On August 1, CMS issued its fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) final rule, applying to discharges occurring on or after October 1, 2022.
The 2023 Inpatient Prospective Payment System (IPPS) final rule, which takes effect October 1, includes updates to payment rates, MS-DRGs, and a number of quality and reporting programs.
CMS is weighing an expansion of the hospital outpatient department prior authorization program, changes to 340B reimbursement in the wake of the Supreme Court’s decision, and alternative rate setting data among other proposals in the 2023 Outpatient Prospective Payment System (OPPS) proposed rule.
Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-19-related billing flexibilities, and value-based care, according to the 2023 Medicare Physician Fee Schedule (MPFS) proposed rule released July 7.
The Supreme Court ruled that HHS’ failure to survey hospital costs before enacting the cuts exceed the agency’s authority under the Medicare statute, making the decision to reduce 340B reimbursement unlawful.
NAHRI Advisory Board member Jugna Shah, MPH, CHRI,president of Nimitt Consulting, Inc., in Spicer, Minnesota, discusses how advocating for fair reimbursement and payment systems and raising awareness of the rules governing hospital pricing is fundamental to revenue integrity.
