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BPCI Initiative: Model 3 Filtered View
data.cms.gov | Last Updated 2019-10-03T16:52:59.000Z[Data Formatted for Mapping] The Innovation Center develops new payment and service delivery models in accordance with the requirements of section 1115A of the Social Security Act. Additionally, Congress has defined – both through the Affordable Care Act and previous legislation – a number of specific demonstrations to be conducted by CMS.
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Strong Start for Mothers and Newborns Initiative Filtered View
data.cms.gov | Last Updated 2019-10-03T16:52:59.000Z[Data Formatted for Mapping] The Innovation Center develops new payment and service delivery models in accordance with the requirements of section 1115A of the Social Security Act. Additionally, Congress has defined – both through the Affordable Care Act and previous legislation – a number of specific demonstrations to be conducted by CMS.
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Provider Outpatient Hospital Charge Data by APC, CY2016
data.cms.gov | Last Updated 2019-08-28T17:43:37.000ZThe Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 35 C-APC Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2016 by hospital provider. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
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2016 Qualifying Health Plan Selections by Metal Level and County, as of February 1, 2016
data.cms.gov | Last Updated 2017-03-30T00:59:11.000ZAll figures are based on plan selections with coverage periods that include March 2016. A consumer's metal level corresponds to the policy that he or she selected. Metal levels include platinum, gold, silver, bronze, and catastrophic plans. Catastrophic plans have the lowest premiums, but the highest deductibles and other out-of-pocket expenses, while platinum have the highest premiums and lowest deductibles and out-of-pocket costs. All states allow the sale of gold, silver, and bronze plans but may not allow the sale of platinum and/or catastrophic plans. Additionally, catastrophic plans are generally only available to consumers younger than 30.
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State Summary of Outpatient Charge Data by APCs, CY2016
data.cms.gov | Last Updated 2019-08-28T17:47:18.000ZThe Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 35 C-APC Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2016 by state. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
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National Summary of Outpatient Hospital Charge Data by APC, CY2015
data.cms.gov | Last Updated 2019-08-28T17:52:36.000ZThe Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 25 C-APC Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2015. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
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Revalidation Due Date List
data.cms.gov | Last Updated 2019-10-31T17:56:59.000ZSection 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers/suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. CMS has completed its initial round of revalidations and will be resuming regular revalidation cycles in accordance with 42 CFR §424.515. In an effort to streamline the revalidation process and reduce provider/supplier burden, CMS has implemented several revalidation processing improvements one of which is established due dates by which you must revalidate.
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2015 Qualifying Health Plan Selections by Metal Level and County, as of February 22, 2015
data.cms.gov | Last Updated 2017-03-30T00:34:38.000ZAll figures are based on plan selections with coverage periods that include March 1, 2015. A consumer's metal level corresponds to the policy that he or she selected. Metal levels include platinum, gold, silver, bronze, and catastrophic plans. Catastrophic plans have the lowest premiums, but the highest deductibles and other out-of-pocket expenses, while platinum have the highest premiums and lowest deductibles and out-of-pocket costs. All states allow the sale of gold, silver, and bronze plans but may not allow the sale of platinum and/or catastrophic plans. Additionally, catastrophic plans are generally only available to consumers younger than 30.
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State Summary of Outpatient Charge Data by APCs, CY2017
data.cms.gov | Last Updated 2019-08-28T17:40:18.000ZThe Outpatient Hospital Utilization and Payment Public Use File (Outpatient Hospital PUF) presents information on comprehensive APC (C-APC) services provided to Medicare fee-for-service beneficiaries. The Outpatient Hospital PUF presents information on the number of beneficiaries, number of APC services, hospitals' average total estimated submitted charges, the average Medicare allowed charges (which includes Medicare regular provider payments and beneficiary cost-sharing payments), the average Medicare regular provider payments, the number of APC services with outlier payments, and the average Medicare outlier provider payments among those services for 60 C-APC Groups paid under the Medicare Outpatient Prospective Payment System (OPPS) for calendar year (CY) 2017 by state. The estimated average charges and the average Medicare payments are provided at the individual hospital level. The actual charges at an individual hospital for an individual service within these APC groups may differ.
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Medicare Hospital Cost Report PUF 2015
data.cms.gov | Last Updated 2019-12-06T14:40:48.000ZThe Hospital Cost Report Public Use File (Hospital Cost Report PUF) presents select measures provided by hospitals through their annual cost report, and is organized at the hospital level. The Hospital Cost Report PUF is available in a downloadable, user-friendly Excel format. The PUF does not contain all measures reported in the cost reports, but rather includes a subset of commonly used measures. Any hospital that submitted a cost report in a given year will be included in the PUF. For a full list of variables included in this PUF and their descriptions, please see the attachments. The variables in the Hospital Cost Report PUF have not been edited or changed and will be identical to what is available in the online HCRIS system in the 2015 SAS dataset as of December 2nd, 2019. Please note however that the HCRIS datasets are updated quarterly, while the PUF is created annually, and therefore the data may not match if compared to later versions of the HCRIS files.