CMS releases new payment model for radiation oncology
The U.S. Centers for Medicare and Medicaid Services (CMS) today released its...Read more on AuntMinnie.comRelated Reading: Groups tout value of nuclear medicine to Congress Expanded Medicaid tied to more thyroid cancer diagnoses CMS approves payments for Viz.ai software No need to defer cancer treatment for fear of COVID-19 Radiology's declining reimbursement spans over a decade (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - September 18, 2020 Category: Radiology 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
Notice of final rule from the Centers for Medicare and Medicaid Services to revise the FY 2021 Medicare hospital inpatient prospective payment systems (IPPS) for capital and operating costs of acute care hospitals, make changes to Medicare graduate medical education (GME) for teaching hospitals and payments to Critical Access Hospitals (CAHs). Also provides the market basket updated that applies to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis, updates payment policies and rates for the Medicare prospective payment system (PPS) for inpatient hospital servi...
Source: Federal Register updates via the Rural Assistance Center - September 18, 2020 Category: Rural Health Source Type: news

CMS: Privacy Act of 1974; Matching Program
Notice from the Centers for Medicare and Medicaid Services (CMS) seeking comment on reestablishing the "Do Not Pay Initiative" computer matching program between CMS and the Department of the Treasury. The program provides CMS with information from Treasury's Working System which CMS will use to identify Medicare providers and suppliers who are ineligible for Medicare enrollment; to promptly suspend or revoke the Medicare billing privileges of the identified disqualified providers and suppliers; to enable recoupment of past payments made to those providers and suppliers; to assist CMS in detecting and preventing f...
Source: Federal Register updates via the Rural Assistance Center - September 17, 2020 Category: Rural Health Source Type: news

CMS Announces New Guidance for Safe Visitation in Nursing Homes During COVID-19 Public Health Emergency
The Centers for Medicare and Medicaid Services (CMS) issued new guidance for nursing homes on safely facilitating visitations during the COVID-19 pandemic. Recommendations include encouraging nursing homes to utilize outdoor visitation and only allowing indoor visitation if there have been no new cases of COVID-19 in 14 days. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - September 17, 2020 Category: Rural Health Source Type: news

CMS Releases CHART Model Notice of Funding Opportunity, Encourages Rural Communities to Apply
The Centers for Medicare and Medicaid Services (CMS) released a Notice of Funding Opportunity (NOFO) for the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track. 15 rural communities will be chosen to receive up-front funding from the Community Transformation Track to help design systems that improve access high quality care. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - September 15, 2020 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comments on a revision to an information collection titled "Medicare Current Beneficiary Survey." The Medicare Current Beneficiary Survey (MCBS) is a nationally-representative, longitudinal survey of Medicare beneficiaries that helps CMS and stakeholders understand and evaluate the impact of Medicare programs and new policy initiatives. Comments are due by November 16, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - September 15, 2020 Category: Rural Health Source Type: news

CMS Issues New Roadmap for States to Accelerate Adoption of Value-Based Care to Improve Quality of Care for Medicaid Beneficiaries
The Centers for Medicare and Medicaid Services (CMS) issued guidance to state Medicaid directors to aid in the adoption of value-based care strategies across their healthcare systems. The guidance includes an assessment of key lessons in implementing value-based care reforms and a comprehensive toolkit of available federal authorities to help states adopt innovative payment reform efforts. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - September 15, 2020 Category: Rural Health Source Type: news

COVID-19 is Still Devastating Nursing Homes. The Trump Administration Isn ’t Doing Much To Stop It
At least 75,000 Americans in nursing homes and other long-term care facilities have already died from COVID-19—and the devastation is far from over. After a decrease earlier this summer, the death toll is now rising once again, and as the country heads into the fall and then flu season, millions of Americans who require institutional long-term care remain at the greatest risk. But, so far, the Trump Administration has talked a big talk—and mostly failed to deliver. The White House trumpeted its efforts to send personal protective equipment (PPE) and testing materials to long-term care facilities, but the suppli...
Source: TIME: Health - September 11, 2020 Category: Consumer Health News Authors: Abigail Abrams Tags: Uncategorized COVID-19 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) Comprehensive Outpatient Rehabilitation Facility (CORF) Certification and Survey Forms; 2) Generic Clearance for the Center for Clinical Standards and Quality IT Product and Support Teams; 3) Pharmacy Benefit Manager Transparency; and 4) Value in Opioid Use Disorder Treatment Demonstration. Comments are due by October 13, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - September 11, 2020 Category: Rural Health Source Type: news

