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Medicare Provider Utilization and Payment Data
As part of the Obama administration’s work to make our health care system more affordable and accountable, data are being released that summarize the utilization and payments for procedures, services, and prescription drugs provided to Medicare beneficiaries by specific inpatient and outpatient hospitals, physicians, and other suppliers. These data include information for the 100 most common inpatient services, 30 common outpatient services, all physician and other supplier procedures and services, and all Part D prescriptions. Providers determine what they will charge for items, services, and procedures provided to patients and these charges are the amount the providers bill for an item, service, or procedure.
Calculating Medicare Fee Schedule Rates
MPPR is a per-day policy that applies across disciplines and across settings. For example, if an SLP and a physical therapist both provide treatment to the same patient on the same day, the MPPR applies to all codes billed that day, regardless of discipline. Under MPPR, full payment is made for the therapy service or unit with the highest practice expense value (MPFS reimbursement rates are based on professional work, practice expense, and malpractice components) and payment reductions will apply for any other therapy performed on the same day. For the additional procedures provided on the same day, the practice expense (i.e., support personnel time, supplies, equipment, and indirect costs) of each fee will be reduced by 50% (effective April 1, 2013) for Part B services in all settings. The professional work and malpractice expense components of the payment will not be affected. ASHA has developed three MPPR scenarios to illustrate how reductions are calculated.
Medicare Sustainable Growth Rate
Section 101 of the Tax Relief and Health Care Act of 2006 (MIEA-TRHCA) provided a 1-year update of 0% for the conversion factor for CY 2007 and specified that the conversion factor for CY 2008 must be computed as if the 1-year update had never applied. Section 101 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) provided a 6-month increase of 0.5% in the CY 2008 conversion factor, from January 1, 2008, through June 30, 2008, and specified that the conversion factor for the remaining portion of 2008 and the conversion factors for CY 2009 and subsequent years must be computed as if the 6-month increase had never applied. Section 131 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) extended the increase in the CY 2008 conversion factor that was applicable for the first half of the year to the entire year, provided for a 1.1% increase to the CY 2009 conversion factor, and specified that the conversion factors for CY 2010 and subsequent years must be computed as if the increases had never applied.
Medicare Supplement Rate, Medicare Supplement Rates
This material is for information only. This is a solicitation to sell Aetna Medicare Supplement insurance underwritten by Aetna Life Insurance Company (Aetna). A sales representative may call. Benefits and costs may vary depending upon the insurance plan. Insurance plans are subject to exclusions, limitations and eligibility requirements. Neither Aetna Life Insurance Company nor any of its agents or Medicare Supplement insurance plans are connected with or endorsed by the U.S. or state government, Social Security or Federal Medicare program.
Best Medicare Supplement Insurance Quotes
Every Medicare supplemental insurance plan must follow federal and state laws designed to protect you. Medicare supplement plan insurance companies can only sell you a “modernized” Medicare supplemental insurance plan identified by letters A through N. Each modernized Medicare supplemental insurance plan must offer the same basic benefits, no matter which insurance company sells it.