+ Regulatory
Jamie Barrand | Nov 3, 2015

New Medicare reimbursement rules set for 2016

Final rules were set last week by the Centers for Medicare and Medicaid Services (CMS) on how the agency will reimburse health care providers who provide Medicare services to patients in 2016. 

Major policies included in the rules included the finalization of the home health value-based purchasing model, in which the maximum payment adjustment in the first year of the model was reduced from 5 percent to 3 percent; finalization of the “Two-Midnight” rule, which clarifies when inpatient admissions are appropriate for payment under Medicare Part A; finalization of the End-Stage Renal Disease Quality Incentive Program, which will apply payment incentives to dialysis facilities; establishment of a new physician payment system after the Sustainable Growth Rate (SGR) formula's repeal; and finalization of a provision to empower patients and their families regarding advance care planning.

"CMS is pleased to implement the first fee schedule since Congress acted to improve patient access by protecting physician payments from annual cuts," CMS Acting Administrator Andy Slavitt said. "These rules continue to advance value-based purchasing and promote program integrity, making Medicare better for consumers, providers and taxpayers." 

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