On January 3, 2025, OIG posted the results of an audit that found that Medicare could have saved $7.7 billion if critical access hospitals’ (CAH) payments for swing-bed services were similar to those of the fee-for-service...more
1/22/2025
/ Audits ,
Bi-Partison Balanced Budget Act (BBA) ,
Centers for Medicare & Medicaid Services (CMS) ,
Critical Access Hospitals ,
Fee-for-Service ,
Health Care Providers ,
Healthcare Costs ,
Healthcare Facilities ,
Hospitals ,
Medicare ,
OIG ,
Payment Systems ,
Rural Health Care Providers ,
Skilled Nursing Facility
On December 11, 2024, the Ninth Circuit struck down an HHS policy that boosted the wage index, and therefore the Medicare reimbursement rate, for hospitals in low-income communities in Kaweah Delta Health Care District v....more
12/20/2024
/ Administrative Procedure Act ,
Arbitrary and Capricious ,
Centers for Medicare & Medicaid Services (CMS) ,
Department of Health and Human Services (HHS) ,
Hospitals ,
Interim Final Rules (IFR) ,
Medicare ,
Minimum Wage ,
Reimbursements ,
Summary Judgment ,
Wage and Hour
On November 1, 2024, Senators Bill Cassidy (R-LA) and Maggie Hassan (D-NH) released a framework titled “Lowering Health Costs for Seniors Framework” (the Framework). The Framework proposes site-neutral payment for services in...more
On August 12, 2024, OIG announced the results of an audit of payments made to hospitals for inpatient claims with the Medicare Severity Diagnosis-Related Groups (MS-DRGs) that require ninety-six hours of consecutive...more
8/30/2024
/ Audits ,
Billing ,
Centers for Medicare & Medicaid Services (CMS) ,
Extrapolation ,
Hospitals ,
Inpatient Billing ,
Inpatient Rehab Facilities ,
Medicare ,
OIG ,
Overpayment ,
Policies and Procedures