CMS: Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Expenses
Notice from the Centers for Medicare and Medicaid Services (CMS) on a final rule amending Medicare Advantage regulations and the Prescription Drug Benefit program regulations to help reduce out-of-pocket costs and lower drug prices. The regulations will take effect January 1, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 23, 2019 Category: Rural Health Source Type: news

Baylor St. Luke ’s Medical Center takes steps after federal review reveals conditions posing ‘immediate jeopardy’
Baylor St. Luke ’s Medical Center, a prominent hospital in the Texas Medical Center in Houston, has released another list of corrections it is implementing in the wake of a federal review. The Centers for Medicare and Medicaid Services surveyed the hospital between March 25 and April 4, 2019. In a 203-page repor t, CMS outlined several “deficient practices” identified during that survey that “were determined to pose immediate jeopardy to patient health and safety, and placed all patients at… (Source: bizjournals.com Health Care:Physician Practices headlines)
Source: bizjournals.com Health Care:Physician Practices headlines - May 21, 2019 Category: American Health Authors: Olivia Pulsinelli Source Type: news

Baylor St. Luke ’s Medical Center takes steps after federal review reveals conditions posing ‘immediate jeopardy’
Baylor St. Luke ’s Medical Center, a prominent hospital in the Texas Medical Center in Houston, has released another list of corrections it is implementing in the wake of a federal review. The Centers for Medicare and Medicaid Services surveyed the hospital between March 25 and April 4, 2019. In a 203-page repor t, CMS outlined several “deficient practices” identified during that survey that “were determined to pose immediate jeopardy to patient health and safety, and placed all patients at… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - May 21, 2019 Category: Biotechnology Authors: Olivia Pulsinelli Source Type: news

Mallinckrodt Files Suit against U.S. Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) to Protect Medicaid Patient Access to Acthar(R) Gel
Company challenges CMS' unexplained and unlawful reversal of its repeated 2012 written authorizations on calculation of Medicaid Rebates for Acthar Gel After extensive efforts to resolve matter, Mallinckrodt seeks Court intervention to ensure that CMS f... Biopharmaceuticals, Reimbursement, Litigation Mallinckrodt, Acthar Gel (Source: HSMN NewsFeed)
Source: HSMN NewsFeed - May 21, 2019 Category: Pharmaceuticals Source Type: news

CMS: Medicare Program; Approved Renewal of Deeming Authority of the Utilization Review Accreditation Commission for Medicare Advantage Health Maintenance Organizations and Local Preferred Provider Organizations
The Centers for Medicare and Medicaid Services (CMS) renews the authority of the Utilization Review Accreditation Commission (URAC) to accredit preferred provider and health maintenance organizations for Medicare Advantage. The renewal is effective May 31, 2019 until June 2, 2025. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 21, 2019 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
The Centers for Medicare and Medicaid Services (CMS) requests comments on two information collections. One revision would approve an electronic version of hospital reports of deaths associated with seclusion or restraint and the other would continue requiring rate filing justifications for unreasonable increases in health insurance premiums. Comments are due June 19, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 20, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS: Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Expenses
Pre-publication notice from the Centers for Medicare and Medicaid Services (CMS) on a final rule amending Medicare Advantage regulations and the Prescription Drug Benefit program regulations to help reduce out-of-pocket costs and lower drug prices. The regulations will take effect January 1, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 16, 2019 Category: Rural Health Source Type: news

CMS: Medicare and Medicaid Programs: Regulation to Require Drug Pricing Transparency
Notice of a final rule from the Centers for Medicare and Medicaid Services (CMS) that would require television advertisements of prescription drugs and biological products for which payment is available through Medicare or Medicaid to include the list price of the product to help beneficiaries make informed decisions and reduce costs. The rule will go into effect July 9, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 10, 2019 Category: Rural Health Source Type: news