Unity Center for Behavioral Health responds to another round of patient safety complaints
Unity has submitted a plan of correction to the Centers for Medicare and Medicaid Services and the Oregon Health Authority. (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - September 9, 2020 Category: Biotechnology Authors: Elizabeth Hayes Source Type: news

CMS: Medicare and Medicaid Programs; Adjustment of Civil Monetary Penalties for Inflation; Continuation of Effectiveness and Extension of Timeline for Publication of the Final Rule
The Centers for Medicare and Medicaid Services has announced a continuation of, effectiveness of, and extension of the timeline for the publication of a final rule for the Adjustment of Civil Monetary Penalties for Inflation which was originally published as an interim final rule on September 6, 2016. All provisions remain in effect and the timeline for publication of the final rule has been extended to September 6, 2021. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - September 8, 2020 Category: Rural Health Source Type: news

Watchdog report blasts KCK nursing home that was early Covid-19 hot spot
A scathing federal inspection of practices at a Kansas City, Kan., nursing home that was an early hot spot for Covid-19 could help the 12 lawsuits filed against the facility, which saw dozens of people die from the disease. The Centers for Medicare and Medicaid Services inspection found that workers at Riverbend Post-Acute Rehabilitation returned to work the day after testing positive and wore the same PPE when moving between residents who were positive and residents who at the time tested negative,… (Source: bizjournals.com Health Care:Pharmaceuticals headlines)
Source: bizjournals.com Health Care:Pharmaceuticals headlines - September 4, 2020 Category: Pharmaceuticals Source Type: news

CMS approves payments for Viz.ai software
The U.S. Centers for Medicare and Medicaid Services (CMS) has approved a reimbursement...Read more on AuntMinnie.comRelated Reading: Viz.ai debuts new stroke care AI platform Medtronic, Viz.ai team up on stroke care Viz.ai adds $21M in new funding FDA OK's Viz.ai's CT software FDA clears Viz.ai's stroke detection software (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - September 3, 2020 Category: Radiology 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
Pre-publication notice of final rule from the Centers for Medicare and Medicaid Services to revise the FY 2021 Medicare hospital inpatient prospective payment systems (IPPS) for capital and operating costs of acute care hospitals, make changes to Medicare graduate medical education (GME) for teaching hospitals and payments to Critical Access Hospitals (CAHs). Also provides the market basket updated that applies to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis, updates payment policies and rates for the Medicare prospective payment system (PPS) for inpatien...
Source: Federal Register updates via the Rural Assistance Center - September 3, 2020 Category: Rural Health Source Type: news

Johns Hopkins All Children's in St. Pete regains essential standing with federal agency
Johns Hopkins All Chlidren's Hospital in St. Petersburg has cleared a major hurdle after making changes required by the Centers for Medicare and Medicaid Services. The hospital has fully met all the conditions of participation in a systems improvement agreement it made with the Centers for Medicare and Medicaid Services last year. The agreement was needed after the hospital came under fire when the Tampa Bay Times revealed extraordinary fatality rates from the Heart Institute in 2018. The Centers… (Source: bizjournals.com Health Care:Biotechnology headlines)
Source: bizjournals.com Health Care:Biotechnology headlines - September 1, 2020 Category: Biotechnology Authors: Veronica Brezina-Smith Source Type: news

CMS: Medicare Program: Medicare Coverage of Innovative Technology and Definition of Reasonable and Necessary
Notice of proposed rule from the Centers for Medicare and Medicaid Services to establish a Medicare coverage pathway to provide beneficiaries with faster access to innovative medical devices designated as breakthrough by the Food and Drug Administration. Comments on the proposed rule are due by November 2, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - September 1, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; FY 2016 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements; Correcting Amendment
The Centers for Medicare and Medicaid Services has released a correcting amendment to theAugust 6, 2015 final rule. Corrections are applicable beginning October 1, 2015. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 31, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Medicare Coverage of Innovative Technology and Definition of Reasonable and Necessary
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services to establish a Medicare coverage pathway to provide beneficiaries with faster access to innovative medical devices designated as breakthrough by the Food and Drug Administration. Comments on the proposed rule are due within 60 days of publication of this notice in the Federal Register, which is scheduled for September 1, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 31, 2020 Category: Rural Health Source Type: news

