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CMS Issues Additional Waivers & Interim Final Rule (CMS-5531-IFC) for COVID-19

On the afternoon of April 30th, the Centers for Medicare and Medicaid Services (CMS) announced that it submitted a second interim final rule (IFC) to the Federal Register and that it released an additional set of blanket waivers under section 1135 of the Social Security Act aimed at addressing the ongoing COVID-19 public health emergency (PHE). Below are many of the new flexibilities and capabilities included in the waivers and rule: Interim Final [...] Read More

CMS Releases Final Physician Payment Rule for 2020, Changes Made to E/M Coding and Care Management

On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the final calendar year (CY) 2020 Physician Fee Schedule (PFS). The rule includes the annual payment update for physicians in the Medicare program and also includes policies for the Quality Payment Program, care management services, and Opioid Treatment Program (OTPs). Provisions of [...] Read More

Medicare Can Do More to Improve Access to Digital Health For Seniors

Smart phones, social networks and internet applications help us communicate with family, friends and colleagues, but they can do so much more to improve our lives. Advances in technology and connectivity offer new methods for monitoring and accessing information about our health and well-being. Earlier this year, CMS Administrator Seema Verma announced that the Centers [...] Read More

Payments to Hospitals to Increase Over 3 Billion in FY 2020; Changes to Wage Index and New Technology Add-On Payments Adopted

Tweet On August 2, 2019, the Centers for Medicare and Medicaid Services (CMS) released the final FY 2020 payment rule for hospital inpatient departments and long-term care hospitals. The rule includes the payment update for both types of facilities as well as policies for new technology add-on payments, graduate medical education, and the hospital wage [...] Read More

CMS Finalizes Updates to Payment and Quality Reporting for Inpatient Rehabilitation Facilities; Amends Definition of Rehab Physician for FY 2020

Tweet On July 31, 2019, the Centers for Medicare and Medicaid Services (CMS) released the final FY 2020 inpatient rehabilitation facility payment rule. This final rule also includes updates to the IRF Quality Reporting Program (QRP). Provisions of this final rule become effective October 1, 2019. IRFs Will See Payment Increase of 2.5 Percent in [...] Read More

Inpatient Psychiatric Facility Rule Finalizes Payment Increases, Incorporates Medication Adherence Measure

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

CMS Proposes Enhanced Payments for New Dialysis Technology and Attempts to Streamline DME Pricing and Claims

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

CMS Estimates Over $600 Million in Savings from Changes to Long Term Care Facility Requirements

On July 16, 2019, Centers for Medicare and Medicaid Services (CMS) released proposed changes to requirements for Long Term Care facilities. Comments are due September 16, 2019. CMS proposes changes to Long Term Care (LTC) facility requirements and estimates administrative cost savings of $616 million annually over five years. As part of the Administration's [...] Read More

CMS Finalizes 2016 Proposed Updates to PACE Program, Includes Compliance and Quality Requirements

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

Verma Announces Plan to Foster Innovation for Transformative Medical Technologies

On May 2, CMS Administrator Seema Verma announced the Trump Administration’s “comprehensive strategy” to foster innovation for and improve patient’s access to transformative medical technologies. The strategy, detailed by Administrator Verma in a speech at the Medical Device Manufacturers Association (MDMA) Annual Meeting, is based on two specific changes related to coding. CMS says that [...] Read More

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