TV Ads for Drugs Must Now Include Prices. It ’s the Latest Effort to Drive Down Pharmaceutical Costs
At a time when nearly a fifth of Americans have struggled to pay medical bills, the Trump Administration will soon require drug companies to list medication prices in television advertisements. It’s a move meant to boost transparency and drive down ballooning drug costs. The rule, which is set to go into effect this summer, will require commercials to mention the list price of any prescription drug that is covered by Medicare or Medicaid, if it costs at least $35 for a month’s supply or the usual course of treatment. That will affect many ads viewers see on television, since, according to the Department of Heal...
Source: TIME: Health - May 9, 2019 Category: Consumer Health News Authors: Jamie Ducharme Tags: Uncategorized Drugs onetime Source Type: news

Drug Prices Will Soon Appear in Many TV Ads
A Trump administration change will require TV ads for prescription drugs covered by Medicare or Medicaid to include the list price if it is over $35. (Source: NYT Health)
Source: NYT Health - May 8, 2019 Category: Consumer Health News Authors: GLENN THRUSH and KATIE THOMAS Tags: Drugs (Pharmaceuticals) Prices (Fares, Fees and Rates) Health Insurance and Managed Care Centers for Medicare and Medicaid Services Azar, Alex M II Trump, Donald J your-feed-healthcare Source Type: news

Public Inspection: CMS: Medicare and Medicaid Programs: Regulation to Require Drug Pricing Transparency
Pre-publication notice of a final rule from the Centers for Medicare and Medicaid Services (CMS) that would require television advertisements of prescription drugs and biological products for which payment is available through Medicare or Medicaid to include the list price of the product to help beneficiaries make informed decisions and reduce costs. The rule will go into effect 60 days after publication of this notice in the Federal Register, which is scheduled for May 10, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 8, 2019 Category: Rural Health Source Type: news

Putting our Rethinking Rural Health Strategy into Action
Blog post from the Centers for Medicare and Medicaid Services (CMS) Administrator about initiatives CMS has undertaken to advance rural health. Focuses on the CMS Rural Health Strategy, which seeks to reduce unintended CMS policy impacts on rural healthcare and strengthen rural health. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - May 8, 2019 Category: Rural Health Source Type: news

Remarks by Administrator Seema Verma at the National Rural Health Association Annual Conference
The Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma spoke today at the National Rural Health Association Conference in Atlanta, Georgia. Her speech addresses some of the healthcare challenges facing rural communities and success stories, as well as CMS efforts to improve rural health. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - May 8, 2019 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 Proposed Policy Changes and Fiscal Year 2020 Rates; Proposed Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Promoting Interoperability Programs Proposed Requirements for Eligible Hospitals and Critical Access Hospitals
Notice from the Centers for Medicare and Medicaid Services of a proposed rule regarding changes to critical access hospital (CAH) payments, Medicare graduate medical education for teaching hospitals, and Medicare hospital inpatient prospective payment systems (IPPS) for capital and operating costs of acute care hospitals. The rule also proposes new quality requirements and revisions related to current requirements. Comments are due June 24, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - May 3, 2019 Category: Rural Health Source Type: news

CMS: Draft Guidance for Hospital Co-location with Other Hospitals or Healthcare Facilities
The Centers for Medicare and Medicaid Services (CMS) is releasing a draft guidance to help hospitals make decisions about space sharing and contracted staff arrangements. Comments on the draft policies will be due July 2, 2019. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - May 3, 2019 Category: Rural Health Source Type: news

CMS: Medicare and Medicaid Programs: Risk Adjustment Data Validation
Notice from the Centers for Medicare and Medicaid Services (CMS) announcing the release of additional data underlying the proposed policies for the Fee-for-Service (FFS) Adjuster. The notice also extends the comment period on the Risk Adjustment Data Validation (RADV) provisions of the proposed ruleMedicare and Medicaid Programs; Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and 2021 until August 28, 2019. (Source: Federal Register updates v...
Source: Federal Register updates via the Rural Assistance Center - April 30, 2019 Category: Rural Health Source Type: news

CMS, HHS: Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2020
Notice of a final rule 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. The rule will be effective June 24, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 25, 2019 Category: Rural Health Source Type: news