CMS Issues 2020 Federally-Facilitated Exchange Navigator Awards
Announcement from the Centers for Medicare and Medicaid Services of awards for the Federally-Facilitated Exchange Navigator program. Grantees will provide assistance and education to those seeking information about, and to those enrolling in healthcare coverage on the Federal Health Insurance Exchange during the 2021 open enrollment period of November 1 - December 15, 2020. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - August 28, 2020 Category: Rural Health Source Type: news

Online Therapy, Booming During the Coronavirus Pandemic, May Be Here to Stay
Mental health flows from the ceramic jug psychotherapist Lori Gottlieb keeps on her desk. There’s nothing special about the jug—a minor accessory in an office designed with the sort of tidy impersonality common to her field. And there’s no special elixir in it—just water. But all the same, the jug provides a certain kind of healing. When patients are struggling, crying, overcome in some way, Gottlieb, a Los Angeles based practitioner and author of the book Maybe You Should Talk to someone, will offer up a cup of water, pour it for them and hand it across. In that small gesture is a whole constellati...
Source: TIME: Health - August 27, 2020 Category: Consumer Health News Authors: Jeffrey Kluger Tags: Uncategorized COVID-19 Source Type: news

Trump Administration Strengthens COVID-19 Surveillance with New Reporting and Testing Requirements for Nursing Homes, Other Providers
The Centers for Medicare and Medicaid Services (CMS) announced regulatory changes that require nursing homes to test staff and offer testing to residents for COVID-19. Includes information on new testing requirements for nursing homes, reporting requirements for hospitals and labs, and requirements for physicians and pharmacists ordering tests. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - August 25, 2020 Category: Rural Health Source Type: news

CMS: Announcement of the Advisory Panel on Outreach and Education (APOE) September 23, 2020 Virtual Meeting
The Centers for Medicare and Medicaid Services announces a virtual public meeting of the Advisory Panel on Outreach and Education (APOE) on September 23, 2020 from 12:00-5:00 p.m. Eastern. Presentations and written comments much be submitted to thedesignated federal official by September 9, 2020. Current agenda items include a listening session with CMS leadership, a recap of the previous meeting, information on CMS programs and priorities, and an opportunity for public comment. Registration is due by September 9, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 24, 2020 Category: Rural Health Source Type: news

Trump Administration Issues Joint Informational Bulletin Intended to Improve Health and Housing Outcomes for Older Adults and People with a Disability in Rural America
The Centers for Medicare and Medicaid Services (CMS) issued a Joint Informational Bulletin with five other U.S. agencies, which includes information on federal resources available to help improve health and housing outcomes for older adults and those with disabilities in rural America. The resources can help address physical environmental barriers in the home, increase safety, minimize the risk of falls, and support a person's ability and desire to remain in their own home. (Source: News stories via the Rural Assistance Center)
Source: News stories via the Rural Assistance Center - August 19, 2020 Category: Rural Health Source Type: news

Medicare proposes major cut to radiology for 2021
The U.S. Centers for Medicare and Medicaid Services has released its annual...Read more on AuntMinnie.comRelated Reading: CMS postpones 'appropriate use' mandate past 2021 Early pandemic funding sources may require action now Medicare requires prior authorization for venous ablation What did radiologists miss while focused on COVID-19? New PPP loan forgiveness application forms available now (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - August 18, 2020 Category: Radiology Source Type: news

CMS to resume routine inspections
The U.S. Centers for Medicare and Medicaid Services (CMS) said on August 17...Read more on AuntMinnie.comRelated Reading: CMS postpones 'appropriate use' mandate past 2021 Radiology payments to be lower under 2021 MPFS, HOPPS CMS suspends emergency loan program CMS delivers $34B in accelerated COVID-19 payments CMS grants exceptions for Medicare reporting (Source: AuntMinnie.com Headlines)
Source: AuntMinnie.com Headlines - August 18, 2020 Category: Radiology Source Type: news

Current lung cancer public health screening guidelines under count African Americans
(International Association for the Study of Lung Cancer) Public health screening guidelines for lung cancer followed by the United States Preventive Services Task Force (USPSTF) and the Center for Medicare and Medicaid Services (CMS) undercount African Americans, contributing to disparities in lung cancer screening and treatment, according to a study published today in the Journal of Thoracic Oncology. The JTO is the official journal of the International Association for the Study of Lung Cancer. (Source: EurekAlert! - Cancer)
Source: EurekAlert! - Cancer - August 18, 2020 Category: Cancer & Oncology Source Type: news

