(Nov. 10, 2023) – Policymaker Speaks Out Against Site-Neutral Payment Policies
An op-ed for AL.com, written by Alabama State Representative Anthony Daniels explains why "it is especially alarming to see so-called site-neutral legislation now being pushed through Congress, which could make high-quality health care less accessible for women, particularly in rural areas."
Speaking to the challenges already facing women seeking maternal health care in rural and underserved communities, Daniels writes that "these realities should give pause to lawmakers advocating for site-neutral legislation. Such bills would cut payments for hospitals and health care systems regardless of the distinct and higher costs they face to deliver care."
The Coalition to Protect America's Health Care, of which the AHA is a founding member, is sharing the piece with media and across its communications channels.
Please contact Alicia Mitchell, AHA senior vice president of communications, if you have questions.
CMS Publishes CY 2025 Technical Changes to MA, Prescription Drug Program and All-Inclusive Care
The Centers for Medicare and Medicaid Services released a proposed rule revising the Medicare Advantage program, Medicare Part D, Medicare Cost Plan Programs and Programs of All-Inclusive Care for the Elderly. The rule provides guardrails for MA compensation to agents and brokers, improves access to behavioral health care providers, ensures that MA plans analyze their utilization management policies and procedures from a health equity perspective and enhances enrollees' rights to appeal to an MA plan's decision to terminate coverage.
CMS Publishes Final CY 2024 Medicare Outpatient PPS Payment and Policy Updates
The Centers for Medicare & Medicaid Services released the calendar year 2024 final payment and policy updates for the Medicare Ambulatory Surgical Center and Outpatient prospective payment system. The 2024 payment update is 3.1 percent, which includes a 3.3 percent market basket increase reduced by a 0.2 percent productivity adjustment. The following are major components of the rule.
- CMS estimates CY 2024 OPPS payments to increase by $6 billion compared to CY 2023
- CMS estimates CY 2024 ASC payments to increase by $207 million compared to CY 2023
- Hospitals that fail to meet outpatient quality payment reporting will receive a 2 percent reduction to the OPPS payments through a 0.9806 adjustment factor
- CMS applies changes to Community Mental Health Centers CoPs
- Medicare payment rates are being finalized for 240 dental codes
- Hospital price transparency policies are being revised
- Policies are changing to expand access to behavioral health care
CMS Issues Hospital Outpatient PPS Remedy for 340B-Acquired Drug Payments
Based on a 2022 Supreme Court Decision, the Centers for Medicare & Medicaid Services issued a final rule that includes a remedy for the Medicare Outpatient Prospective Payment System 340B-acquired drug payment policy for calendar years 2018–2022. The remedy includes lump sum payments totaling $9 billion to affected 340B providers for claims covering calendar years 2018 through Sept. 27, 2022. CMS announced that approximately 1,700 affected 340B-covered entities would receive the payment. CMS will implement the remedy through a budget neutrality adjustment that will reduce the OPPS conversion factor by 0.5 percent beginning in CY 2026.
CMS Publishes Final CY 2024 Medicare PFS Payment and Policy Updates
The Centers for Medicare & Medicaid Services released the calendar year 2024 final payment and policy updates for Medicare payments under the physician fee schedule. The payment rates will be reduced by 1.25 percent in calendar year 2024, as compared to CY 2023, while including significant increases in payments for primary care services. The rule also:
- Finalizes payments paid to practitioners who train caregivers to support patients with certain medical needs
- Finalizes coding and payment changes to better account for resources involved in furnishing patient-centered care
- Includes a policy to pay separately for Community Health Integration, Social Determinants of Health Risk Assessment and Principal Illness Navigation services
- Temporarily adds health and well-being coaching services to the Medicare telehealth service lists
- Includes payments for preventive vaccine administration services
FMT Releases New CAHMPAS Financial Data for CAHs
The Flex Monitoring Team added new data to the Critical Access Hospital Measurement and Performance Assessment System tool. This data tool allows CAHs to assess their performance on financial, quality and community benefit measures. The CAHMPAS financial data have been updated with the 2022 data available to date (using June 2023 hospital cost report data).
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews:
Before You Go...
- The American Hospital Association released a series of posters focused on patient-centered, respectful language. The People Matter, Words Matter series covers a wide range of behavioral health topics, including suicide, substance use disorders and maternal mental health.
- The American Hospital Association is hosting a complimentary webinar, Strategic Onboarding: Maximize Employee Retention from Day One, at noon on Wednesday, Nov. 15. Felicia Sadler, vice president of quality and partner at Relias, will discuss steps organizations can take to attract and retain clinical staff, as well as highlight low-cost incentives to recognize and reward employees.
- Research shows that transgender and gender-diverse populations experience higher rates of minority stress because of actual and perceived stigma. This has detrimental effects on all areas of life, especially mental and physical health. This meta-analysis delves into the impacts of enacted stigma on psychological distress and substance use within the transgender and gender-diverse populations.