WASHINGTON, D.C. (January 26, 2021)— The Health and Human Services Department’s Office of the Inspector General (OIG) has launched an audit of home health services provided through telehealth during the COVID-19 public health emergency to verify that providers aren’t doing more than they’re supposed to do to qualify for reimbursement.
CMS
WASHINGTON, D.C. (January 22, 2021)—A definition of “reasonable and necessary” was included of the recently finalized rule, Medicare Program; Medicare Coverage of Innovative Technology (MCIT) and Definition of ‘‘Reasonable and Necessary’’.
WASHINGTON, D.C. (January 15, 2021)—The Centers for Medicare & Medicaid Services (CMS) has finalized a signature accomplishment of the new Office of Burden Reduction & Health Informatics (OBRHI). This final rule builds on the efforts to drive interoperability, empower patients, and reduce costs and burden in the health care market by promoting secure electronic access to health data in new and innovative ways.
WASHINGTON, D.C. (January 14, 2021) -- The Centers for Medicare & Medicaid Services (CMS) issued a final rule on Tuesday that propels innovative technology so Medicare beneficiaries have access to the latest, most advanced devices. The action is designed to help smooth the Medicare coverage pathway for innovative products, resulting in faster access to new devices for America’s seniors.
NASHVILLE, Tenn. (January 13, 2021)—On January 8, the State of Tennessee announced that its “block grant” waiver request for TennCare (the state Medicaid program) was approved by the Centers for Medicare & Medicaid Services (CMS) after a year of negotiation. This new agreement will allow TennCare to administer the program with less oversight from the federal government and is intended to give more flexibility.
WASHINGTON, D.C. (January 8, 2021)—Today, the Centers for Medicare & Medicaid Services (CMS) announced that the Home Health Value-Based Purchasing (HHVBP) Model has been certified for expansion through rulemaking beginning no sooner than Calendar Year (CY) 2022. The model, implemented in nine states, has resulted in an average 4.6% improvement in home health agencies’ quality scores as well as average annual savings of $141 million to Medicare.
WASHINGTON, D.C. (January 6, 2021)—Occupational therapy practitioners are celebrating passage of the large year-end omnibus legislative package because one measure will ease access to therapy for our nation’s most vulnerable populations. The Medicare Home Health Flexibility Act (H.R. 3127/S. 1725) was enacted among multiple health care priorities when signed into law on Dec.
WASHINGTON, D.C. (December 18, 2020)—The Centers for Medicare & Medicaid Services (CMS) has published the CY 2021 Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule. As of Jan. 1, 2021, CMS will continue to apply the CARES Act relief rates for rural and nonrural areas.
BALTIMORE (December 15, 2020)—The American Academy of Home Care Medicine (Academy) has expressed concerns that the Medicare cuts beginning in 2021 threaten care for patients receiving primary care in their homes when they are being encouraged to stay home to stay safe.
CAESAREA, Israel (December 11, 2020)—Itamar Medical Ltd., a medical device and digital health company focused on the integration of sleep apnea management into the cardiac patient care pathway, commented on the recent release of the 2021 Physician Fee Schedule from the U.S. Centers for Medicare & Medicaid Services (CMS). This Fee Schedule represents the third year of a four-year proposed plan to reevaluate reimbursement in home sleep apnea diagnostic codes.
BIRMINGHAM, Ala. (December 8, 2020)—President-elect Joe Biden has announced his intention to nominate Xavier Becerra, currently serving as attorney general of California, as Secretary of Health and Human Services.
Becerra is well-known for his defense of the Affordable Care Act. Health care industry leaders praised the nomination on Twitter and in the news. Here’s what some of them had to say.
WASHINGTON, D.C. (December 7, 2020)—The Centers for Medicare & Medicaid Services (CMS) has announced a 0.6% CPI-U adjustment to the 2021 DMEPOS fee schedule for products previously subject to competitive bidding provided in Competitive Bidding Areas (CBAs). The adjustment for suppliers in rural and other non-bid areas is expected to be even less.
WASHINGTON, D.C. (December 1, 2020)—The Centers for Medicare & Medicaid Services (CMS) has outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus disease 2019 (COVID-19) hospitalizations across the country.
WASHINGTON, D.C. (November 24, 2020)—The Centers for Medicare & Medicaid Services (CMS) released Care Compare on medicare.gov in September, to streamline the eight original health care compare tools. Since then, providers have had the opportunity to use and familiarize themselves with Care Compare while having the option to use the original compare tools, too.
WASHINGTON, D.C. (November 23, 2020)—Today, the Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based reimbursement.
WASHINGTON, D.C. (November 23, 2020)—Beginning on Jan. 1, 2021, through the VBID Model, participating Medicare Advantage Organizations (MAOs) can voluntarily participate in the Hospice Benefit Component of the Model, according to a November 13 transmittal (10458/CR 12045) from the Centers for Medicare & Medicaid Services (CMS).
WASHINGTON, D.C. (November 18, 2020)—The American Association for Homecare (AAHomecare) urged government officials to include DMEPOS suppliers in the Phase 1 Distribution of COVID-19 vaccine for front-line health care personnel.
WASHINGTON, D.C. (November 18, 2020)—The Centers for Medicare & Medicaid Services (CMS) announced that the Medicare Fee- For-Service (FFS) improper payment rate has continued to decline, the fourth year Medicare FFS improper payment rate has been below 10%, the threshold for compliance established in the Payment Integrity Information Act of 2019.
WASHINGTON, D.C. (November 13, 2020)—The Centers for Medicare & Medicaid Services (CMS) announced that Medicare beneficiaries can receive coverage of monoclonal antibodies to treat coronavirus disease 2019 (COVID-19) with no cost-sharing during the public health emergency (PHE). CMS’s coverage of monoclonal antibody infusions applies to bamlanivimab, which received an emergency use authorization (EUA) from the U.S. Food and Drug Administration on Nov. 9.
WASHINGTON, D.C. (November 6, 2020)—The Centers for Medicare & Medicaid Services (CMS) has issued another revision to change request 11855—Penalty for Delayed Request for Anticipated Payment (RAP) Submission—Implementation. The Change Request (CR) revision added remittance advice message information related to the No Pay RAP penalty.
Home health agencies (HHAs) should note that Medicare Administrative Contractors (MACs) will: