CMS

CMS Ups Medicare Payment for At-Home COVID-19 Vaccinations, Again

by Jacqueline LaPointe

To increase the rate of COVID-19 vaccinations among vulnerable patients, CMS is once again increasing the Medicare reimbursement rate it pays to providers who immunize patients in their...

Nursing Home Staff Must Get Vaccinated or Risk Medicare Funding

by Jill McKeon

Nursing home staff must get vaccinated against COVID-19 or risk losing Medicare and Medicaid funding, President Biden announced Wednesday. The announcement comes at a time when healthcare worker...

Leaked CMS Report Targets Medicare Noncompliance at CA Hospital

by Jill McKeon

A leaked CMS report put HCA Healthcare-owned Good Samaritan Hospital in California at risk of program termination by October if they fail to fix Medicare noncompliance issues that resulted in patient...

OIG: CMS Should Remove IPPS New Hospital Capital Cost Exemption

by Jill McKeon

A recent Office of Inspector General (OIG) audit recommended that CMS remove the inpatient prospective payment system (IPPS) new hospital capital cost exemption, which in recent years resulted in new...

MGMA Calls on CMS to Prevent EFT Fees, Predatory Business Tactics

by Jill McKeon

The Medical Group Management Association (MGMA) penned a letter to CMS urging the agency to use its authority to prohibit unfair electronic funds transfer (EFT) fees imposed on medical groups by health...

CMS Holds Off on Hospital Price Transparency Noncompliance Penalties

by Jill McKeon

CMS will hold off on hospital price transparency noncompliance penalties for the moment, a CMS spokesperson told Bloomberg Law. CMS proposed an increase in penalty amounts for noncompliant hospitals in...

AHA Addresses No Surprises Act Patient Notice and Consent Provisions

by Jill McKeon

AHA released comments regarding CMS’ guidance on notice and consent and public disclosure provisions under the No Surprises Act, recommending that CMS make some changes to the documents to reduce...

OIG: Medicare Overpays for Chronic Care Management Services

by Jill McKeon

An Office of the Inspector General (OIG) audit discovered that Medicare consistently overpaid for chronic care management (CCM) services, incurring millions in costs for Medicare and its...

Medicare Reimbursement Available for Third Dose of COVID-19 Vaccine

by Jacqueline LaPointe

Now that the Food and Drug Administration (FDA) has authorized a third dose of COVID-19 vaccines for immunocompromised people, CMS said it will provide Medicare reimbursement for immunizers. A CMS...

CMS Drops 4 FY22 Medicare Payment Rules: SNF, Hospice, IRF, IPF

by Jacqueline LaPointe

CMS recently released four final Medicare payment rules for fiscal year (FY) 2022. The rules cover new rates and other policies for skilled nursing facilities (SNFs), hospice agencies, inpatient...

94% of Hospitals Noncompliant with Hospital Price Transparency Rule

by Jill McKeon

Only 5.6 percent of hospitals are compliant with the hospital price transparency rule just over six months after its implementation, according to a report on 500 randomly selected US hospitals...

Key Quality Payment Program Changes in 2022 PFS Proposed Rule

by Jill McKeon

If finalized, the Quality Payment Program (QPP) will undergo significant policy changes under the Medicare Physician Fee Schedule (PFS) proposed rule. Most notably, the rule introduced the first seven...

CMS Proposes 2022 OPPS Rates, Higher Hospital Price Transparency Penalty

by Jacqueline LaPointe

CMS is seeking greater hospital price transparency enforcement through the newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022. The rule proposed...

CMS Seeks Health Equity, Telehealth in Physician Fee Schedule Rule

by Jacqueline LaPointe

CMS has proposed a new rule that would update the Medicare Physician Fee Schedule and seek more health equity and telehealth utilization among physicians. The proposed rule would establish a new...

AHA’s Recommendations for Inpatient Medicare Reimbursement in FY22

by Jill McKeon

The American Hospital Association (AHA) released comments on CMS’s FY 2022 Inpatient Prospective Payment System (IPPS) proposed rule, which would increase inpatient Medicare reimbursement rates...

CMS Proposes New Value-Based Payment for End-Stage Renal Disease

by Jacqueline LaPointe

CMS has issued a proposed rule that would create a new value-based payment pathway for end-stage renal disease (ESRD) facilities, as well as update Medicare rates for renal dialysis services next...

CMS Proposes $310M Boost, Value-Based Purchasing for Home Health

by Jacqueline LaPointe

CMS has released the proposed rule for the Home Health Prospective Payment System next year. The rule seeks to expand the Home Health Value-Based Purchasing (HHVBP) Model and address health equity...

CMS Increases Medicare Payments for At-Home COVID-19 Vaccinations

by Jill McKeon

Medicare payments will increase by $35 per dose for providers who administer at-home COVID-19 vaccinations for Medicare beneficiaries, CMS announced today. In alignment with President Biden’s...

CJR Model Linked to Increased Health Disparities, Study Reveals

by Jill McKeon

In a study of over four million Medicare beneficiaries, researchers found that the Comprehensive Care for Joint Replacement (CJR) model may be widening racial and socioeconomic health disparities in...

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...