OMB: Proposed Designation of Databases for Treasury's Working System Under the Do Not Pay Initiative
Notice from the Office of Management and Budget (OMB) proposing which databases to include in the Treasury's Working System under the Do Not Pay (DNP) Initiative. Proposed databases include the Department of Agriculture's National Disqualified List (NDL) and the Center for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES), among others. Comments are due by February 22, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 22, 2021 Category: Rural Health Source Type: news

CMS unveils final rule to speed up coverage of advanced tech
The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a final...Read more on AuntMinnie.comRelated Reading: MSN touts new CMS clinical data registry measures ACR urges Congress to stop Medicare cuts CMS grants pass-through status for Detectnet CMS finalizes major cut in radiology reimbursement CMS issues final rule modernizing Stark law (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - January 19, 2021 Category: Radiology Source Type: news

CMS: Medicare and Medicaid Programs; Contract Year 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly
Notice of final rule from the Centers for Medicare and Medicaid Services (CMS) revising regulations for Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), and the Medicare Cost Plan program, and Programs of All-Inclusive Care for the Elderly (PACE), among other things. This rule is effective March 22, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 19, 2021 Category: Rural Health Source Type: news

CMS: Medicaid Program; Medicaid Fiscal Accountability Regulation
Notice from the Centers for Medicare and Medicaid Services (CMS) withdrawing theNovember 18, 2019 proposed rule, which would have created new reporting requirements for states to address the financing of supplemental and base Medicaid payments through the non-federal share. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 19, 2021 Category: Rural Health Source Type: news

CMS: Medicare Program; CY 2021 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-In Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions From the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19; Correction
Notice from the Centers for Medicare and Medicaid Services making technical corrections to theDecember 28, 2020 final rule. This correction is effective January 19, 2021, and is applicable January 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 19, 2021 Category: Rural Health Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Operations - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Special Topics - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS: Journal of Emergency Medical Services News - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Latest News - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Patient Care - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

New Innovation to Address System Overload by Systemizing the Field Triage and Treatment of Non-Emergent Patients
Introductory Note from JEMS Editor Emeritus A.J. Heightman, MPA, EMT-P JEMS has prided itself on introducing countless groundbreaking concepts and innovations to the EMS community since its inception in 1980. As an example, in May 1980, JEMS introduced Jack Stout’s Public Utility Model and System Status management which changed the way many EMS Systems operated. His concepts introduced new ways to maximize resources and revenue through changes in the deployment of crews and resources. In Feb. of 1981, Dr. Jeff Clawson’s dispatch priority training and the Medical Priority Dispatch System (MPDS); the impact...
Source: JEMS Administration and Leadership - January 18, 2021 Category: Emergency Medicine Authors: Marc Eckstein, MD, MPH Tags: Administration and Leadership Communications & Dispatch Exclusives California EMS Prehospital Telemedicine Source Type: news

CMS streamlines prior authorizations in final rule
The U.S. Centers for Medicare and Medicaid Services (CMS) has issued a final...Read more on AuntMinnie.comRelated Reading: MSN touts new CMS clinical data registry measures ACR urges Congress to stop Medicare cuts CMS grants pass-through status for Detectnet CMS finalizes major cut in radiology reimbursement CMS issues final rule modernizing Stark law (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - January 15, 2021 Category: Radiology Source Type: news

Public Inspection: CMS: Medicaid Program: Medicaid Fiscal Accountability Regulation
Pre-publication notice from the Centers for Medicare and Medicaid Services (CMS) withdrawing the November 18, 2019 proposed rule, which would have created new reporting requirements for states to address the financing of supplemental and base Medicaid payments through the non-federal share. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 15, 2021 Category: Rural Health Source Type: news

Public Inspection: CMS: CY 2021 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19; Correction
Pre-publication notice from the Centers for Medicare and Medicaid Services making technical corrections to theDecember 28, 2020 final rule. This correction is effective upon publication of this notice, which is scheduled for January 19, 2021, and is applicable January 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 14, 2021 Category: Rural Health Source Type: news

CMS Issues New Roadmap for States to Address the Social Determinants of Health to Improve Outcomes, Lower Costs, Support State Value-Based Care Strategies
The Centers for Medicare and Medicaid Services (CMS) issued guidance to state health officials describing how to adopt strategies that address the social determinants of health (SDOH) in Medicaid and the Children's Health Insurance Program (CHIP). Discusses how SDOH exacerbate health disparities among a variety of populations, including rural communities, and the guidance aims to help states improve population health and reduce costs. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - January 7, 2021 Category: Rural Health Source Type: news