CMS: Emergency Clearance: Public Information Collection Requirements Submitted to the Office of Management and Budget (OMB)
In light of the economic hardship faced by individuals and small employers due to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) is requesting the review of a new information collection request to collect health insurance premium credit data related to the COVID-19 Emergency under the emergency clearance process. The use of normal clearance procedures will not allow CMS to update its enrollment data in a timely fashion and would likely not be able to provide a timely distribution of 1095-A tax forms to affected consumers. Health Insurance Exchanges furnish Form 1095-A to individuals to allow th...
Source: Federal Register updates via the Rural Assistance Center - August 17, 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 under a Prescription Drug Plan or an MA-PD plan; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; and Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy
Notice of proposed rule from the Centers for Medicare and Medicaid Services making changes to the following: 1) Physician Fee Schedule and Medicare Part B payment policies; 2) Medicare Shared Savings Program requirements; 3) Medicaid Promoting Interoperability Program requirements for Eligible Professionals; 4) updates to the Quality Payment Program; 5) Medicare coverage of opioid use disorder services furnished by opioid treatment programs; 6) Medicare enrollment of Opioid Treatment Programs; 7) payment for office/outpatient evaluation and management services; 8) requirement for Electronic Prescribing for Controlled Subst...
Source: Federal Register updates via the Rural Assistance Center - August 17, 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) Annual Medical Loss Ratio (MLR) and Rebate Calculation Report and MLR Rebate Notices; 2) Data Collection for Medicare Facilities Performing Carotid Artery Stenting with Embolic Protection in Patients at High Risk for Carotid Endarterectomy; 3) Conditions for Coverage of Suppliers of End Stage Renal Disease (ESRD) Services and Supporting Regulations; and 4) Clinical Laboratory Improvement Amendments (CLIA) Regulations. Comments are due by September 14, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 14, 2020 Category: Rural Health Source Type: news

CMS: Agency Information Collection Activities: Proposed Collection; Comment Request
The Centers for Medicare and Medicaid Services is seeking comments on changes made to the data collected for the hospital quality reporting program. Comments are due by October 13, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 13, 2020 Category: Rural Health Source Type: news

CMS: Medicare and Medicaid Programs; Quarterly Listing of Program Issuances - April Through June 2020
Quarterly listing of Centers for Medicare and Medicaid Services (CMS) manual instructions, substantive and interpretive regulations, and Federal Register notices published from April through June 2020, including contact information for general questions or additional information about specific sections. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 12, 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; and Physician-owned Hospitals
Notice of proposed rule from the Centers for Medicare and Medicaid Services revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021. Also updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program, as well as establishes and updates the Overall Hospital Quality Star Rating beginning with the 2021 calendar year, among other things. Includes rural references throughout. Comments on the proposed changes are due on October 5, 2020. (Source: F...
Source: Federal Register updates via the Rural Assistance Center - August 12, 2020 Category: Rural Health Source Type: news

Tech Companies Are Transforming People ’s Bedrooms Into ‘Virtual Hospitals.’ Will It Last Post-COVID?
When Curtis Carlson started having back pain this spring, he tried to put off seeing a doctor. The COVID-19 pandemic was raging, his job at a transitional housing organization in Ukiah, Calif. was busier than ever amid the economic collapse, and a hospital seemed like the last place he wanted to be. But when he finally took himself to the emergency room and he was diagnosed with a kidney infection, Carlson figured he would have no choice but to stay. Instead, his doctors told him about a new program that would allow him to finish the rest of his hospital care at home, with a medical team monitoring him virtually around th...
Source: TIME: Health - August 10, 2020 Category: Consumer Health News Authors: Abigail Abrams Tags: Uncategorized COVID-19 Source Type: news

CMS: Medicare Program; Announcement of the Advisory Panel on Hospital Outpatient Payment Meeting
The Centers for Medicare and Medicaid Services (CMS) will hold a virtual meeting of the Advisory Panel on Hospital Outpatient Payment for 2020 on August 31, 2020. The agenda will focus on the announcement of four new members to the panel, which is charged with providing recommendations to CMS and the Department of Health and Human Services on matters concerning the hospital outpatient prospective payment system. Comment and presentation submissions to be considered at the meeting are due by August 14, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 10, 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) Retiree Drug Subsidy (RDS) Application and Instructions; 2) Retiree Drug Subsidy Payment Request and Instructions; 3) Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biologicals; and 4) Consumer Experience Survey Data Collection. Comments are due by September 9, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 10, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2021
Notice of final rule from the Centers for Medicare and Medicaid Services updating the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2021. Among other things, this rule adopts the most recent Office of Management and Budget (OMB) statistical area delineations, with a 5% cap on wage index decreases; removes the post-admission physician evaluation requirement; and allows non-physician practitioners to perform certain IRF coverage requirements that are currently required to be performed by a rehabilitation physician. This rule is effective on October 1, 2020. (Source: Federal Registe...
Source: Federal Register updates via the Rural Assistance Center - August 10, 2020 Category: Rural Health Source Type: news

