Policy and Regulation

CMS Sets Medicare Reimbursement Rate for COVID-19 Vaccine

by Jacqueline LaPointe

A new interim final rule with comment period ensures Medicare reimbursement for the administration of a COVID-19 vaccine and provider use of innovative treatments for the novel coronavirus. The rule...

CMS Wants to Streamline DMEPOS Reimbursement, Boost Rural Pay

by Jacqueline LaPointe

A new proposed rule from CMS is seeking to streamline how the agency determines if durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) qualify for Medicare reimbursement and...

After Pushback, HHS Revises Provider Relief Fund Reporting Rules

by Jacqueline LaPointe

HHS is walking back a change it made to Provider Relief Fund reporting rules in September after hospitals and lawmakers warned the change could result in some providers having to return...

Providers Want Congress to Pause Medicare Sequester in 2021, Too

by Jacqueline LaPointe

Major provider groups are asking Congress to extend a congressionally-enacted moratorium on the application of the Medicare sequester cuts into 2021. The American Hospital Association, American...

CMS Pushes Back Launch of Radiation Oncology Model

by Jacqueline LaPointe

CMS recently announced via email that it intends to delay the start of the Radiation Oncology Model after receiving feedback from stakeholders. “CMS has received feedback from a number of...

Lawmakers Seek Bipartisan Solution for Physician Fee Schedule Cuts

by Jacqueline LaPointe

Over 200 Representatives are calling on Congress to examine possible bipartisan solutions to address proposed Medicare Physician Schedule cuts for certain specialties, including surgical care. In a...

CMS Reduces Medicare Reimbursement Rate for Some COVID-19 Tests

by Jacqueline LaPointe

CMS will reduce the base Medicare reimbursement rate for COVID-19 tests done by laboratories using high throughput technology, according to a new announcement. The announcement made late last week...

CMS Provides Medicare Reimbursement for More Telehealth During PHE

by Jacqueline LaPointe

CMS recently added 11 new services to the Medicare telehealth services list, qualifying the services for Medicare reimbursement through the COVID-19 public health emergency (PHE). The new telehealth...

Senators Call for Changes to Provider Relief Fund Reporting

by Jacqueline LaPointe

Senators are raising issues with recent changes to Provider Relief Fund reporting requirements, citing concerns about hospitals having to return the payments during the ongoing public health...

Top 3 Concerns with the 2021 Medicare Physician Fee Schedule Rule

by Jacqueline LaPointe

Provider groups are concerned that some proposals in the Medicare Physician Fee Schedule rule for 2021 would exacerbate the financial challenges physicians are already facing during the COVID-19...

CMS Amends Repayment Terms for Accelerated, Advance Payments

by Jacqueline LaPointe

UPDATED 10/14/2020 CMS recently announced new repayment terms for payments issued to providers under the Accelerated and Advance Payment Programs at the start of the COVID-19 public health...

CMS Releases Guidance on COVID-19 Data Reporting as Medicare CoP

by Jacqueline LaPointe

New guidance from CMS shares how the agency plans to implement a recent interim final rule that makes COVID-19 data reporting a condition of participation (CoP) in Medicare for hospitals. The guidance...

HHS Distributes Another $20B in Provider Relief Funds

by Jacqueline LaPointe

HHS recently announced new Phase 3 Provider Relief Funding for healthcare providers, including an expanded group of behavioral health providers. According to the announcement, HHS will begin...

Lawmakers Provide Accelerated, Advance Medicare Payment Relief

by Jacqueline LaPointe

A continuing resolution signed by President Trump early Thursday morning included key healthcare provisions, including an extension for providers who had their Medicare payments advanced during the...

AHA: Reinstate June’s Provider Relief Fund Reporting Requirements

by Jacqueline LaPointe

The American Hospital Association (AHA) is urging HHS to reinstate Provider Relief Fund reporting requirements outlined in a June 19 FAQ rather than move forward with those detailed in a Sept. 19...

CMS Streamlines CLIA Certification to Expand COVID-19 Testing

by Jacqueline LaPointe

CMS is seeking to expand COVID-19 testing by streamlining Clinical Laboratory Improvement Amendments (CLIA) certification and compliance. In an announcement late last week, the agency provided a...

White House Gives Congress Until Dec. 31 to Ban Surprise Billing

by Jacqueline LaPointe

UPDATED 09/30/2020 An executive order on a number of healthcare issues includes a new timeline for a surprise billing solution and further advancements in hospital price transparency. Signed by...

How FTC’s New Merger Retrospective Program Will Impact Healthcare

by Jacqueline LaPointe

The Federal Trade Commission’s (FTC’s) Bureau of Economics recently unveiled a revamped Merger Retrospective Program that will expand and formalize the Bureau’s retrospective research...

HHS Releases Reporting Requirements for COVID-19 Relief Payments

by Jacqueline LaPointe

HHS recently released an updated guidance document on reporting requirements for healthcare organizations that received COVID-19 relief payments of $10,000 or more. The document released on the HHS...

CMS Finalizes Alternative Payment Models for Specialty Care

by Jacqueline LaPointe

CMS is transitioning more specialty care to value-based reimbursement with two new alternative payment models for end-stage renal disease and cancer care. A final rule released late last week unveiled...