CMS Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2020
Notice of a proposed rule from the Centers for Medicare and Medicaid Services seeking comments on updates to the prospective payment system for skilled nursing facilities (SNFs) for fiscal year 2020, including changes for the Patient Drive Payment Model (PDPM). Includes proposals for the SNF quality reporting program and the value-based purchasing program that will affect Medicare payment to SNFs. Comments are also sought on the appropriateness of the wage index used to adjust SNF payments. Includes rural considerations throughout. Comments are due by June 18, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 25, 2019 Category: Rural Health Source Type: news

CMS: Medicare Program: Fiscal Year 2020 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements
Notice of a proposed rule from the Centers for Medicare and Medicaid Services updating the hospice wage index, payment rates, and cap amount for fiscal year 2020. Provides details of the proposed changes, including those that impact rural hospice programs, as well as updates to the Hospice Quality Reporting Program. Comments are due by June 18, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 25, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare and Medicaid Programs: Risk Adjustment Data Validation
Pre-publication notice from the Centers for Medicare and Medicaid Services (CMS) announcing the release of additional data underlying the proposed policies for the Fee-for-Service (FFS) Adjuster. The notice also extends the comment period on the Risk Adjustment Data Validation (RADV) provisions of the proposed ruleMedicare and Medicaid Programs; Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Program of All-inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and 2021 until August 28, 2019. This notice is sche...
Source: Federal Register updates via the Rural Assistance Center - April 25, 2019 Category: Rural Health Source Type: news

CMS Proposes 5 Rules Affecting FY20 Payment & Quality Programs
The Centers for Medicare and Medicaid Services has released 5 proposed rules that would affect Fiscal Year 2020 payment and quality programs. They include: 1) Proposed FY 2020 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) addressing inequalities in rural health& barriers to medical innovation; 2) Inpatient Rehabilitation Facility (IRF): FY 2020 Proposed Payment and Policy Changes; 3) Inpatient Psychiatric Facility (IPF): FY 2020 Proposed Payment and Quality Reporting Updates; 4) Skilled Nursing Facilities (SNF): FY 2020 Proposed Payment and Polic...
Source: News stories via the Rural Assistance Center - April 24, 2019 Category: Rural Health Source Type: news

CMS: Medicare Program; Inpatient Rehabilitation Facility (IRF) Prospective Payment System for Federal Fiscal Year 2020 and Updates to the IRF Quality Reporting Program
Notice of a proposed rule from the Centers for Medicare and Medicaid Services updating the prospective payment rates and the methods and data for calculating them for inpatient rehabilitation facilities (IRF). The proposed rule also addresses changes to the IRF Quality Reporting Program (QRP) and data collection. Comments are due June 17, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 24, 2019 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request
Notice from the Centers for Medicare and Medicaid Services (CMS) of revision to an approved information collection that would implement and test the Medicare Advantage Qualifying Payment Arrangement Incentive (MAQI) Demonstration. Comments are due May 24, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 24, 2019 Category: Rural Health Source Type: news

CMS: Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2020 and Updates to the Inpatient Rehabilitation Facility Quality Reporting Program
Notice of a proposed rule from the Centers for Medicare and Medicaid Services seeking comments on updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2020, including amendments to the weighting factors for the case-mix groups, updates to the IRF wage index, and new measures for the IRF Quality Reporting Program. Includes rural considerations throughout. Comments are due by June 17, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 24, 2019 Category: Rural Health Source Type: news

Medicare offers to partially raise payment for cancer CAR-Ts
The U.S. Centers for Medicare and Medicaid Services will slightly increase coverage for expensive CAR-T cell therapies administered at certain large hospitals, and is considering other ways to pay more for the cancer treatments, the agency said on Tuesday. (Source: Reuters: Health)
Source: Reuters: Health - April 24, 2019 Category: Consumer Health News Tags: healthNews Source Type: news

Mandating public health emergency preparedness: analysis of the CMS rule - Myers N, Bearss A.
Public health emergency preparedness is an area of growing policy concern with the emergence of new threats. The Centers for Medicare and Medicaid Services issued a proposed rule in 2013 laying out mandates that hospitals and other facilities would have to... (Source: SafetyLit)
Source: SafetyLit - April 23, 2019 Category: International Medicine & Public Health Tags: Disaster Preparedness Source Type: news

