Updates & Analysis

On July 29th, CMS issued a final rule to update the FY 2017 Medicare payment rates under the prospective payment system for skilled nursing facilities (SNFs). The rule also finalizes various requirements for the SNF Value-Based Payment Program and implements new quality and resource use measures for the SNF Quality Reporting Program to comply with…

On July 29th, the Centers for Medicare and Medicaid Services (CMS) released a final rule for FY 2017 Medicare payment policies and rates for the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) and the IRF Quality Reporting Program (IRF QRP). The provisions of the final rule go into effect on October 1, 2016. The…

On July 25th, CMS issued a proposed rule to establish new bundled payment models for cardiac and hip fracture care. The proposed rule aims to advance care coordination, improve quality of care, and reduce spending through financial accountability. The proposed rule includes policies such as: New bundled payment models for cardiac care and an extension…

On July 7th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would update the Physician Fee Schedule (PFS) and other Medicare Part B payment policies for CY 2017. CMS estimates that these changes would provide $900 million in additional funding to physicians and practitioners. Other provisions of the rule include:…

On July 6th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for the CY 2017 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. The proposed rule updates Medicare payment policies and rates for hospital outpatient departments, ASCs, and partial hospitalization programs. The proposed rule also includes…

On June 23rd, New York State Homes and Community Renewal (HCR) released a revision to the 2016 Multifamily Open Window Request for Proposals (RFP). This RFP consolidates the availability of funds through a number of programs that support affordable rental housing for low-to-moderate income individuals and families. Projects may include new construction, adaptive reuse of…

On June 28th, CMS issued a proposed rule for the Medicare home health prospective payment system (HH PPS) for calendar year 2017. The proposed rule would update the 2017 payment rates for home health agencies (HHAs). The overall impact of the HH PPS payment rate update is an estimated reduction of one percent, or $180…

On June 24th, DOH posted a report on the Health and Recovery Plan (HARP) eligible subpopulation from the Behavioral Health Value-Based Payment (VBP) Clinical Advisory Group (CAG). The report describes proposed subpopulation and episode definitions, risk adjustment criteria, and quality measures for VBP arrangements for total care for the HARP eligible subpopulation. Please find an…

The New York City Human Resources Administration (HRA) has released two Requests for Proposals (RFPs) for emergency and transitional housing services for survivors of domestic violence. The RFPs are attached and summarized below. Emergency Shelter and Support Services for Domestic Violence Survivors This RFP offers an anticipated total of $22.8 million over five years for…

On June 17th, CMS released a final rule that will revise the payment methodology for clinical diagnostic laboratory tests (CDLTs) that are paid under the Clinical Laboratory Fee Schedule (CLFS). Under the final rule, applicable labs will be required to report private payer payment rates and volume for CDLTs. CMS will use these private payer…

On June 13th, CMS issued a proposed rule that would update the Conditions of Participation that hospitals and critical access hospitals must meet to be reimbursed by Medicare and Medicaid. Under the proposed rule, all hospitals would be required to implement infection prevention and antibiotic stewardship programs and establish policies that explicitly prohibit discrimination. The…

On June 6th, CMS issued a final rule on the Medicare Shared Savings Program (MSSP). The final rule refines the methodologies used for resetting benchmarks for ACOs that continue to participate in the MSSP after their initial agreement period. The final rule allows ACOs that outperform regional peers to achieve long-term performance-based payments, and further…