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AHA RFI Response to CMS on Medicare Advantage Data and Oversight
Timely and accurate information on Medicare Advantage plan performance and compliance with existing CMS regulations is critical to ensuring that those enrolled in MA plans are not unfairly subjected to more restrictive rules and requirements than Traditional Medicare, which are contrary to the intent of the MA program and run afoul of federal rules.
Letter to CMS Administrator Brooks-LaSure on the Higher Spending on Two Catheter Codes and the Impact on ACOs
The undersigned organizations write to request that accountable care organizations (ACOs) are held harmless from anomalous Medicare spending outside their control, such as the aberrant billing for catheters experienced in 2023.
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 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.
AHA Comments on CMS’Medicare Appeals Rights for Patient Status Changes Proposed Rule
AHA Comments on CMS’Medicare Appeals Rights for Patient Status Changes Proposed Rule.
AHA Urges Congress to Eliminate Medicaid DSH Cuts, Reject Site-neutral Payments
AHA comments regarding the ongoing government funding discussion, AHA Urges Congress to eliminate Medicaid DSH cuts, reject Site-neutral payments.
AHA Comments on Upcoming MedPAC Payment Update Recommendations
AHA shares comments and ask that commissioners consider the following issues before making their final payment update recommendations at the upcoming Medicare Payment Advisory Commission (MedPAC) meeting.
AHA to CMS: Recommendations for Reducing the Burden of Clinical Documentation
AHA recommends CMS actions to reduce burden of clinical documentation.