Hospital-Acquired Condition Reduction programs.
Overview of Medicare RRP and HAC Programs
An IHA webinar on June 9 provided an overview of the Medicare Readmissions Reduction Program (RRP) and Hospital Acquired Condition (HAC) Program. A recording of the webinar is available here.
Webinar: Top Medicare Reimbursement Opportunities Post COVID
An IHA webinar on May 17 identified strategies to enhance Medicare reimbursement. Access the webinar recording here (password Ehc6efgf). Click "Read More" below for the program slides.
Overview of Medicare VBP Program
An IHA webinar on May 16 provided an overview of the Medicare Value Based Purchasing (VBP) Program, which is the only Medicare quality program to recognize improvement as well as achievement.
Updated Electronic ADT Enforcement Date and ONC Information
The implementation and enforcement deadline for new electronic admission, discharge and transfer notifications tied to Medicare Conditions of Participation is May 1, 2021.
May 1 Implementation Deadline: Electronic Exchange of Patient ADTs as Medicare CoP
As part of Medicare Conditions of Participation, hospitals, psychiatric hospitals and critical access hospitals must send electronic patient admission, discharge and transfer information by May 1.
March 29 Deadline: Apply for IME and DGME FTE Slots
Teaching hospitals have until March 29 to apply for IME and DGME slots made available by the recent closure of two teaching hospitals.
Upcoming Deadlines: Medicare Quality Program Reporting and Reweighting Extensions
Hospitals and clinicians may apply for quality data reporting exceptions due to COVID-19. See an IHA memo with deadlines and additional information.
HHS OIG Work Plan, 2020
IHA closely monitors the OIG Work Plan to keep our members informed about potential changes to the healthcare landscape. This document summarizes current OIG studies members may find most pertinent.
Proposed Specialty Care Models: Radiation Oncology and End-Stage Renal
On July 18, CMS published in the Federal Register (FR) two proposed specialty care models specific to radiation oncology and end-stage renal disease (ESRD).