- The Centers for Medicare and Medicaid Services (CMS) has proposed a 2.6 percent reimbursement increase for hospital outpatient departments and ambulatory surgical centers next year, reflecting a projected 3 percent market basket increase offset by a -0.4 percent productivity adjustment. This proposed rule includes new provisions focused on maternal health and health equity, mandating hospitals to follow specific protocols for pregnant patients to qualify for the full payment hike. CMS also plans to introduce a two-track per diem system for the Partial Hospitalization Program and Intensive Outpatient Program, maintaining two ambulatory payment classifications for varying service levels. Additionally, the rule outlines revisions to emergency services conditions for obstetrics and gynecology, aligning with the White House’s maternal health agenda to improve outcomes and address disparities. The proposed regulation also aims to enhance health equity measures, requiring screening for social determinants of health; facilities not meeting these standards face a 2 percent reduction in payment updates. (Article here)
- Doctors are facing potential Medicare payment cuts of nearly 3 percent next year due to the lack of annual inflation adjustments for physician reimbursements. This recurring issue prompts Congress to enact a year-end “doc fix” to mitigate financial impacts. Despite bipartisan efforts to reform the reimbursement system, achieving a comprehensive overhaul before the cuts is unlikely due to competing priorities and cost concerns. Stakeholders stress the need for a permanent legislative solution rather than temporary fixes. Meanwhile, regulatory proposals suggest potential expansions in telehealth coverage and changes to primary care payment systems under Medicare, aiming to reform health care delivery and reimbursement practices.(Articles here, here, and here)
- The Biden administration introduced new maternal health standards on Wednesday, proposing that hospitals must meet specific requirements to continue receiving Medicare funding, marking a significant initiative in an election year. CMS outlined these requirements, which include having resuscitation equipment available in labor and delivery rooms, ensuring staff receive maternal health training, and establishing protocols for emergency deliveries. Hospitals providing emergency services, even without obstetrics units, must also adhere to emergency delivery protocols. CMS estimates the hospital industry will spend approximately $4.46 billion over a decade to comply with these standards. This move aims to address the U.S.’s maternal mortality crisis, which disproportionately affects Black women, Native women, and rural communities, but faces opposition from hospital groups concerned about the policy’s impact on obstetric services availability. (Article here)
July 17, 2024
Providers | Tea Leaves