KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Medicare Proposes 2.1% Pay Boost For Outpatient Care

The increased rate highlights a trend towards discouraging unnecessary admissions. Meanwhile, the agency announces a pilot project to cut down appeal waits for long-term care providers.

Bloomberg: Hospitals To Get 2.1% Pay Boost On Medicare Outpatients
Medicare payments to hospitals for care they provide on an outpatient basis would increase 2.1 percent under an Obama administration proposal highlighting a trend toward discouraging unnecessary admissions. ... The proposed increase for 2015 was released yesterday in a regulation from the U.S. Centers for Medicare and Medicaid Services. ... The Medicare agency already proposed trimming payments for admissions at hospitals next year by about $241 million. Those cuts are in part due to the Affordable Care Act, which ordered reductions in Medicare costs to help pay for its expansion of insurance coverage, in a deal with the hospital industry (Wayne, 7/4).

McKnight’s: CMS Announces Medicare Appeals Without Administrative Law Judges
Long-term care providers will be able to appeal certain Medicare claims decisions without utilizing an administrative law judge, the Centers for Medicare & Medicaid Services announced Friday. Settlement Conference Facilitation is an alternate dispute resolution process that would bring providers and CMS representatives together to negotiate and settle Medicare disputes with the help of a third party. ... This "settlement conference facilitator" would be an employee of the Office of Medicare Hearings and Appeals, which is a separate agency from CMS, according to a fact sheet on the pilot program (Mullaney, 7/7).

Related KHN coverage: As HHS Moves To End Overload Of Medicare Claims Appeals, Beneficiaries Will Get Top Priority (Jaffe, 1/21).

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