Reimbursement Consulting

UPDATED NOVEMBER 2023

CMS于2022年12月29日发布了医院成本报告表格2552-10的传输文件18. Several changes were made in this transmittal, 但影响几乎所有医院提供者的是更新的医疗保险坏账(表2a)和S-10(表3b和3c)，这些是本传输文件中要求的. 在2023年9月30日或之后结束的成本报告期间需要这些附件.

• Exhibit 2a -从2022年10月1日开始及之后的成本报告期间的医疗保险坏账日志
• Exhibit 3b – S-10 log for charity care charges
• Exhibit 3c – S-10 log for total facility bad debts

More detail of Transmittal 18: http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Transmittals/r18p240i

LBMC准备协助所有受此传输监管的供应商，并协助准备这些展品.

POSTED JANUARY 2023

影响几乎所有医院提供者的是以下更新的展品，这是本传输中要求的. 这种传输影响到从2022年10月1日或之后开始的成本报告期间的供应商.

• Exhibit 1 – Allocation of Physician Compensation
• Exhibit 2 - 2022年10月1日之前开始的成本报告期间的医疗保险坏账日志.
• Exhibit 2a -从2022年10月1日开始及之后的成本报告期间的医疗保险坏账日志
• Exhibit 3a – Medicaid eligible days for a DSH eligible hospital
• Exhibit 3b – S-10 log for charity care charges
• Exhibit 3c – S-10 log for total facility bad debts

2023年拨款法案规定了几个农村卫生项目的资金水平.  It was signed by President Biden December 29, 2022.

该法案指定500万美元在疾病控制和预防中心设立农村卫生办公室。. 疾控中心的农村卫生办公室将加强实施疾控中心的农村卫生组合, 协调疾控中心各项目的工作，制定农村卫生战略计划.

This bill also supports rural hospitals and core rural health care programs, as listed below:

Rural Hospital Programs

• $3.45 billion for the Rural Community Facilities Program and $2 million for the Rural Hospital Technical Assistance Program 通过美国农业部农村发展(RD)项目.
• $64.3 million for the Medicare Rural Hospital Flexibility Grants Program (an increase of more than $2 million over FY 2022 funding levels). The $64.300万美元中包括2100万美元用于小型农村医院改善赠款方案，500万美元用于继续资助农村急诊医院(REH)技术援助方案.

Continuation of Core Rural Health Care Programs

• $12.5 million for State Offices of Rural Health (level funding)
• 1.45亿美元用于农村社区阿片类药物应对计划(增加1000万美元)
• $12.5 million for the Rural Residency Development Program ($2 million increase)
• $125 million for the National Health Service Corps ($3 million increase)
• 800万美元用于HRSA的农村妇产管理战略项目(RMOMS)(增加200万美元)

Statutory Pay-As-You-Go Act (PAYGO) of 2010

2010年的法定现收现付法案(PAYGO)要求一项强制性的支出和收入立法，以避免增加联邦预算赤字.  随着《明升体育app下载》的通过，现收现付的自动减支在22年12月31日之前被放弃.  现收现付的自动减支现在被推迟到2025年1月，这避免了4%的医疗保险报销削减.

Telehealth

Telehealth flexibilities will now continue until December 31, 2024. 在2022财年的综合拨款法案中，远程医疗的灵活性延长了151天. The bill extends these critical PHE provisions, including audio-only flexibilities through December 31, 2024.

Medicare Payments

• Low-Volume Hospital (LVH) and Medicare-Dependent Hospital (MDH) designation both extended through September 30, 2024.
• Ground Ambulance add-on payments extended for two years through December 31, 2024.
• Physician add-on payments for services furnished in calendar year 2023, the add-on payment will be 2.5 percent for physicians. For services furnished in calendar year 2024, the add-on payment will be 1.25 percent.
• Home health rural add-on payment at one percent through the end of 2023.

Mental Health Provisions

• 医疗保险下的婚姻和家庭治疗师(MFT)和心理健康顾问(MHC)的覆盖范围.
• 新增200个精神病学或精神病学专科住院医师名额. In FY 2026, the Secretary shall begin distribution of these slots, with a minimum of 10 percent going toward hospitals located in rural areas.
• Inclusion of the Restoring Hope for Mental Health and Well-Being Act

Here is the link to the American Hospital Association notice regarding this $1.7 trillion omnibus bill.  http://www.aha.org/news/headline/2022-12-30-biden-signs-17-trillion-omnibus-appropriations-bill

Cost Reporting Services

• Preparation and/or review of Medicare and/or Medicaid Cost Reports.
• Review and assistance with tentative settlements, cost report audits, appeals and other correspondence with CMS and MACs.
• 审核以前提交的成本报告，以确定潜在的风险和报销机会.
• 汇编或独立审查各种医疗补助和其他国家计划报告，如住院治疗中心.

Payor Contracting and Negotiations

• Chargemaster Reviews
• Review all current contracts for compliance, performance and renegotiate with payors, as appropriate, to obtain more favorable contract conditions and/or rates.
• Review all new contract proposals and recommend acceptance or denial, based on potential performance and fit with the group’s strategy and goals.
• Review payor market shares in your area and new contract recommendations.
• 就付款人合同相关问题向员工提供电话和电子邮件支持.
• Provide ongoing monitoring of contracts for payor compliance.
• Project environments: Hospitals, ASC, Rehab, Psych (inpatient and outpatient), Physicians (hospital and non-hospital based) and Ancillary services.

Consulting Services

• 确定并协助医疗/外科和康复医院的不成比例份额(DSH)和低收入(LIP)报销机会, respectively.
• 协助编制和/或审查传统的医疗保险坏账和医疗补助“交叉”坏账.
• Square Footage Analysis for proper cost allocations.

Other Reimbursement Services

• 协助工资指数审核和审查潜在的地理重新分类.
• Consultations for various Provider based issues.
• Assistance with completion and filing of occupational mix surveys.
• 尽职调查，协助处理收购/合并活动中的机会和责任.