CMS

Clinicians to Earn MIPS Credit for Joining COVID-19 Clinical Trial

by Jacqueline LaPointe

Clinicians earning value-based reimbursement through the Merit-Based Incentive Payment System (MIPS) will be able to earn credit for participating in and reporting information on COVID-19 clinical...

CMS Issues Guidance on Resuming Elective Services in Certain Areas

by Jacqueline LaPointe

As COVID-19 outbreaks start to wane in certain areas, CMS is releasing guidance on resuming non-emergent, elective services to non-coronavirus patients without symptoms. For more coronavirus updates,...

CMS Unveils More Flexibilities to Maximize Healthcare Workforce

by Jacqueline LaPointe

In an effort to maximize the healthcare workforce during the COVID-19 pandemic, CMS is now allowing physicians to virtually treat patients at rural hospitals and nurse practitioners to perform more...

2.3% Medicare Payment Hike Planned for Skilled Nursing Facilities

by Jacqueline LaPointe

Skilled nursing facilities are slated to see a 2.3 percent, or $784 million, increase in Medicare payments in the 2021 fiscal year (FY), according to a rule proposed by CMS late on Friday. CMS also...

CMS Pays Out $34B in Advance Medicare Reimbursement to Providers

by Jacqueline LaPointe

UPDATED 04/04/2020: CMS has now approved over $51 billion in accelerated and advance Medicare reimbursement for providers, according to a news alert emailed to journalists on April 9. In a...

CMS to Pay For Hospital COVID-19 Care Furnished in Other Settings

by Jacqueline LaPointe

CMS recently announced new, temporary regulatory flexibilities for hospitals battling the COVID-19 pandemic. For more coronavirus updates, visit our resource page, updated twice daily by...

CMS Offers Upfront Medicare Reimbursement During COVID-19 Pandemic

by Jacqueline LaPointe

More healthcare providers will be able to access advanced Medicare reimbursement during the COVID-19 pandemic as CMS expands the Accelerated and Advanced Payment Program. For more coronavirus updates,...

National Healthcare Spending to Climb to 19.7% of GDP by 2028

by Jacqueline LaPointe

Researchers at the Office of the Actuary at CMS project national healthcare spending to grow at an average annual rate of 5.4 percent from 2019 through 2018, outpacing the average projected growth in...

Key Waivers, Regulatory Flexibility for Providers During COVID-19

by Jacqueline LaPointe

President Trump declared the COVID-19 outbreak a national emergency last week in a move that will allow HHS to enact 1135 waivers and regulatory flexibilities to help hospitals activate emergency...

CMS Releases Medicare Reimbursement Details for COVID-19 Tests

by Jacqueline LaPointe

Following the development of new billing codes, CMS is now letting clinical laboratories know how much they will receive in Medicare reimbursement for testing patients for COVID-19. CMS emailed...

ACOs Back Hospitalization Alerts in Final Interoperability Rule

by Jacqueline LaPointe

Accountable care organizations (ACOs) are calling a new Medicare requirement on hospitalization alerts “a win for better population health management,” the National Association of ACOs...

CMS Develops New Billing Codes for Coronavirus Lab Tests

by Jacqueline LaPointe

CMS recently announced the development of new billing codes for coronavirus lab tests that will enable clinical laboratories and other providers to receive reimbursement for supporting patients during...

CMS Selects Participants for New Emergency Care Payment Model

by Samantha McGrail

CMS announced it selected 205 applications who will participate in the Emergency Triage, Treat, and Transport (ET3) Model, a payment model that ensures beneficiaries’ access to emergency...

CMS Seeks Extension for Comprehensive Care for Joint Replacement

by Jacqueline LaPointe

The Comprehensive Care for Joint Replacement (CJR) Model is slated to sunset by the end of the year, but a recently proposed rule from CMS would extend the bundled payment program for another three...

Policymakers, Industry Leaders Call for Innovation Center Changes

by Jacqueline LaPointe

The CMS Innovation Center – otherwise known as CMMI – has been the federal government’s key instrument for healthcare payment and care delivery reform. But lately, policymakers and...

Practices in Oncology Care Model Ready to Assume Two-Sided Risk

by Samantha McGrail

Oncology practices participating in CMS’ Oncology Care Model (OCM) are willing to take on two-sided risk, according to a survey conducted by the Community Oncology Alliance (COA).  The...

New Quality Measure to Evaluate Psychiatric Hospital Readmissions

by Samantha McGrail

University of Florida Health (UF) researchers have partnered with the Health Services Advisory Group (HSAG) to complete a new quality measure for CMS to evaluate care in psychiatric hospitals...

Hospital Price Transparency Services Scratch Surface of Spending

by Jacqueline LaPointe

A recent analysis conducted by the Health Care Cost Institute (HCCI) is raising questions about the efficacy of a consumer-centered hospital price transparency requirement slated to take effect next...

High Quality Hospitals Treat Less Medicare Advantage Enrollees

by Samantha McGrail

Medicare Advantage enrollees had a 2.8 percentage point lower probability of being admitted to a highly rated hospital compared to traditional Medicare enrollees, according to a report from Brown...

Cost Disparities Spell Trouble for Healthcare Price Transparency

by Samantha McGrail

The national disparity between gross charges for hospital procedures is substantial, at an average of 297 percent difference between the lowest and highest gross charge for each individual procedure,...