Tweet Today, CMS released the final fiscal year (FY) 2020 Inpatient Psychiatric Facility (IPF) prospective payment system rule. The rule rebalances the market basket used to update IPF payments annually, implements rate updates beginning October 1, 2019, and adds an additional measure to the IPF quality reporting program. CMS estimates that the payment updates will [...] Read More
Tweet On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) released its 2020 End Stage Renal Disease/Durable Medical Equipment Payment proposed rule. In addition to changes to payments under the end-stage renal disease (ESRD) and durable medical equipment (DME) programs, the rule proposes changes to payment for renal dialysis, the ESRD quality [...] Read More
On May 28, 2019, the Centers for Medicare & Medicaid Services (CMS) released the Medicare and Medicaid Programs’ Programs of All-Inclusive Care for the Elderly (PACE) Final Rule which finalizes the policies proposed in the August 2016 PACE proposed rule. Specifically, the final rule addresses application and waiver procedures, sanctions, enforcement actions and termination, administrative [...] Read More
Today, President Trump released his FY 2020 budget proposal, including $1.313 trillion in discretionary proposals (a reduction of $24 billion from his FY 2019 proposal). On the healthcare front, the budget requests an additional $500 million in funding devoted to childhood cancer research, $291 million to eliminate most new HIV infections within 5 years and [...] Read More
The Clinical Laboratory Improvement Amendments of 1988 and their associated regulations require laboratories performing moderate- or high-complexity testing to enroll in an approved proficiency-testing (PT) program “for each specialty, subspecialty, and analyte or test for which the laboratory is certified under CLIA.” These regulations were most-recently amended in 2012, and as of January 2017 there [...] Read More
With the release of the final 2019 Medicare Physician Fee Schedule (PFS) payment rule, CMS is touting program changes that aim to promote beneficiary access to virtual care and refine Medicare quality reporting requirements to emphasize reporting on measures linked to patient outcomes. Major initiatives are focused on: Proposed changes to the payment structure for [...] Read More
This evening, the Centers for Medicare and Medicaid Services (CMS) released the CY 2019 final payment rule for the End-Stage Renal Disease (ESRD) program. The rule contains a payment update for the ESRD Prospective Payment System, changes to the ESRD quality program, and an expansion of the ESRD Transitional Drug Add-on Payment Adjustment (TDAPA). Additionally, the [...] Read More
This evening, the Centers for Medicare and Medicaid Services (CMS) released the CY 2019 final payment rule for Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS) and for the End-Stage Renal Disease (ESRD) program. The rule contains changes to the DMEPOS competitive bidding program as well to DME fee schedule payments where competitive bidding is not [...] Read More
Following the release of an HHS report on international drug pricing, President Trump announced a new Department of Health and Human Services (HHS) initiative to index pricing for Medicare Part B drugs to international prices. The advance notice of proposed rulemaking solicits comments on a demonstration program HHS is considering that would test changes to [...] Read More
Today, the Centers for Medicare & Medicaid Services announced amendments to its Medicare Program Integrity Manual in accordance with the 21st Century Cures Act to modify the procedures by which Medicare Administrative Contractors (MACs) arrive at Local Coverage Determinations (LCDs). While any move in the direction of increased transparency is laudable, it remains to be seen [...] Read More