proposed rule
WASHINGTON, D.C. (September 17, 2019)—The National Association for Home Care & Hospice (NAHC) submitted comments on the 2020 home health prospective payment system rate update proposed rule.
WASHINGTON, D.C. (August 13, 2019)—The Bipartisan Budget Act of 2018 (BBA 2018) included a provision permitting physician assistants (PAs), beginning Jan. 1, 2019, to serve as hospice attending physicians.
Watch for streamlining of claims & new fee schedule determinations
WASHINGTON, D.C. (July 26, 2019)—In the 2020 home health prospective payment system (HHPPS) rate update proposed rule, the Centers for Medicare & Medicaid Services (CMS) proposes a number changes to the Home Health Quality Reporting Program (HHQRP) for calendar year (CY) 2022.
WASHINGTON, D.C. (June 18, 2019)—The Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) have issued a proposed rule significantly revising the nondiscrimination regulations that implemented Section 1557 of the Affordable Care Act (ACA). The revisions are intended to reduce burden, eliminate redundancy with several other nondiscriminatory regulations, and provide clarity in the application of nondiscrimination requirements.
WASHINGTON, D.C. (February 11, 2019)—The Centers for Medicare & Medicaid Services (CMS) released CMS-9115-P, the Interoperability and Patient Access Proposed Rule. The new rule outlines proposed policy changes to the MyHealthEData initiative to improve patient access to and advance electronic data exchange and care coordination throughout the health care system. CMS is also releasing two requests for information (RFIs) for feedback from providers in post-acute care settings.
(December 4, 2018)—On October 26, 2018, CMS issued Contract Year (CY) 2020 Medicare Advantage and Part D Flexibility Proposed Rule CMS-4185-P. The rule updates Medicare Advantage (MA) and Medicare Part D by promoting flexibility and innovation so that MA and Part D sponsors are empowered with the tools to improve quality of care and provide more choices.
ALEXANDRIA, Va. (December 3, 2018)—A new drug pricing rule (CMS-4180-P), proposed by the Centers for Medicare & Medicaid Services (CMS), released Monday, November 26, considers policies the National Community Pharmacists Association and CMS say will lower patients’ out-of-pocket costs at the pharmacy counter and lead to a more competitive and efficient Part D program.
Beware of common ownership and subcontract arrangements
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.
The proposed rule eliminates administrative hurdles to providing more affordable prescription drugs and will allow Medicare to combat opioid overprescribing and abuse.
WASHINGTON, D.C. (November 20, 2017)—The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule November 16, that includes a number of changes that, if finalized, will ensure that Part D Medicare enrollees have access to more affordable prescription drugs and more robust prescription drug coverage at the pharmacy they prefer. The rule also gives health plans a new tool to combat the opioid crisis.
The leading home health organizations commend CMS for not finalizing the model.
WASHINGTON, D.C. (November 1, 2017)—The nation’s leading home health organizations, including the Partnership for Quality Home Healthcare (Partnership), the National Association for Home Care & Hospice (NAHC) and ElevatingHOME, commend the Centers for Medicare & Medicaid Services (CMS) for not finalizing the proposed Home Health Groupings Model (HHGM) in the Home Health Prospective Payment System (HHPPS) Proposed Rule for CY 2018.
Proposed rule updates geographic areas and mandatory participation requirements.
—Via CMS—WASHINGTON, D.C. (August 15, 2017)—Today, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule to reduce the number of mandatory geographic areas participating in the Center for Medicare and Medicaid Innovation’s (Innovation Center) Comprehensive Care for Joint Replacement (CJR) model from 67 to 34. In addition, CMS proposes to allow CJR participants in the 33 remaining areas to participate on a voluntary basis.
The coalition asks CMS to partner with homecare organizations to ensure Medicare beneficiaries are protected.
Proposed rule aims to simplify reporting requirements and offer support for doctors and clinicians in 2018.
WASHINGTON, D.C. (June 21, 2017)—The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make changes in the second year of the Quality Payment Program as required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). CMS’s goal is to simplify the program, especially for small, independent and rural practices, while ensuring fiscal sustainability and high-quality care within Medicare.
WASHINGTON, D.C. (July 7, 2016)—CMS proposed updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. Several of the proposed policy changes would improve the quality of care Medicare patients receive by better supporting their physicians and other health care providers.
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.
CMS published a proposed rule in the <em>Federal Register</em> that would establish a three-year "minimum lifetime standard for items to meet the durability criterion for DME."
In a perplexing turn, CMS issued a proposed rule that requires a face-to-face exam by a physician who orders home health services under Medicaid. The proposal also requires a face-to-face encounter for DME