CMS: Medicare Program; FY 2020 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2019 (FY 2020)
Notice of proposed rule from the Centers for Medicare and Medicaid Services updating the FY 2020 prospective payment rates, outlier threshold, and wage index for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF), including psychiatric hospitals and excluded psychiatric units of an acute care hospital or Critical Access Hospital. The proposed rule also requests comment on the IPF wage index and proposes updates to quality and reporting measures, among other things. Comments on the proposed rule are due on June 17, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 23, 2019 Category: Rural Health Source Type: news

CMS: Medicare and Medicaid Programs: Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans in the Federally-facilitated Exchanges and Health Care Providers; Supplement and Extension of Comment Period
Notice of from the Centers for Medicare and Medicaid Services extending the comment period for theMarch 4th proposed rule with the same title. Comments are now due on June 3, 2019 and effective dates of policies related to the rule will be adjusted as necessary based on public comments. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 23, 2019 Category: Rural Health Source Type: news

CMS Advances Agenda to Re-Think Rural Health and Unleash Medical Innovation
The Centers for Medicare and Medicaid Services (CMS) have announced proposed changes to update the Medicare payment policies for hospitals in the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) for the fiscal year 2020. The proposed rule changes support two CMS top priorities: Rethinking Rural Health and Unleashing Innovation. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - April 23, 2019 Category: Rural Health Source Type: news

CMS Proposes Wage Index Hike for Rural Hospitals
The Centers for Medicare and Medicaid Services is proposing changes to the inpatient hospital wage index intended to help hospitals in rural areas, including changes to the rural floor wage index and increases for hospitals with low wage indexes. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - April 23, 2019 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 Proposed Policy Changes and Fiscal Year 2020 Rates; Proposed Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Promoting Interoperability Programs Proposed Requirements for Eligible Hospitals and Critical Access Hospitals
Pre-publication notice from the Centers for Medicare and Medicaid Services of a proposed rule regarding changes to critical access hospital (CAH) payments, Medicare graduate medical education for teaching hospitals, and Medicare hospital inpatient prospective payment systems (IPPS) for capital and operating costs of acute care hospitals. The rule also proposes new quality requirements and revisions related to current requirements. The notice is scheduled to be published May 3, 2019 and comments will be due June 24, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 23, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS, HHS: Patient Protection and Affordable Care Act: HHS Notice of Benefit and Payment Parameters for 2020
Pre-publication notice of final rule 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. The rule will be effective 60 days after publication of this notice in the Federal Register, which is scheduled for April 25, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 22, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS Medicare Program: Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2020
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services seeking comments on updates to the prospective payment system for skilled nursing facilities (SNFs) for fiscal year 2020, including changes for the Patient Drive Payment Model (PDPM). Includes proposals for the SNF quality reporting program and the value-based purchasing program that will affect Medicare payment to SNFs. Comments are also sought on the appropriateness of the wage index used to adjust SNF payments. Includes rural considerations throughout. The official publication of this notice in the Federal Register is April 25, 2...
Source: Federal Register updates via the Rural Assistance Center - April 22, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Fiscal Year 2020 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2019
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services updating the FY 2020 prospective payment rates, outlier threshold, and wage index for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF), including psychiatric hospitals and excluded psychiatric units of an acute care hospital or Critical Access Hospital. The proposed rule also requests comment on the IPF wage index and proposes updates to quality and reporting measures, among other things. The notice will be officially published in the Federal Register on April 23, 2019 and comments are due on J...
Source: Federal Register updates via the Rural Assistance Center - April 22, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Fiscal Year 2020 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services updating the hospice wage index, payment rates, and cap amount for fiscal year 2020. Provides details of the proposed changes, including those that impact rural hospice programs, as well as updates to the Hospice Quality Reporting Program. This notice will officially be published in the Federal Register on April 25, 2019 and comments are due by June 18, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 22, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare and Medicaid Programs: Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans in the Federally-facilitated Exchanges and Health Care Providers; Supplement and Extension of Comment Period
Pre-publication notice of from the Centers for Medicare and Medicaid Services extending the comment period for theMarch 4th proposed rule with the same title. Comments are now due on June 3, 2019 and effective dates of policies related to the rule will be adjusted as necessary based on public comments. This notice will officially be published in the Federal Register on April 23, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 22, 2019 Category: Rural Health Source Type: news

