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Rural Health
News by Topic: Reimbursement and payment models

Sep 17, 2020 - Notice from the Centers for Medicare and Medicaid Services (CMS) seeking comment on reestablishing the "Do Not Pay Initiative" computer matching program between CMS and the Department of the Treasury. The program provides CMS with information from Treasury's Working System which CMS will use to identify Medicare providers and suppliers who are ineligible for Medicare enrollment; to promptly suspend or revoke the Medicare billing privileges of the identified disqualified providers and suppliers; to enable recoupment of past payments made to those providers and suppliers; to assist CMS in detecting and preventing fraud, waste, abuse and in avoiding making future improper payments to disqualified providers and suppliers; and to enhance patient safety for beneficiaries in CMS programs. Comments are due by October 19, 2020.
Source: Federal Register
Sep 15, 2020 - The Centers for Medicare and Medicaid Services (CMS) issued guidance to state Medicaid directors to aid in the adoption of value-based care strategies across their healthcare systems. The guidance includes an assessment of key lessons in implementing value-based care reforms and a comprehensive toolkit of available federal authorities to help states adopt innovative payment reform efforts.
Source: Centers for Medicare and Medicaid Services
Sep 14, 2020 - The Centers for Medicare and Medicaid Services (CMS) released Part I of the 2022 Medicare Advantage Advance Notice three months early to allow Medicare Advantage organizations and Part D plans more time to prepare their bids for 2022. This notice includes information on Medicare Advantage risk adjustment with a 60-day comment period.
Source: Centers for Medicare and Medicaid Services
Aug 31, 2020 - The Centers for Medicare and Medicaid Services has released a correcting amendment to the August 6, 2015 final rule. Corrections are applicable beginning October 1, 2015.
Source: Federal Register
Aug 17, 2020 - Notice of proposed rule from the Centers for Medicare and Medicaid Services making changes to the following: 1) Physician Fee Schedule and Medicare Part B payment policies; 2) Medicare Shared Savings Program requirements; 3) Medicaid Promoting Interoperability Program requirements for Eligible Professionals; 4) updates to the Quality Payment Program; 5) Medicare coverage of opioid use disorder services furnished by opioid treatment programs; 6) Medicare enrollment of Opioid Treatment Programs; 7) payment for office/outpatient evaluation and management services; 8) requirement for Electronic Prescribing for Controlled Substances for a Covered Part D drug under a prescription drug plan or an MA-PD plan; and 9) Medicare Diabetes Prevention Program (MDPP) expanded model Emergency Policy. Includes rural references throughout. Comments on the proposed rule are due by October 5, 2020.
Source: Federal Register
Aug 12, 2020 - Notice of proposed rule from the Centers for Medicare and Medicaid Services revising the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Medicare Ambulatory Surgical Center (ACS) payment system for calendar year 2021. Also updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program, as well as establishes and updates the Overall Hospital Quality Star Rating beginning with the 2021 calendar year, among other things. Includes rural references throughout. Comments on the proposed changes are due on October 5, 2020.
Source: Federal Register
Aug 11, 2020 - The Trump Administration announced new funding opportunities that will increase access to and improve the quality of the rural healthcare system. The Community Health Access and Rural Transformation (CHART) Model allows providers two options for participation: The Community Transformation Track will provide $75 million in seed money to 15 rural communities, and the Accountable Care Organization (ACO) Transformation Track, where providers enter two-sided risk arrangements as part of the Medicare Shared Savings Program (MSSP) and may use all waivers available in the MSSP program.
Source: Centers for Medicare and Medicaid Services
Aug 10, 2020 - The Centers for Medicare and Medicaid Services (CMS) will hold a virtual meeting of the Advisory Panel on Hospital Outpatient Payment for 2020 on August 31, 2020. The agenda will focus on the announcement of four new members to the panel, which is charged with providing recommendations to CMS and the Department of Health and Human Services on matters concerning the hospital outpatient prospective payment system. Comment and presentation submissions to be considered at the meeting are due by August 14, 2020.
Source: Federal Register
Aug 6, 2020 - Notice of proposed rule from the Centers for Medicare and Medicaid Services to establish a policy for the treatment of patient days associated with those enrolled in a Medicare Advantage plan for the purpose of calculating a hospital's disproportionate patient percentage for cost reporting periods beginning before fiscal year 2014. This proposed rule is in response to the ruling in Azar v. Allina Health Services on June 3, 2019. Comments on the rule are due by October 5, 2020.
Source: Federal Register
Aug 6, 2020 - Executive Order from the Office of the President intended to increase access to, improve the quality of, and improve the financial economics of rural healthcare, including by increasing access to care through telehealth. Provides information and timelines for implementation of various initiatives to accomplish these goals.
Source: Federal Register