CMS

WASHINGTON, D.C.

WASHINGTON, D.C. (January 29, 2016)—On January 27, CMS published the final rule to Medicaid Program; Face-to-Face Requirements for Home Health Services; Policy Changes and Clarifications Related to Home Health.

WASHINGTON, D.C. (January 27, 2016)—Today, the Centers for Medicare & Medicaid Services Office of Minority Health (CMS OMH), released a new Guide to Preventing Readmissions among Racially and Ethnically Diverse Medicare Beneficiaries.

WASHINGTON, D.C. (January 27, 2016)—Since the start of the New Year, AAHomecare leadership has taken part in numerous discussions with leading companies and associations in the HME sector to map out strategy to get relief for companies in rural areas, as well as those in other non-bid areas, now subject to Medicare competitive bidding-derived pricing.

WASHINGTON, D.C. (January 26, 2016)—In order to effectively implement provisions of the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) finalized a rule detailing reforms to the rebate and reimbursement systems for Medicaid prescription drugs, which will save federal and state governments an estimated $2.7 billion over five years.

WASHINGTON, D.C. (January 26, 2016)—Many suppliers have been waiting to learn when CMS will adjust the fee schedules for group 3 accessories for power wheelchairs as mandated by the Patient Access and Medicare Protection Act (PAMPA). Unfortunately, CMS has published that the adjustments to the fee schedule will not be available until July 1, 2016.

WASHINGTON, D.C. (January 14, 2016)—Today, the Centers for Medicare & Medicaid Services (CMS) announced 121 new participants in Medicare Accountable Care Organization (ACO) initiatives designed to improve the care patients receive in the health care system and lower costs. With this announcement, ACOs now represent 49 states and the District of Columbia.

EXETER, PA (January 13, 2016)—Pride Mobility Products Corporation is pleased to announce the promotion of Seth Johnson to Senior Vice President of Government Affairs.

WASHINGTON, D.C. (January 7, 2016)—On December 29, 2015, CMS published the final rule to Medicare Program: Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies. This comes a year and a half after the proposed rule, which came out on May 28, 2014. Originally CMS proposed that the timeframe for a response to a prior authorization request would be made within 10 days or two days for expedited requests.

Hospitals Required to Keep Caregivers in the Loop

WASHINGTON, D.C. (January 4, 2016)—CMS Tuesday issued a final rule, “Medicare Program: Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies,” that would establish a prior authorization process for certain DMEPOS items that they cite as frequently subject to unnecessary utilization.

WASHINGTON, D.C. (December 29, 2015)—CMS finalized the rule to implement Prior Authorization for general DMEPOS items. The final rule was published on December 29th. The proposed rule, published in May 2014, suggested that a prior authorization requirement be imposed for selected HCPCS that are frequently subject to unnecessary utilization. The originally proposed master list consisted of 139 HCPCS.

WASHINGTON, D.C. (December 15, 2015)—The Centers for Medicare & Medicaid Services (CMS) is committed to providing current quality performance data that is useful to the consumer. Recently, data was refreshed on both the Physician Compare and Hospital Compare websites to improve these consumer online tools.

One House Call Has Big Aging-In-Place Payoff
When it comes to helping seniors age in their own home, an in-home assessment from a physician or nurse practitioner goes a long way. (Tim Mullaney/Home Health Care News)

WASHINGTON, D.C. (December 2, 2015)—In 2014, per-capita health care spending grew by 4.5 percent and overall health spending grew by 5.3 percent, a study by the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS) published today as a Web First by Health Affairs. Those rates are below most years prior to passage of the Affordable Care Act.

WASHINGTON, D.C. (November 24, 2015)—On November 23, the Centers for Medicare & Medicaid Services (CMS) announced the release of the 2016 Medicare Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) fee schedule amounts.

WASHINGTON, D.C. (November 19, 2015)—The Centers for Medicare & Medicaid Services (CMS) released a new report today showing that consumers have received more than $2.4 billion premium rebates since 2011 because the Affordable Care Act requires that health insurance companies spend at least 80 percent of premium dollars on health care. For 2014 alone, over 5.5 million consumers received nearly $470 million in rebates, for an average of $129 per family.

WASHINGTON, D.C. (November 18, 2015)—Hip and knee replacements are the most common inpatient surgery for Medicare beneficiaries and can require lengthy recovery and rehabilitation periods. In 2014, there were more than 400,000 procedures, costing more than $7 billion for the hospitalizations alone.

WASHINGTON, D.C. (NOVEMBER 11, 2015)—Today, the Centers for Medicare & Medicaid Services (CMS) announced the 2016 premiums and deductibles for the Medicare inpatient hospital (Part A) and physician and outpatient hospital services (Part B) programs.

Part B Premiums/Deductibles

WASHINGTON, D.C. (November 3, 2015)—The Centers for Medicare & Medicaid Services (CMS) released an interactive online mapping tool which shows geographic comparisons at the state, county, and ZIP code levels of de-identified Medicare Part D opioid prescription claims—prescriptions written and then submitted to be filled—within the United States.