Price Transparency: A Gift To Americans In The New Year
On January 1, a new rule from the Centers for Medicare and Medicaid Services went into effect requiring hospitals to publish the prices they negotiate with insurers for various medical procedures. This rule will inject some sorely needed transparency into the U.S. healthcare system. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - January 4, 2021 Category: Pharmaceuticals Authors: Sally Pipes, Contributor Tags: Policy /policy Business /business Innovation /innovation Healthcare /healthcare sallypipesblog Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment two information collections: 1) Solicitation for Applications for Medicare Prescription Drug Plan 2022 Contracts and 2) CMS Plan Benefit Package (PBP) and Formulary CY 2022 to collect plan bids to establish Medicare Advantage and Prescription Drug plan benefit package options for the next contract year. Comments are due by February 3, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - January 4, 2021 Category: Rural Health Source Type: news

CMS: Medicaid Program: Establishing Minimum Standards in Medicaid State Drug Utilization Review and Supporting Value-Based Purchasing for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability Requirements
Notice of final rule from the Centers for Medicare and Medicaid Services (CMS) regarding regulatory changes to support state flexibility to enter into value-based purchasing arrangements (VBPs) with manufacturers. This rule also implements provisions of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act designed to reduce opioid-related fraud, misuse, and abuse through the Medicaid Drug Utilization Review (DUR) program. This rule is effective March 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 31, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; Secure Electronic Prior Authorization For Medicare Part D
Notice of final rule from the Centers for Medicare and Medicaid Services (CMS) adopting a new standard for the Medicare Prescription Drug Benefit program's (Part D) e-prescribing program as required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT for Patients and Communities Act). This rule amends regulations to require Part D plan sponsors to support a National Council for Prescription Drug Programs (NCPDP) SCRIPT standard for use in certain electronic prior authorization transactions. This rule is effective February 1, 2021. (Source: Federal R...
Source: Federal Register updates via the Rural Assistance Center - December 31, 2020 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services (CMS) is seeking comments on the following information requests: 1) State Permissions for Enrollment in Qualified Health Plans in the Federally-Facilitated Exchange& Non-Exchange Entities and 2) Transparency in Coverage. Comments are due by March 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 30, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program; Secure Electronic Prior Authorization For Medicare Part D
Pre-publication notice of final rule from the Centers for Medicare and Medicaid Services (CMS) adopting a new standard for the Medicare Prescription Drug Benefit program's (Part D) e-prescribing program as required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT for Patients and Communities Act). This rule amends regulations to require Part D plan sponsors to support a National Council for Prescription Drug Programs (NCPDP) SCRIPT standard for use in certain electronic prior authorization transactions. This rule is effective 60 days after public...
Source: Federal Register updates via the Rural Assistance Center - December 30, 2020 Category: Rural Health Source Type: news

CHART Model Community Transformation Track Application Deadline Extension
The Centers for Medicare and Medicaid Services (CMS) extended the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track application deadline to March 16, 2021. The Community Transformation Track will provide funding to up to 15 rural communities to design systems of care that improve access to high quality care that is sustainable and value-based. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - December 30, 2020 Category: Rural Health Source Type: news

