Reimbursement and Payment Methodologies

CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, moving forward with year two of the site-neutral payment policy for clinic visits, while also asking for comments on how to potentially undo its policy that reduced payments for drugs purchased under the 340B drug discount program by nearly 30%.

Learn how to make the connections that will lead you to revenue integrity success with this issue of the quarterly NAHRI Journal.

Put CMS’ proposed changes in perspective to see the bigger picture.

Learn what you need to do now to ensure seamless Appropriate Use Criteria reporting.

Take a look at how the Appropriate Use Criteria Program applies to different types of facilities and in different settings.

Consider the potential impact of future appropriate use criteria changes including prior authorization.

Officials say the move will result in lower healthcare costs by unleashing competition. Some industry stakeholders are disputing that claim.

On April 30, NAHRI presented its second members-only quarterly call of 2019, where members heard from revenue integrity experts on charge error correction and observation, as well as received some updates on what’s new at NAHRI.

CMS published the FY 2020 Inpatient Prospective Payment System (IPPS) proposed rule on April 23, introducing policies designed to significantly alter rural health payments and expedite opportunities to pay for new technology.