WASHINGTON, D.C. (August 10, 2018)—The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule to overhaul the Medicare Shared Savings Program. The program was established under the Affordable Care Act and launched in 2012. The majority of Medicare’s Accountable Care Organizations (ACOs) operate under the program.
CMS
WASHINGTON, D.C. (August 3, 2018)—On August 1, the Centers for Medicare & Medicaid Services (CMS) finalized regulations first proposed in late April regarding the FY2019 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Requirements (CMS-1692-F).
(July 24, 2018)—In a July 19 blog post, the Centers for Medicare & Medicaid Services announced the creation of the CMS Chief Health Informatics Officer (CHIO). The goal of the CHIO’s role is to drive health IT and data sharing to enhance health care delivery, improve health outcomes, drive down costs and empower patients, according to CMS. The role will be filled with a leader in the health care IT space and serve on CMS Administrator Seema Verma’s leadership team.
WASHINGTON, D.C. (July 11, 2018)—The Centers for Medicare & Medicaid Services (CMS) took steps toward changing Medicare’s DME fee schedule payments, proposing market-oriented reforms to the durable medical equipment prosthetics, orthotics and supplies (DMEPOS) competitive bidding program (CBP).
By Liz Carey
In its July 11, 2018, proposed rule, the Centers for Medicare & Medicaid Services (CMS) pitched new lead item pricing as a measure to improve the competitive bidding program, saying the change would greatly reduce the complexity of the bidding process and the burden on suppliers since they would no longer have to submit bids for numerous items in a product category.
WASHINGTON, D.C. (July 11, 2018)—The Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicaid Provider Reassignment regulation that would eliminate a state’s ability to divert Medicaid payments away from providers, with the exception of payment arrangements explicitly authorized by statute.
Opportunities for improvement exist
Agency green lights remote monitoring, new groupings model
WASHINGTON, D.C. (July 3, 2018)—To foster adoption of emerging technologies by home health agencies and to result in more effective care planning, the Centers for Medicare & Medicaid Services (CMS) proposed an updated home health prospective payment system (PPS), adding allowables for remote patient monitoring technology and implementing a new patient-driven groupings model (PDGM).
WASHINGTON, D.C. (June 27, 2018)—The Centers for Medicare & Medicaid Services (CMS) announced new and enhanced initiatives designed to improve Medicaid program integrity through greater transparency and accountability, strengthened data, and innovative and robust analytic tools.
WASHINGTON, D.C. (June 20, 2018)—The Centers for Medicare & Medicaid Services (CMS) issued a Request for Information (RFI) seeking recommendations and input from the public on how to address any undue impact and burden of the physician self-referral law (also known as the Stark Law), focusing in part on how the law may impede care coordination, a key aspect of systems that deliver value.
WASHINGTON, D.C. (June 18, 2018)—The June 15 release of MedPAC’s report to Congress on Medicare and the health care delivery system represents another missed opportunity by the Commission to address the serious problems with Medicare’s competitive bidding program for durable medical equipment (DME) as well as the disastrous application of bidding-derived pricing to rural and other less-populous communities, stated the American Association for Homecare (AAHomecare).
WASHINGTON, D.C. (June 7, 2018)—Since 2015, AAHomecare has been tracking the number of suppliers and their locations to monitor the impact of competitive bidding and other factors on the industry. The analysis has helped to bring these issues to the attention of Congressional offices and HHS to illustrate the need for more sustainable Medicare reimbursement rates and bidding program reforms.
Hospital-acquired condition rates falling with improved best practices.
WASHINGTON, D.C. (June 6, 2018)—Data released this week by the Agency for Healthcare Research and Quality (AHRQ) show continued progress in improving patient safety, a signal that initiatives led by the Centers for Medicare & Medicaid Services (CMS) are helping to make care safer.
What to consider when conducting a risk assessment
WASHINGTON, D.C. (June 4, 2018)—On Friday, June 1, 2018, CMS released CMS-6080-N, “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.”
SAN FRANCISCO (May 30, 2018)—ClearCare, a technology platform for homecare agencies, announced the nationwide availability of a new technology to seamlessly connect these agencies with insurance companies and hospitals.
Report does not adequately assess beneficiary access issues, CQRC says.
WASHINGTON, D.C. (May 29, 2018)—The Council on Quality Respiratory Care (CQRC) today warned a report released by the Department of Health and Human Services Office of Inspector General (OIG)—Round 2 Competitive Bidding for Oxygen: Continued Access For Vast Majority of Beneficiaries—underestimates the negative impact the Competitive Bidding Program for Durable Medicare Equipment (DME) continues to have on beneficiary access to home respiratory supplies and services.
Recent report recommends extending and renewing current programs.
By Kristin Easterling
(May 24, 2018)—Recently, the Government Accountability Office (GAO) conducted a study on Medicare prior authorization requirements. The requirements began in seven states for certain power mobility devices such as power wheelchairs in 2012. The categories later expanded to include DME, home health and others.
CMS Provider Compliance Group provides insight during keynote speech.
Tom Ryan (left) of AAHomecare presented Doug Coleman with the Mal Mixon Award