Finance and Reimbursement

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Finance and Reimbursement
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Hospitals in Kansas and across the nation have been working to develop fair and compassionate policies to help the uninsured and underinsured.
For many Kansas health care organizations, government payment program beneficiaries represent a significant portion of the total patients served each year, and reimbursements for these programs comprise a significant percentage of revenues. KHA closely monitors state and federal budget provisions for these programs, as well as operational issues that affect its members. This site has been developed to provide information on various reimbursement topics that affect Kansas hospitals.
In the 2009 Outpatient Prospective Payment System final rule, the Centers for Medicare and Medicaid Services issued what they called a "clarification and restatement" of an existing policy regarding physician supervision of outpatient therapeutic services that was in place since 2001. Since the adoption of that rule, KHA, AHA and other organizations have pointed out to CMS that their clarification was a change in Medicare policy. In the 2010 OPPS final rule, CMS made some changes, but the changes have not gone far enough. This site contains documents explaining the concerns voiced by member hospitals, as well as a log of actions taken by KHA.
The Centers for Medicare and Medicaid Services (CMS) authorized the Recovery Audit Contractor (RAC) program to identify improper payments in the Medicare and Medicaid programs.  The Medicare RAC program was expanded nationwide in 2010.  The Medicaid RAC program has not been expanded ationwide, however, a State of Kansas fiscal year 2011 budget bill required the State to enter into a contract by Oct. 1, 2010.
In the Medicare Inpatient Prospective Payment System Final Rule for 2015, the Centers for Medicare & Medicaid Services reminds hospitals of the Affordable Care Act hospital price transparency requirement that went into effect on Oct. 1, 2014. The rule allows hospitals to determine how best to implement the law by either making public a list of their standard charges (their charge master or another form of their choice), or their policy for allowing the public to view a list of those charges in response to an inquiry. The information below will assist you with developing and implementing your transparency policies and information.

It is important for hospital boards to understand what types of services patients in their region are seeking and where those patients are going for care. Please join KHA for a Noon Briefing on Friday, June 30, where Sally Othmer, senior director of data and quality, will explore how to use generated reports from the Analytic Advantage Plus website to support strategic market-share decisions by identifying trends in both inpatient and outpatient activity.
The Kansas Hospital Association is hosting a three-part management development webinar series that will take place over several months. This webinar series will provide new and more experienced managers with the nuts and bolts of management.
For more information regarding the KHA Leadership Institute, contact the KHA Education Department at cmadden@kha-net.org or (785) 233-7436.
For more information regarding this program, contact Tish Hollingsworth or Dee Lewis at (785) 233-7436.
The Kansas Hospital Association is hosting a three-part management development webinar series that will take place over several months. This webinar series will provide new and more experienced managers with the nuts and bolts of management.