WASHINGTON, D.C (September 26, 2018)—On September 13, 2018, Representatives Sam Johnson (R-Texas) and John Larson (D-Connecticut) introduced the Homecare for Seniors Act (HR 6813) in the House of Representatives. The act amends the Internal Revenue Code to allow seniors to use funds from health savings accounts for qualified homecare services.
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ATLANTA (September 6, 2018)—On January 1, 2019, any willing provider will be able to participate in the Medicare program, regardless of prior bidding “wins” or losses. What should providers do? Educational advisory board (EAB) members at Medtrade will outline all of the options, possible action, and consequences in a new educational track dubbed “The New Competitive Bidding.”
SPARTANBURG, S.C. (September 3, 2018)—QS/1, a pharmacy management system provider, has been selected to participate in the Surescripts Early Adopter program for the new National Council for Prescription Drug Program’s (NCPDP) SCRIPT standard version 2017071. The Centers for Medicare & Medicaid Services (CMS) is working to implement the standard in early 2020.
WASHINGTON, D.C. (August 30, 2018)—The Centers for Medicare & Medicaid Services (CMS) released an evaluation report for the first performance year of the Innovation Center’s Next Generation Accountable Care Organization (ACO) Model showing promising early results.
WASHINGTON, D.C. (August 23, 2018)—The Centers for Medicare & Medicaid Services (CMS) awarded $8.6 million in funding to 30 states and the District of Columbia to provide state insurance regulators with the opportunity to enhance states’ ability to strengthen their respective health insurance markets through innovative measures that support market reforms and consumer protections under the Patient Protection and Affordable Care Act (PPACA).
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.
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