CMS Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; New Categories for Hospital Outpatient Department Prior Authorization Process; Clinical Laboratory Fee Schedule: Laboratory Date of Service Policy; Overall Hospital Quality Star Rating Methodology; Physician-owned Hospitals; Notice of Closure of Two Teaching Hospitals and Opportunity To Apply for Available Slots, Radiation Oncology Model; and Reporting Requirements for Hospitals and Critical Access Hospitals (CAHs) to Report COVID-19 Therapeutic Inventory and Usage and to Report Acute Respiratory Illness During the Public Health Emergency (PHE) for Coronavirus Disease 2019 (COVID-19)
Notice of final rule with comment period and interim final rule with comment period from the Centers for Medicare and Medicaid Services (CMS). The final rule revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021, updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program, and establishes and updates the Overall Hospital Quality Star Rating beginning with the 2021 calendar year, among other things. The interim final rule modifies the Radi...
Source: Federal Register updates via the Rural Assistance Center - December 29, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicaid Program: Establishing Minimum Standards in Medicaid State Drug Utilization Review and Supporting Value-Based Purchasing for Drugs Covered in Medicaid, Revising Medicaid Drug Rebate and Third Party Liability Requirements
Pre-publication notice of final rule from the Centers for Medicare and Medicaid Services (CMS) regarding regulatory changes to support state flexibility to enter into value-based purchasing arrangements (VBPs) with manufacturers. This rule also implements provisions of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act designed to reduce opioid-related fraud, misuse, and abuse through the Medicaid Drug Utilization Review (DUR) program. This rule is effective 60 days publication of this notice in the Federal Register, which is scheduled for December 3...
Source: Federal Register updates via the Rural Assistance Center - December 28, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; CY 2021 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19
Notice of final rule and interim final rule from the Centers for Medicare and Medicaid Services. The final rule includes changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; Medicare Shared Savings Program requirements; Medicaid Promoting Interoperability Program requirements for Eligible Professionals; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; Medicare enrollment of Opioid Treatment Programs; payment for off...
Source: Federal Register updates via the Rural Assistance Center - December 28, 2020 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Application for Enrollment in Medicare the Medical Insurance Program; 2) Request for Retirement Benefit Information; 3) Bid Pricing Tool (BPT) for Medicare Advantage (MA) Plans and Prescription Drug Plans (PDP); 4) Fast Track Appeals for Notice of Medicare Non-Coverage and Detailed Explanation of Non-Coverage and how to file the appeals request. Comments are due by January 22, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 23, 2020 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on an information collection for the development and testing of questionnaires, instrumentation, and data collection protocols for the Medicare Current Beneficiary Survey. Comments are due by January 22, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 23, 2020 Category: Rural Health Source Type: news

Now That Grandma Has Been Vaccinated, May I Visit Her?
The start of a mass coronavirus vaccination campaign at U.S. nursing homes has brought hope to many families. But it may be a while before restrictions loosen. Here are answers to common questions. (Source: NYT Health)
Source: NYT Health - December 21, 2020 Category: Consumer Health News Authors: Matt Richtel Tags: Nursing Homes Elderly Vaccination and Immunization Coronavirus (2019-nCoV) Elder Care Centers for Medicare and Medicaid Services American Health Care Assn Moderna Inc Pfizer Inc your-feed-healthcare Source Type: news

CMS: Medicaid Program; Patient Protection and Affordable Care Act; Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients' Electronic Access to Health Information for Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-facilitated Exchanges; Health Information Technology Standards and Implementation Specifications
Notice of proposed rule from the Centers for Medicare and Medicaid Services (CMS) that would place new requirements on state Medicaid and CHIP fee-for-service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data and streamline processes related to prior authorization. The Office of the National Coordinator for Health Information Technology (ONC) is also proposing the adoption of certain specified implementation guides (IGs) needed to support the proposed Applicatio...
Source: Federal Register updates via the Rural Assistance Center - December 18, 2020 Category: Rural Health Source Type: news

CMS Office of the Actuary Releases 2019 National Health Expenditures
The Office of the Actuary at the Centers for Medicare and Medicaid Services (CMS) published a report detailing national healthcare spending in 2019. Report shows total national healthcare spending in 2019 grew 4.6%, breaks down several types of spending data, including health insurance spending, hospital spending, retail prescription drug spending, and government spending. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - December 16, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicaid Program: Patient Protection and Affordable Care Act; Reducing Provider and Patient Burden by Improving Prior Authorization Processes, and Promoting Patients' Electronic Access to Health Information for Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, and Issuers of Qualified Health Plans on the Federally-facilitated Exchanges; Health Information Technology Standards and Implementation Specifications
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services (CMS) that would place new requirements on state Medicaid and CHIP fee-for-service (FFS) programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to improve the electronic exchange of health care data and streamline processes related to prior authorization. The Office of the National Coordinator for Health Information Technology (ONC) is also proposing the adoption of certain specified implementation guides (IGs) needed to support the pro...
Source: Federal Register updates via the Rural Assistance Center - December 15, 2020 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Mandatory Insurer Reporting Requirements of Section 111 of the Medicare, Medicaid and SCHIP Act of 2007; 2) Part D Coordination of Benefits Data; and 3) Medicare Current Beneficiary Survey. Comments are due by January 6, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 7, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Final Policy Changes and Fiscal Year 2021 Rates; Quality Reporting and Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals; Correction
Pre-publication notice from the Centers for Medicare and Medicaid Services making technical and typographical corrections to theSeptember 18, 2020 final rule. Corrections are effective December 1, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 7, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; New Categories for Hospital Outpatient Department Prior Authorization Process; Clinical Laboratory Fee Schedule: Laboratory Date of Service Policy; Overall Hospital Quality Star Rating Methodology; Physician-owned Hospitals; Notice of Closure of Two Teaching Hospitals and Opportunity To Apply for Available Slots, Radiation Oncology Model; and Reporting Requirements for Hospitals and Critical Access Hospitals (CAHs) to Report COVID-19 Therapeutic Inventory and Usage and to Report Acute Respiratory Illness During the Public Health Emergency (PHE) for Coronavirus Disease 2019 (COVID-19)
Pre-publication notice of final rule with comment period and interim final rule with comment period from the Centers for Medicare and Medicaid Services (CMS). The final rule revises the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021, updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program, and establishes and updates the Overall Hospital Quality Star Rating beginning with the 2021 calendar year, among other things. The interim final rule m...
Source: Federal Register updates via the Rural Assistance Center - December 4, 2020 Category: Rural Health Source Type: news

