CMS

Chiquita Brooks-LaSure Becomes Next CMS Administrator

by Jacqueline LaPointe

The Senate has confirmed Chiquita Brooks-LaSure to lead the Centers for Medicare & Medicaid Services (CMS) by a vote of 55 to 44. Brooks-LaSure is the first Black woman to lead the agency...

CMS to Reweight MIPS Cost Performance Category for 2020

by Jill McKeon

CMS announced it will be reweighting the cost performance category under the Merit-Based Incentive Payment System (MIPS) from 15 percent to zero percent for the 2020 performance period to provide...

CMS Delays Codifying Definition of “Reasonable and Necessary”

by Jill McKeon

CMS announced that it will delay the effective date of a final rule updating the definition of “reasonable and necessary” and the guidelines surrounding the Medicare Coverage of Innovative...

Medicare Payment Bumped for COVID-19 Antibody, At-Home Infusions

by Jacqueline LaPointe

CMS has raised the Medicare payment rate for certain COVID-19 antibody infusions and included a new payment policy for at-home administration, which will have a higher payment rate compared to other...

CMS Proposes $2.5B IPPS Rate Hike, With Eye on Rural, Health Equity

by Jacqueline LaPointe

CMS is proposing to increase Medicare hospital inpatient rates by $2.5 billion next fiscal year, in addition to bolstering the rural healthcare workforce and health equity reporting. The rate increase...

How Fowler Plans to Refresh CMMI’s Value-Based Care Vision

by Jacqueline LaPointe

The healthcare system is at a critical point in its transition to value-based care a decade after implementation of the Affordable Care Act and its Center for Medicare and Medicaid Innovation (CMMI),...

2% Medicare Sequester Cuts Delayed Through End of 2021

by Jacqueline LaPointe

A two percent cut to Medicare reimbursement will be paused until the end of the year, CMS recently announced. The announcement via the MLN Connects newsletter on April 16th stated that the Medicare...

Hospital Price Transparency Rule Compliance Is Inconsistent

by Hannah Nelson

Many hospitals are not complying with the CMS price transparency rule more than four months after its passage, according to a new KFF analysis that calls for data standardization. Put into effect on...

AHA Backs Chiquita Brooks-LaSure as Next CMS Administrator

by Jacqueline LaPointe

The American Hospital Association (AHA) has announced its support of President Biden’s pick for CMS Administrator, Chiquita Brooks-LaSure, ahead of the confirmation hearing this week. The...

CMS Stops Accepting New Direct Contracting Applications

by Jacqueline LaPointe

CMS has announced that it will not be soliciting any more applications for the Global and Professional Direct Contracting Models slated to launch on January 1, 2022. Organizations that had already...

CMS Plans 1.3% Medicare Payment Hike for Skilled Nursing Facilities

by Jacqueline LaPointe

CMS has proposed a $444 million increase in Medicare payments to skilled nursing facilities (SNFs) in the federal fiscal year (FY) 2022, according to a new proposed rule. The rule released late...

CMS Proposes Medicare Payment Bump for Rehab, Psychiatric Facilities

by Jacqueline LaPointe

CMS has released the proposed rules for the Inpatient Rehabilitation Facility (IRF) Prospective Payment System and the Inpatient Psychiatric Facility Prospective Payment System for fiscal year (FY)...

CMS Starts Recouping Accelerated, Advance Medicare Payments

by Jacqueline LaPointe

CMS has started recouping Medicare payments it fronted to healthcare providers last year during the COVID-19 pandemic. In a recent MLN Matters newsletter, the agency stated that it has begun...

CMS Holding Claims Until Medicare Sequester Decision

by Jacqueline LaPointe

UPDATED 04/16/2021 CMS is temporarily holding claims from providers in anticipation of legislation that will extend the suspension of the 2 percent Medicare sequester, according to a recent...

CMS Delays CHART Model’s ACO Transformation Track

by Jacqueline LaPointe

CMS has pushed back the application cycle by a year for a new rural-focused accountable care organization (ACO) model. In an email sent yesterday, CMS said it has delayed the request for applications...

CMS Announces 184 Participants For ET3 Model, New Funding

by Jacqueline LaPointe

CMS has shared the final list of 184 public and private ambulance providers and suppliers selected to participate in the agency’s Emergency Triage, Treat, and Transport (ET3) Model, an...

CMS Boosts Medicare Reimbursement for COVID-19 Vaccinations

by Jacqueline LaPointe

UPDATED 03/16/21 CMS has significantly increased Medicare reimbursements rates for the administration of new COVID-19 vaccines in an effort to accelerate rollout, according to a new...

Biden Administration Pauses Key Value-Based Reimbursement Models

by Jacqueline LaPointe

The Biden administration has paused several prominent value-based reimbursement models run by the CMS Innovation Center (CMMI) to review model details, according to several updates provided on model...

Hospital Risk Stratification Leads To Equitable Value-Based Payment

by Hannah Nelson

When hospitals in the Hospital-Acquired Condition Reduction Program (HACRP) were stratified by social risk, value-based penalties for safety-net hospitals decreased, according to a new study published...

AHA Decries UnitedHealthcare’s Diagnostic, Drug Coverage Policies

by Jacqueline LaPointe

The American Hospital Association (AHA) is seeking immediate relief from UnitedHealthcare’s new benefit design program that would restrict in-network diagnostic providers. The hospital group...