Despite the Coronavirus Pandemic, Medicare Officials Continue Push for Price Transparency by Pressuring Hospitals to Disclose Rates Negotiated with Private Payers
Clinical laboratories are advised to continue developing methods for making prices for procedures available to the general public Even as an effective treatment for COVID-19 continues to elude federal healthcare agencies, Medicare officials are pressing ahead with efforts to bring about transparency in hospital healthcare pricing, including clinical laboratory procedures and prescription drugs costs. In […] (Source: Dark Daily)
Source: Dark Daily - August 7, 2020 Category: Laboratory Medicine Authors: Jude Tags: Compliance, Legal, and Malpractice Laboratory Management and Operations Laboratory News Laboratory Operations Laboratory Pathology AHA American Hospital Association anatomic pathology CAR centers for medicare and medicaid services Char Source Type: news

CMS: Medicare Program: Treatment of Medicare Part C Days in the Calculation of a Hospital's Medicare Disproportionate Patient Percentage
Notice of proposed rule from the Centers for Medicare and Medicaid Services to establish a policy for the treatment of patient days associated with those enrolled in a Medicare Advantage plan for the purpose of calculating a hospital's disproportionate patient percentage for cost reporting periods beginning before fiscal year 2014. This proposed rule is in response to the ruling inAzar v. Allina Health Services on June 3, 2019. Comments on the rule are due by October 5, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 6, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Value-Based Purchasing Program for Federal Fiscal Year 2021
Notice of a final rule from the Centers for Medicare and Medicaid Services updating the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year 2021. Makes changes to the case-mix classification code mappings used under the SNF PPS, adopts the most recent Office of Management and Budget (OMB) statistical area delineations, and makes changes to the SNF value-based purchasing (VBP) program. Includes rural considerations throughout. This rule is effective October 1, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 5, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2021
Pre-publication notice of final rule from the Centers for Medicare and Medicaid Services updating the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2021. Among other things, this rule adopts the most recent Office of Management and Budget (OMB) statistical area delineations, with a 5% cap on wage index decreases; removes the post-admission physician evaluation requirement; and allows non-physician practitioners to perform certain IRF coverage requirements that are currently required to be performed by a rehabilitation physician. This rule is effective on October 1, 2020 and will ...
Source: Federal Register updates via the Rural Assistance Center - August 5, 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; and Physician-owned Hospitals
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021. Also updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program, as well as establishes and updates the Overall Hospital Quality Star Rating beginning with the 2021 calendar year, among other things. Includes rural references throughout. Comments on the proposed changes are due on October 5, ...
Source: Federal Register updates via the Rural Assistance Center - August 5, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Treatment of Medicare Part C Days in the Calculation of a Hospital's Medicare Disproportionate Patient Percentage
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services to establish a policy for the treatment of patient days associated with those enrolled in a Medicare Advantage plan for the purpose of calculating a hospital's disproportionate patient percentage for cost reporting periods beginning before fiscal year 2014. This proposed rule is in response to the ruling inAzar v. Allina Health Services on June 3, 2019. Comments on the rule are due within 60 days of publication of this notice in the Federal Register, which is scheduled for August 6, 2020. (Source: Federal Register updates via the Ru...
Source: Federal Register updates via the Rural Assistance Center - August 5, 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 under a Prescription Drug Plan or an MA-PD plan; Payment for Office/Outpatient Evaluation and Management Services; Hospital IQR Program; Establish New Code Categories; and Medicare Diabetes Prevention Program (MDPP) Expanded Model Emergency Policy
Pre-publication notice of proposed rule from the Centers for Medicare and Medicaid Services making changes to the following: 1) Physician Fee Schedule and Medicare Part B payment policies; 2) Medicare Shared Savings Program requirements; 3) Medicaid Promoting Interoperability Program requirements for Eligible Professionals; 4) updates to the Quality Payment Program; 5) Medicare coverage of opioid use disorder services furnished by opioid treatment programs; 6) Medicare enrollment of Opioid Treatment Programs; 7) payment for office/outpatient evaluation and management services; 8) requirement for Electronic Prescribing for ...
Source: Federal Register updates via the Rural Assistance Center - August 5, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; FY 2021 Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) and Special Requirements for Psychiatric Hospitals for Fiscal Year Beginning October 1, 2020 (FY 2021)
Notice of final rule from the Centers for Medicare and Medicaid Services updating the FY 2021 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 adopts the most recent Office of Management and Budget (OMB) statistical area delineations, and applies a 2-year transition for all providers negatively impacted by wage index changes. Also includes responses to comment submitted on the prop...
Source: Federal Register updates via the Rural Assistance Center - August 4, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program; FY 2021 Hospice Wage Index and Payment Rate Update
Notice of a final rule from the Centers for Medicare and Medicaid Services updating the hospice wage index, payment rates, and cap amount for fiscal year 2021. Includes changes related to the adoption of the most recent Office of Management and Budget (OMB) statistical area delineations, with a 5% cap on wage index decreases. Also summarizes the changes to the hospice election statement finalized in the FY 2020 Hospice Wage Index and Rate Update final rule; and provides hospices with a model election statement and sample addendum. Includes rural considerations throughout. This rule is effective October 1, 2020. (Source: Fe...
Source: Federal Register updates via the Rural Assistance Center - August 4, 2020 Category: Rural Health Source Type: news

