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Protecting Critically Ill Medicare Beneficiaries Through Reforms to the Long-term Care Hospital PPS High-Cost Outlier Policy
AHA recommendations to CMS regarding protecting critically ill Medicare beneficiaries through reforms to the Long-term Care Hospital PPS High-Cost Outlier Policy.
AHA House Statement on Enhancing Access to Care at Home in Rural and Underserved Communities
AHA statement before the House Committee on Ways and Means regarding “Enhancing Access to Care at Home in Rural and Underserved Communities."
CMS Issues Proposed Rule for CY 2025 Medicare Advantage, Prescription Drug Plans
The Centers for Medicare & Medicaid Services (CMS) Nov. 6 released its proposed Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly, and Health Information Technology Standards for Contract Year (CY) 2025 (CMS-4205-P).
AHA Urges CMS to Swiftly Correct Medicare Advantage Plan Policies That Appear to Violate CY 2024 Rule
The American Hospital Association is deeply concerned that these practices will result in the maintenance of the status quo where MAOs apply their own coverage criteria that is more restrictive than Traditional Medicare proliferating the very behavior that CMS sought to address in the final rule, resulting in inappropriate denials of medically necessary care and disparities in coverage between beneficiaries in MA and those in the Traditional Medicare program.
AHA Urges MedPAC to Examine Medicare Advantage Denials, Hospital Market Basket
We appreciate the Medicare Payment Advisory Commission’s (MedPAC) November meeting discussions on Medicare Advantage (MA) prior authorization and network management. As MedPAC begins its discussions on payment adequacy for the Medicare program, we outline concerns about the impact that the shifting labor force and costs have had on hospitals and health systems, including whether the current market basket methodology is adequate to capture these changes.
AHA Comments on CMS’ Proposed Medicare Advantage Policies for 2025
AHA comments on the CMS proposed rule for policy and technical changes to the Medicare Advantage program in contract year 2025.
CMS Issues Frequently Asked Questions Related to CY 2024 Medicare Advantage Final Rule
The CMS Feb. 6 released a Frequently Asked Questions document pursuant to the calendar year 2024 Medicare Advantage final rule, which went into effect Jan. 1.
Rehabilitation Services
Rehabilitation services are measures taken to promote optimum attainable levels of physical, cognitive, emotional, psychological, social, and economic usefulness, and thereafter to maintain the individual at the maximal functional level.