NAHC President talks quantifying the value of hospice
CMS
30.19 million of the 59.82 million people with both Medicare Part A and Part B were enrolled in a private plan
KFF reported that data released from the Centers for Medicare & Medicaid Services (CMS), shows Medicare Advantage (MA) now provides Medicare coverage for more than half of its eligible beneficiaries.
CMS posted 25 questions and answers and includes two specific to DME supplies and one for CGMs.
The Centers for Medicare & Medicaid Services (CMS) published the much-anticipated Frequently Asked Questions (FAQ) that provides some directions on the ending of the COVID-19 Public Health Emergency (PHE).
Prior to her new role, Verma was administrator of CMS.
AUSTIN, Texas—Oracle announced Seema Verma has been named senior vice president and general manager, Life Sciences. In this role, she will lead the Oracle Life Sciences and Oracle Cerner Enviza lines of business.
Witkowski fraudulently trafficked in orders for durable medical equipment (DME) such as back, knee and elbow braces.
NEW YORK—Damian Williams, the United States Attorney for the Southern District of New York, announced Matthew Taylor Witkowski was sentenced to 60 months in prison for conspiracy to commit health care fraud by fraudulently trafficking in orders for durable medical equipment (DME) such as back, knee and elbow braces. Witkowski previously pled guilty to the conspiracy charge and was sentenced before United States District Judge Denise L. Cote.
Nonmedical benefits have value for health & independence
WASHINGTON—The U.S. Department of Health and Human Services (HHS) announced it is releasing ownership data for all Medicare-certified hospice and homecare agencies. For the first time, anyone can now review detailed information on the ownership of more than 6,000 hospices and 11,000 home health agencies certified to participate in the Medicare program on the Centers for Medicare & Medicaid Services (CMS) website.
Attaining TCT accreditation identifies a health department as an Exemplary Provider.
Spring House, PENNSYLVANIA—The Compliance Team (TCT), a Centers for Medicare & Medicaid Services (CMS)-approved national healthcare accreditation organization, announced a new accreditation program for Local Health Departments (LHDs).
Srivastav used doctors orders to obtain more than $48 million in fraudulent payments from Medicare.
ATLANTA – Nagaindra Srivastav has been sentenced on conspiracy and kickback charges for his role in selling fraudulent doctors’ orders to his co-conspirators who used the orders to obtain more than $48 million in fraudulent payments from Medicare.
The extension also grants health plans the ability to restrict MAOs from using out-of-network providers.
Hospice patients will be able to receive concurrent care with Medicare Advantage as the Centers for Medicare and Medicaid Services (CMS) extended its Value-Based Insurance Design for calendar years 2025 through 2030. The extension also grants health plans the ability to restrict Medicare Advantage Organizations (MAOs) from using out-of-network providers in 2026.
CMS will phase in certain updates, and on average, CMS said it anticipates a payment increase for MA plans of 3.32%
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), released the Calendar Year (CY) 2024 Medicare Advantage (MA) and Part D Rate Announcement that finalized payment policies for these programs. According to HHS, the final policies in the Rate Announcement aim to improve payment accuracy and ensure taxpayer dollars are well spent.
Medicare paid Agu’s companies more than $3 million based on the fraudulent claims.
HOUSTON—A 63-year-old Sugar Land resident has been ordered to prison for conspiracy to pay and receive kickbacks, announced U.S. Attorney Alamdar S. Hamdani.
NAHC critiqued CMS's attempt to communicate to stakeholders about the payment rates
Washington, D.C.—In response to a requirement of the Consolidated Appropriations Act (CAA), 2023, the Centers for Medicare & Medicaid Services (CMS) presented data used to determine Medicare home health payment rates for calendar year (CY) 2023, including the permanent and temporary rate adjustments calculated under the Patient Driven Groupings Model (PDGM) “budget neutrality” requirements.
ALEXANDRIA, Virginia—The National Home Infusion Association (NHIA) announced it successfully petitioned the Centers for Medicare and Medicaid Services (CMS) to secure a new billing code for injectable immunotherapies and revise an existing code to facilitate administration of a wider range of monoclonal antibodies for Respiratory Syncytial Virus (RSV).
Decision places AppliedVR's flagship product RelieVR in an existing benefit category, providing a next step for securing public and commercial health insurance coverage.
LOS ANGELES— AppliedVR, an immersive therapeutics (ITx) company, announced the Centers for Medicare and Medicaid Services (CMS) established a unique Healthcare Common Procedure Coding System (HCPCS) Level II code (E1905) for its flagship product, the RelieVRx program.
Letter to CMS seeks information on lower Part B coinsurance for prescription drugs due to IRA-created price gouging penalty
Washington, D.C.—U.S. Senator Bob Casey (D-PA) joined 21 Senators in a request to the Biden Administration to publicize the effect of the Inflation Reduction Act’s Medicare Part B inflation rebate on coinsurance in the program.
AAHomecare seeks clear guidance from CMS for patient care post-PHE
AAHomecare and oxygen stakeholders joined major respiratory associations in asking HHS to protect access to respiratory products for patients who qualified for care under relaxed guidelines during the COVID-19 Public Health Emergency (PHE).
This is the second report by CMS illustrating the failure of the Part B HIT services benefit to attract providers.
Seniors’ Timely Access to Care Act/CMS Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) released a proposed national coverage determination (NCD) decision that would, for the first time, expand coverage for power seat elevation equipment on certain power wheelchairs to Medicare individuals. The proposed NCD is open for public comment for 30 days.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has issued additional provider-specific guidance for the winding down of the COVID-19 public health emergency, which is set to end May 11.
WASHINGTON—The Centers for Medicare & Medicaid Services (CMS) has added 10 HCPCS codes to the list of those that require face-to-face encounter and a written order, bringing the total up to 63 codes, according to VGM Government Relations.
The new codes, all for back, knee and ankle or foot braces, are: