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News by Topic: Medicare

May 22, 2023 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of receipt of an application for initial recognition of the Center for Improvement in Healthcare Quality (CIHQ) as a national accrediting organization for psychiatric hospitals that wish to participate in the Medicare or Medicaid programs. Comments are due by June 21, 2023.
Source: Federal Register
May 22, 2023 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of the approval of the Center for Improvement in Healthcare Quality (CIHQ) as a national accrediting organization for Critical Access Hospitals that wish to participate in the Medicare or Medicaid programs. The approval is effective June 1, 2023, to June 1, 2027.
Source: Federal Register
May 19, 2023 - Senators Susan Collins of Maine and Catherine Cortez-Masto of Nevada introduced legislation to ensure all communities, regardless of population, have access to adequate emergency medical services. The Protecting Access to Ground Ambulance Medical Services Act allows ambulance providers to be properly reimbursed by Medicare for the costs of providing emergency services, while also ensuring that existing EMT services, particularly in rural locations, remain operational, with sufficient staff and supplies.
Source: Office of Senator Susan Collins
May 12, 2023 - Quarterly listing of Centers for Medicare and Medicaid Services (CMS) manual instructions, substantive and interpretive regulations, and Federal Register notices published from January through March 2023, including contact information for general questions or additional information about specific sections.
Source: Federal Register
May 11, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on the extension of the Home Health Agency Cost Report, Form CMS–1728–20. The cost report is used to determine a provider's reasonable cost incurred in furnishing medical services to Medicare beneficiaries and reimbursement due to or from a provider and for annual rate setting and payment refinement activities, including developing a home health market basket. Comments are due by July 10, 2023.
Source: Federal Register
May 10, 2023 - An HHS fact sheet outlining what is and is not changing around telehealth as the COVID-19 Public Health Emergency ends, including information on coverage of services. Provides guidance around licensure portability, a measure intended to increase access to healthcare for rural and underserved communities. Also outlines broadband initiatives that increase access to healthcare and reduce disparities.
Source: U.S. Department of Health and Human Services
May 4, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) Medicare Enrollment Application for Institutional Providers; 2) Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey; and 3) End-stage Renal Disease (ESRD) Quality Incentive Program (QIP): Study of Quality and Patient Experience. Comments are due by June 5, 2023.
Source: Federal Register
May 2, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on an information collection request titled "Patient Provider Dispute Resolution Requirements Related to Surprise Billing: Part II." This information collection request (ICR) focuses on the patient-provider dispute resolution process requirements under the October 7, 2021, interim final rule. Comments are due by July 3, 2023.
Source: Federal Register
May 2, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing that in-person delivery of Medicare Diabetes Prevention Program (MDPP) services can be suspended through December 31, 2023. This extension allows MDPP suppliers additional time to resume in-person services as the COVID-19 public health emergency concludes. This notice is effective May 2, 2023.
Source: Federal Register
May 1, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) regarding changes to the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2024. Contains details of changes impacting Medicare graduate medical education (GME) for teaching hospitals and inpatient hospital services provided by long-term care hospitals, among other things. This proposed rule also includes information and updates on the Rural Emergency Hospital (REH) designation. Comments are due by June 9, 2023.
Source: Federal Register
Apr 28, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey; 2) Medicare Advantage and Prescription Drug Program: Final Marketing Provisions in 42 CFR 422.111(a)(3) and 423.128(a)(3); 3) Medicaid Drug Rebate Program Labeler Reporting Format; and 4) Testing Experience and Functional Tools (TEFT): Functional Assessment Standardized Items (FASI) Based on the CARE Tool. Comments are due by May 30, 2023.
Source: Federal Register
Apr 27, 2023 - Announcement of the Resident Physician Shortage Reduction Act, proposed legislation to address physician shortages. Legislation would remove the cap on Medicare-funded graduate medical education positions and increase the number of available positions over 7 years. The increase in positions includes prioritization for rural areas and Health Professional Shortage Areas.
Source: Office of Senator Susan Collins
Apr 20, 2023 - Announces the release of ownership data for Medicare-certified hospice and home health agencies following an Executive Order from President Biden. Data release will allow anyone to see ownership of more than 6,000 hospices and 11,000 home health agencies. Data includes not just current owner information but also information on mergers and other changes of ownership since 2016. Data will be updated quarterly.
Source: Centers for Medicare & Medicaid Services
Apr 18, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) seeking comments on revisions to the Minimum Data Set 3.0 Nursing Home and Swing Bed Prospective Payment System (PPS) for the collection of data related to the Patient-Driven Payment Model and the Skilled Nursing Facility (SNF) Quality Reporting Program (QRP). CMS uses the MDS 3.0 PPS Item Set to collect the data used to reimburse skilled nursing facilities for SNF-level care furnished to Medicare beneficiaries and to collect information for quality measures and standardized patient assessment data under the SNF QRP. Comments are due by May 18, 2023.
Source: Federal Register
Apr 17, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) Manufacturer Submission of Average Sales Price (ASP) Data for Medicare Part B Drugs and Biologicals; 2) CAHPS Hospice Survey; 3) Elimination of Cost-Sharing for full benefit dual-eligible Individuals Receiving Home and Community-Based Services; 4) Annual Eligibility Redetermination, Product Discontinuation and Renewal Notices. Comments are due by May 17, 2023.
Source: Federal Register
Apr 14, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing its approval of the Accreditation Commission for Health Care (ACHC) for continued recognition as a national accrediting organization for hospitals that wish to participate in the Medicare or Medicaid programs. Comments are due by May 15, 2023.
Source: Federal Register
Apr 14, 2023 - The Centers for Medicare and Medicaid Services (CMS) will hold a virtual public meeting on May 30 - June 1, 2023, to discuss the preliminary coding, Medicare benefit category, and payment determinations for new revisions to the Healthcare Common Procedure Coding System (HCPCS) Level II code set. The agenda and information on how to join the meeting will be posted on the CMS website. Registration is required.
Source: Federal Register
Apr 12, 2023 - Notice of final rule from the Centers for Medicare & Medicaid Services (CMS) revising regulations for Medicare Advantage (Part C), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE). Revisions include changes related to Star Ratings, health equity, provider directories, coverage criteria, prior authorization, passive enrollment, network adequacy, and other programmatic areas. These regulations are effective June 5, 2023.
Source: Federal Register
Apr 11, 2023 - The Centers for Medicare & Medicaid Services (CMS) is seeking comment on the following information collections: 1) CMS HCPCS Modification to Code Set Form; and 2) Emergency Ambulance Transports and Beneficiary Signature. Comments are due by May 11, 2023.
Source: Federal Register
Apr 11, 2023 - A series of recommendations from an advisory committee to the Secretary of the U.S. Department of Health and Human Services (HHS) for the expansion of Programs of All-Inclusive Care for the Elderly (PACE) could enable elderly residents in rural communities to age in place. Recommendations include expanding telehealth, supporting a program focused on Medicare beneficiaries, allowing PACE sites to be eligible for student loan repayment, and encouraging students trained through the Indian Health Service to rotate to PACE sites.
Source: HealthLeaders Media
Apr 10, 2023 - Notice of proposed rule from the Centers for Medicare and Medicaid Services (CMS) updating the FY 2024 prospective payment rates, outlier threshold, and wage index for Medicare inpatient hospital services provided by inpatient psychiatric facilities (IPF), including psychiatric hospitals and excluded psychiatric units of an acute care hospital or Critical Access Hospital. The proposed rule discusses proposals on quality measures and reporting requirements under the Inpatient Psychiatric Facilities Quality Reporting (IPFQR) Program, with proposed changes beginning with the FY 2024 payment determination through changes beginning with the FY 2028 payment determination. Comments are due by June 5, 2023.
Source: Federal Register
Apr 10, 2023 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) that would update the skilled nursing facility (SNF) payment rates for fiscal year 2024 and implement the second phase of the Patient-Driven Payment Model (PDPM) parity adjustment recalibration. Includes proposals to update the diagnosis code mappings used under PDPM, the SNF Quality Reporting Program (QRP), and the SNF Value-Based Purchasing (VBP) Program. Comments are due by June 5, 2023.
Source: Federal Register
Apr 7, 2023 - Notice of a proposed rule from the Centers for Medicare and Medicaid Services (CMS) seeking comments on updates to the prospective payment system for inpatient rehabilitation facilities (IRFs) for fiscal year 2024. Among other things, this proposed rule would rebase and revise the IRF market basket to reflect a 2021 base year, modifies the regulation regarding when IRF units can become excluded and paid under the IRF PPS, and updates the IRF Quality Reporting Program. Includes rural considerations throughout. Comments are due by June 2, 2023.
Source: Federal Register
Apr 5, 2023 - Quarterly notice from the Department of Health and Human Services' Office of Medicare Hearings and Appeals (OMHA) listing the instructions finalized during the period of October through December 2022 related to procedures for carrying out adjudicative functions to resolve disagreements with Medicare claims.
Source: Federal Register
Apr 4, 2023 - The Centers for Medicare and Medicaid Services is seeking comment on the following information collections: 1) Notice of Denial of Medical Coverage (or Payment), which requires Medicare health plans to provide written notice to enrollees in plain language for reasons for denied services and information on the appeals process; and 2) Proposed Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Process and Requirements for a Potential National Model, which allows CMS to collect information to continue RSNAT model operations. Comments are due by June 5, 2023.
Source: Federal Register
Apr 4, 2023 - The Centers for Medicare and Medicaid Services is seeking comment on two information collections: 1) Registration, Attestation, Dispute Resolution and Correction, Assumptions Document and Data Retention Requirements for Open Payments; and 2) Medicaid Managed Care and Supporting Regulations. Comments are due by May 4, 2023.
Source: Federal Register
Apr 4, 2023 - Notice of a proposed rule from the Centers for Medicare and Medicaid Services (CMS) updating the hospice wage index, payment rates, and aggregate cap amount for fiscal year 2024. Includes updates to the Hospice Quality Reporting Program; discusses the Hospice Outcomes and Patient Evaluation tool; provides an update on Health Equity and future quality measures; and provides updates on the Consumer Assessment of Healthcare Providers and Systems, Hospice Survey Mode Experiment. Among other things, this rule also includes information on hospice utilization trends and solicits comments regarding information related to the provision of higher levels of hospice care; ownership transparency; and ways to examine health equity under the hospice benefit. Includes rural considerations throughout. Comments are due by May 30, 2023.
Source: Federal Register
Apr 3, 2023 - Notice from the Centers for Medicare & Medicaid Services (CMS) announcing its approval of the Accreditation Commission for Health Care, Inc., for continued recognition as a national accrediting organization for Ambulatory Surgical Centers that wish to participate in the Medicare or Medicaid programs.
Source: Federal Register