CMS: Medicare Program; Update to the Required Prior Authorization List of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items That Require Prior Authorization as a Condition of Payment
Notice from the Centers for Medicare and Medicaid Services announcing the addition of 12 codes to the Healthcare Common Procedure Coding System (HCPCS) Required Prior Authorization List of Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items that require prior authorization as a condition of payment. Implementation of Phase 1 of this rule will be effective on July 22, 2019 and Phase 2 will be effective on October 21, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 22, 2019 Category: Rural Health Source Type: news

CMS: Medicare Program; Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items; Update to the Master List of Items Frequently Subject to Unnecessary Utilization
Notice from the Centers for Medicare and Medicaid Services adding four codes to the Healthcare Common Procedure Coding Systems (HCPCS) Master List of Items Frequently Subject to Unnecessary Utilization that could potentially be subject to prior authorization as a condition of payment. The rule is effective on May 22, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 22, 2019 Category: Rural Health Source Type: news

Proposed Fiscal Year 2020 Payment and Policy Changes for Medicare Skilled Nursing Facilities (CMS-1718-P)
Fact sheet from the Centers for Medicare and Medicaid Services (CMS) announcing a proposed rule to update fiscal year (FY) 2020 payment rates and quality programs for skilled nursing facilities (SNFs) under the SNF Prospective Payment System (PPS), the SNF Value-Based Purchasing Program (VBP), and the SNF Quality Reporting Program (QRP). (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - April 19, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2020 and Updates to the Inpatient Rehabilitation Facility Quality Reporting Program
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services seeking comments on updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2020, including amendments to the weighting factors for the case-mix groups, updates to the IRF wage index, and new measures for the IRF Quality Reporting Program. Includes rural considerations through. The official publication of this notice in the Federal Register is April 24, 2019. Comments are due by June 17, 2019. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - April 18, 2019 Category: Rural Health Source Type: news

CMS Proposes Small Boost to Inpatient Rehab Facility Payments
Highlights the impact of the Centers for Medicare and Medicaid Services' proposed rule to update payments systems for inpatient rehabilitation facilities in fiscal year 2020. Payments per discharge for facilities in urban areas will increase by 2.2%, while those in rural areas will be 4.3% higher than in FY2019. Freestanding rehabilitation hospitals will not see the same increase, and in fact will receive a 2% lower per discharge payment in rural areas. (May require subscription to view full article.) (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - April 17, 2019 Category: Rural Health Source Type: news

Medicare and Medicaid Programs: Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, etc.
Notice from the Centers for Medicare and Medicaid Services of a final rule regarding changes to Medicare Advantage and Medicare Part D policies. The changes increase access to telehealth services for Medicare Advantage beneficiaries, revise how the star ratings are calculated and technical changes related to quality improvement, update the grievances and appeals requirements, and more. Some provisions will go into effect June 17, 2019, some go into effect January 1, 2020, and others go into effect January 1, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 16, 2019 Category: Rural Health Source Type: news

Medicare Aims to Expand Coverage of Cancer Care. But Is It Enough?
Doctors and patients are pushing the Trump administration to pay for a powerful but costly cancer treatment known as CAR-T, one of many new “ personalized medicines. ” (Source: NYT Health)
Source: NYT Health - April 13, 2019 Category: Consumer Health News Authors: ROBERT PEAR Tags: Health Insurance and Managed Care Drugs (Pharmaceuticals) Medicare Immunotherapy Cancer Centers for Medicare and Medicaid Services Hospitals Source Type: news