HHS: Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2022 and Pharmacy Benefit Manager Standards
Notice of a proposed rule with comment period from the Centers for Medicare and Medicaid Services and Department of Health and Human Services related to risk adjustment, user fees, and cost-sharing for state and federal-based exchanges; policies related to prescription drug costs; the Navigator program; and more. Comments are due by December 30, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 4, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program; CY 2021 Payment Policies under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Medicaid Promoting Interoperability Program Requirements for Eligible Professionals; Quality Payment Program; Coverage of Opioid Use Disorder Services Furnished by Opioid Treatment Programs; Medicare Enrollment of Opioid Treatment Programs; Electronic Prescribing for Controlled Substances for a Covered Part D Drug; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy; Coding and Payment for Virtual Check-in Services Interim Final Rule Policy; Coding and Payment for Personal Protective Equipment (PPE) Interim Final Rule Policy; Regulatory Revisions in Response to the Public Health Emergency (PHE) for COVID-19; and Finalization of Certain Provisions from the March 31st, May 8th and September 2nd Interim Final Rules in Response to the PHE for COVID-19
Pre-publication notice of final rule and interim final rule from the Centers for Medicare and Medicaid Services. The final rule includes changes to Medicare Part B payment policies to ensure that payment systems are updated to reflect changes in medical practice, relative value of services, and changes in the statute; Medicare Shared Savings Program requirements; Medicaid Promoting Interoperability Program requirements for Eligible Professionals; updates to the Quality Payment Program; Medicare coverage of opioid use disorder services furnished by opioid treatment programs; Medicare enrollment of Opioid Treatment Programs;...
Source: Federal Register updates via the Rural Assistance Center - December 3, 2020 Category: Rural Health Source Type: news

CMS Announces New Model to Advance Regional Value-Based Care in Medicare
The Centers for Medicare and Medicaid Services (CMS) announced the Geographic Direct Contracting Model, in which model participants will coordinate care and clinical management for beneficiaries in Original Medicare in their region. The model aims to reduce the cost of care for Medicare beneficiaries and give participants a direct incentive to improve care across entire geographic regions. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - December 3, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; Modernizing and Clarifying the Physician Self-Referral Regulations
Notice of proposed rule from the Centers for Medicare and Medicaid Services regarding the physician self-referral law to allow exceptions to the law for referral for certain value-based compensation arrangements between physicians, providers, and suppliers. This final rule is effective January 19, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 2, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program: Specialty Care Models to Improve Quality of Care and Reduce Expenditures; Correction
Notice from the Centers for Medicare and Medicaid Services making technical and typographical corrections to theSeptember 29, 2020 final rule. Corrections are effective December 2, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 2, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Final Policy Changes and Fiscal Year 2021 Rates; Quality Reporting and Medicare and Medicaid Promoting Interoperability Programs Requirements for Eligible Hospitals and Critical Access Hospitals; Correction
Pre-publication notice from the Centers for Medicare and Medicaid Services making technical and typographical corrections to theSeptember 18, 2020 final rule. Corrections are effective upon publication in the Federal Register, which is scheduled for December 7, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 2, 2020 Category: Rural Health Source Type: news

