WASHINGTON, D.C. (November 1, 2022)—The Centers for Medicare & Medicaid Services (CMS) released its final rule for Medicare home health payments on October 31, settling on a rate reduction of 3.925% for 2023 with additional cuts to come in 2024. That's less than the 7.69% cut initially proposed by the agency for 2023, but still a blow to providers, according to industry advocates.
Final Rule
WASHINGTON, D.C (April 19, 2022)—The Centers for Medicare & Medicaid Services (CMS) has issued a final rule with comment period that finalizes two remaining proposals from the original proposed rule that laid out policy and technical changes to the Medicare Advantage program, Medicare Part D, Medicaid and more. That proposed rule was originally issued in February 2020.
WASHINGTON, D.C. (December 21, 2021)—The Centers for Medicare & Medicaid Services (CMS) has just released a long-awaited durable medical equipment (DME) rule that includes significant provisions impacting Medicare reimbursement for DME products and services.
WASHINGTON, D.C. (November 12, 2021)—The Centers for Medicare and Medicare Services (CMS) announced it is rescinding the Medicare Coverage of Innovative Technology and Definition of “Reasonable and Necessary” (MCIT/R&N) final rule because of concerns that the provisions in the final rule may not have been sufficient to protect Medicare patients. By rescinding this rule, CMS can take action that will better address those safety concerns in the future.
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WASHINGTON, D.C. (November 23, 2020)—Today, the Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based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 (May 29, 2020)—The Centers for Medicare & Medicaid Services (CMS) has released the Medicare Program: Contract Year 2021 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program, with important information about the special election period for hospice beneficiaries.
WASHINGTON, D.C. (April 28, 2020)—On March 9, 2020, both the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) issued for display on the ONC website final rules that advance the goals of interoperability of electronic health care records (EHR). On April 22, 2020 these rules went on display at the federal register (FR) and will be published in the FR on May 1, 2020.
Updated November 1 with statement from NAHC
WASHINGTON, D.C. (October 31, 2019)—The Centers for Medicare & Medicaid on Thursday, Oct. 31, issued its final rule governing the transition to the Patient-Driven Groupings Model (PDGM) for home health care—cutting its assumptions for behavioral changes almost in half.
BIRMINGHAM, Ala. (October 2, 2019)—The Centers for Medicare & Medicaid Services released a long-awaited discharge planning final rule for hospitals, critical access hospitals and home health agencies. The proposed rule was posted in November 2015, and has taken almost four years to reach the final version. It will be effective Nov. 29, 2019.
WASHINGTON, D.C. (September 5, 2019)—The Centers for Medicare & Medicaid Services (CMS) issued a final rule that strengthens the agency's ability to stop fraud before it happens by keeping unscrupulous providers out of federal health insurance programs. The rule has been under consideration for more than three years, according to the National Association for Home Care & Hospice (NAHC).
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).
104 Representatives signed the HME-related letter.
Washington, D.C. (October 2, 2017)—Nearly one-fourth of the members of the U.S. House of Representatives have asked the Office of Management & Budget (OMB) to clear an HME-related Interim Final Rule (IFR) currently under review at OMB. The IFR, titled “Durable Medical Equipment Fee Schedule, Adjustments to Resume the Transitional 50/50 Blended Rates to Provide Relief in Non-Competitive Bidding Areas” has been at OMB since late August.
Payment rates and wage index were included in the final rule.
—Via CMS, WASHINGTON, D.C. (August 1, 2017)—On August 1, 2017, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1675-F) that updates fiscal year (FY) 2018 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries, and also updates the hospice quality reporting requirements.
WASHINGTON, D.C. (June 23, 2016)—CMS released a final rule implementing Section 216(a) of the Protecting Access to Medicare Act of 2014 (PAMA), requiring laboratories performing clinical diagnostic laboratory tests to report the amounts paid by private insurers for laboratory tests. Medicare will use these private insurer rates to calculate Medicare payment rates for laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) beginning January 1, 2018.
WASHINGTON, D.C. (June 9, 2016)—The Centers for Medicare & Medicaid Services (CMS) today released a final rule improving how Medicare pays Accountable Care Organizations in the Medicare Shared Savings Program for delivering better patient care. Medicare is moving away from paying for each service a physician provides towards a system that rewards physicians for coordinating with each other.
LENEXA, KAN. (April 14, 2016)—Mediware Information Systems, Inc. is hosting a free webinar for attendees on Wednesday, May 18, 2016, at 1:00 Central, 2:00 EST, to outline how providers can safeguard against payer audits as well as explain your legal obligations if you should discover a potential overpayment or underpayment from Medicare. The webinar is entitled “Responding to Payer Audits and Overpayments: Stay Compliant and within the Law.”
WASHINGTON, D.C. (April 5, 2016)—In conjunction with the President’s visit to the National Rx Drug Abuse and Heroin Summit, the Centers for Medicare & Medicaid Services (CMS) finalized a rule to strengthen access to mental health and substance use services for people with Medicaid or Children’s Health Insurance Program (CHIP) coverage, aligning with protections already required of private health plans.
WASHINGTON, D.C. (February 18, 2016—The Centers for Medicare & Medicaid Services (CMS) has published a final rule that requires Medicare Parts A and B health care providers and suppliers to report and return overpayments by the later of the date that is 60 days after the date an overpayment was identified, or the due date of any corresponding cost report, if applicable.
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 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.