CMS: Medicare Program: Electronic Prescribing of Controlled Substances; Request for Information (RFI)
Notice from the Centers for Medicare and Medicaid Services seeking input on whether CMS should include exceptions to the electronic prescribing of controlled substances (EPCS), which will required for Medicare Part D prescription drug plans and Medicare Advantage Drug Plans beginning January 1, 2021. Feedback on circumstances that exceptions should be made and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be are specifically sought. Comments are due by October 5, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - August 4, 2020 Category: Rural Health Source Type: news

ACR applauds E/M coding changes, telehealth expansion in FY 2021 physician fee schedule
(American College of Rheumatology) The American College of Rheumatology (ACR) today applauded the Centers for Medicare and Medicaid Services (CMS) for taking steps to appropriately value cognitive care and expand telehealth access in its FY 2021 Physician Fee Schedule (PFS) Proposed Rule. (Source: EurekAlert! - Medicine and Health)
Source: EurekAlert! - Medicine and Health - August 4, 2020 Category: International Medicine & Public 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 requests: 1) Establishment of Exchanges and Qualified Health Plans; Exchange Standards for Employers which is used and 2) Medicare Quality of Care Complaint Form. Comments are due by August 31, 2020. (Source: Federal Register updates via the Rural Assistance Center)
Source: Federal Register updates via the Rural Assistance Center - July 31, 2020 Category: Rural Health Source Type: news

Public Inspection: CMS: Medicare Program: Electronic Prescribing of Controlled Substances; Request for Information (RFI)
Prepublication notice from the Centers for Medicare and Medicaid Services seeking input on whether CMS should include exceptions to the electronic prescribing of controlled substances (EPCS), which will required for Medicare Part D prescription drug plans and Medicare Advantage Drug Plans beginning January 1, 2021. Feedback on circumstances that exceptions should be made and whether CMS should impose penalties for noncompliance with this mandate in its rulemaking, and what those penalties should be are specifically sought. Comments are due within 60 days of publication of this notice in the Federal Register, which is sched...
Source: Federal Register updates via the Rural Assistance Center - July 31, 2020 Category: Rural Health Source Type: news

New CMS Proposed Rule Encourages Value-Based Reimbursement Based on Patient Outcomes When Payers and Drug Manufacturers Negotiate Payment for Pricey Therapies
Clinical laboratories and anatomic pathology groups should consider this another example of how CMS is taking forward steps to encourage value-based payment arrangements throughout the health system With the sky-high cost of many prescription drugs and gene therapies, it was only a matter of time before the Centers for Medicare and Medicaid Services (CMS) would […] (Source: Dark Daily)
Source: Dark Daily - July 29, 2020 Category: Laboratory Medicine Authors: Jude Tags: Compliance, Legal, and Malpractice Laboratory Management and Operations Laboratory News Laboratory Operations Laboratory Pathology Laboratory Testing Alexander Dworkowitz anatomic pathology centers for medicare and medicaid services clin Source Type: news