Is your health in check?
Health care is big business in the U.S. — accounting for 17.9 percent of the gross domestic product with $3.5 trillion, or $10,739 per person, spent in 2017, reports the Centers for Medicare and Medicaid Services. And your personal health, and that of your loved ones, should be important business too. The Dayton Business Journal reach ed out to a handful of physicians and specialists in the Dayton region to find out what different age groups should be most cognizant of as they continue aging.… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - April 12, 2019 Category: Biotechnology Authors: Hannah Poturalski Source Type: news

CMS proposes improved ambulatory BP coverage
The U.S. Centers for Medicare & Medicaid Services recently released a proposed decision memo stating that it believes there is evidence sufficient to support the use of ambulatory blood pressure monitoring for diagnosing and treating hypertension in its beneficiaries. The agency laid out circumstances for reimbursement coverage, including white coat hypertension verified through at least two separate clinic or office visits with separate measurements three months apart or suspected masked hypertension, measured similarly. To qualify for coverage, the devices must be quality certified and validated for use in the intend...
Source: Mass Device - April 10, 2019 Category: Medical Devices Authors: Fink Densford Tags: Blood Management Business/Financial News Centers for Medicare and Medicaid Services (CMS) Source Type: news

Tele-EMS Improves Productivity and Reduces Overall Costs
Nationally, it’s estimated that prehospital EMS responds to nearly 40 million annual incidents per year, with two-thirds of these cases requiring ambulance transport to a hospital ED.1 A significant volume of prehospital care is delivered through municipal fire or EMS agencies, which are typically government-funded and have constraints on their ability to raise tax rates or revenues. Many of the calls to 9-1-1 across the nation are not acute or urgent in nature, yet they frequently require the same rapid, resource-intensive response as true emergencies.2 It’s estimated that somewhere between 20–40% of EMS...
Source: JEMS Operations - April 9, 2019 Category: Emergency Medicine Authors: James Langabeer II, PhD, EMT Tags: Exclusive Articles Operations Source Type: news

Available Now: New Resources for the Promoting Interoperability Programs
Press release from the Centers for Medicare and Medicaid Services on updates to their Promoting Interoperability Programs website. Highlights resources for Critical Access Hospitals and other hospitals. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - April 9, 2019 Category: Rural Health Source Type: news

CMS: Clinical Laboratory Improvement Amendments of 1988 (CLIA) Proficiency Testing Regulations Related to Analytes and Acceptable Performance
Notice from the Centers for Medicare and Medicaid Services (CMS) that they are extending the comment period for the previously proposed rule "Clinical Laboratory Improvement Amendments of 1988 (CLIA) Proficiency Testing Regulations Related to Analytes and Acceptable Performance" published in the February 4, 2019 Federal Register. Comments will be extended 60 days past the original April 5, 2019 deadline and are now due June 4, 2019. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 8, 2019 Category: Rural Health Source Type: news

Public Inspection: Medicare and Medicaid Programs: Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, etc.
Pre-publication notice from the Centers for Medicare and Medicaid Services of a final rule regarding changes to Medicare Advantage and Medicare Part D policies. The changes increase access to telehealth services for Medicare Advantage beneficiaries, revise how the star ratings are calculated and technical changes related to quality improvement, update the grievances and appeals requirements, and more. Some provisions will go into effect 60 days after publication of this notice in the Federal Register, which is scheduled for publication April 16, some go into effect January 1, 2020, and others go into effect January 1, 2021...
Source: Federal Register updates via the Rural Assistance Center - April 5, 2019 Category: Rural Health Source Type: news

Public Inspection: CMS: Clinical Laboratory Improvement Amendments of 1988 (CLIA) Proficiency Testing Regulations Related to Analytes and Acceptable Performance
Pre-publication notice from the Centers for Medicare and Medicaid Services (CMS) that they are extending the comment period for the previously proposed rule "Clinical Laboratory Improvement Amendments of 1988 (CLIA) Proficiency Testing Regulations Related to Analytes and Acceptable Performance" published in the February 4, 2019 Federal Register. Comments will be extended 60 days past the original April 5, 2019 deadline. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - April 4, 2019 Category: Rural Health Source Type: news