Public Inspection: HHS: Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2022 and Pharmacy Benefit Manager Standards
Pre-publication notice of a proposed rule with comment period from the Centers for Medicare and Medicaid Services and Department of Health and Human Services related to risk adjustment, user fees, and cost-sharing for state and federal-based exchanges; policies related to prescription drug costs; the Navigator program; and more. Comments are due by December 30, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 2, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Specialty Care Models to Improve Quality of Care and Reduce Expenditures; Correction
Pre-publication notice from the Centers for Medicare and Medicaid Services making technical and typographical corrections to theSeptember 29, 2020 final rule. Corrections are effective upon publication in the Federal Register, which is scheduled for December 2, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 1, 2020 Category: Rural Health Source Type: news

CMS, HHS: Amendments to the HHS-Operated Risk Adjustment Data Validation (HHS-RADV) Under the Patient Protection and Affordable Care Act's HHS-Operated Risk Adjustment Program
Notice of final rule from the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to adopt certain changes to the risk adjustment data validation error estimation methodology beginning with the 2019 benefit year. These regulations are effective December 31, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - December 1, 2020 Category: Rural Health Source Type: news

Trump Administration Finalizes Permanent Expansion of Medicare Telehealth Services and Improved Payment for Time Doctors Spend with Patients
The Centers for Medicare and Medicaid Services (CMS) released the annual Physician Fee Schedule (PFS) final rule, increasing payments to physicians and practitioners for the additional time they spend with patients, especially those with chronic conditions. This final rule adds more than 60 services to the Medicare telehealth list that will continue to be covered beyond the end of the COVID-19 pandemic. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - December 1, 2020 Category: Rural Health Source Type: news

Public Inspection: HHS, CMS: HHS-operated Risk Adjustment Data Validation under the Patient Protection and Affordable Care Act's HHS-operated Risk Adjustment Program
Pre-publication notice of final rule from the Department of Health and Human Services and the Centers for Medicare and Medicaid Services (CMS) to adopt certain changes to the risk adjustment data validation error estimation methodology beginning with the 2019 benefit year. These regulations are effective 30 days after publication, which is scheduled for December 1, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - November 27, 2020 Category: Rural Health Source Type: news

CMS: Most Favored Nation Model
Notice from the Centers for Medicare and Medicaid Services (CMS) of an interim final rule with comment period implementing the Most Favored Nation (MFN) Model. The MFN Model will test whether more closely aligning payment for Medicare Part B drugs and biologicals with international prices and removing incentives to use higher-cost drugs can control growth in Medicare Part B spending without adversely affecting the quality of care for beneficiaries. Comments are due by January 26, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - November 27, 2020 Category: Rural Health Source Type: news

CMS Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge
The Centers for Medicare and Medicaid Services (CMS) outlined comprehensive steps to increase healthcare system capacity to provide care to patients outside of a traditional hospital setting in response to a rise in COVID-19 hospitalizations. Efforts include the development of the Acute Hospital Care At Home program and new flexibilities for Ambulatory Surgical Centers. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - November 25, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program; Modernizing and Clarifying the Physician Self-Referral Regulations
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services regarding the physician self-referral law to allow exceptions to the law for referral for certain value-based compensation arrangements between physicians, providers, and suppliers. This final rule is effective January 19, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - November 23, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; National Expansion of the Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transports
Notice from the Centers for Medicare and Medicaid Services (CMS) announcing the national expansion of the Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transports to all states, but delaying the implementation of the expansion to all additional states due to the COVID-19 Public Health Emergency. The model will continue to operate in the states currently participating in the model. CMS will continue to monitor the Public Health Emergency and will provide public notice before implementing the model in additional states. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - November 23, 2020 Category: Rural Health Source Type: news

CMS: Medicare, Medicaid, and Children's Health Insurance Programs; Provider Enrollment Application Fee Amount for Calendar Year 2021
Notice from the Centers for Medicare and Medicaid Services announcing the application fee for providers that are initially enrolling in the Medicare or Medicaid programs, or the Children's Health Insurance Program (CHIP); revalidating their Medicare, Medicaid, or CHIP enrollment; or adding a new Medicare practice location. The new fee is $599 and is required for applications submitted January 1, 2021 through December 31, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - November 23, 2020 Category: Rural Health Source Type: news