Medicare

Beneficiary advocates are pleased House Democrats’ HEROES Act includes a Medicare Special Enrollment period for Parts A and B, as CMS had already released a nationwide SEP for Medicare Advantage and Part D plans and some said the agency lacked authority to go further to open up Medicare enrollment.

House Republicans Friday (May 15) blasted Democrats for slipping into their sweeping COVID-19 response package new language that creates a federal backstop to prevent insurer losses, saying the move shows the Democrats are about “corporations first.”

Accountable care organizations, health systems, doctors, teaching hospitals and others are pleased with CMS’ moves to mitigate the effects of the COVID-19 outbreak on ACOs, but they also say more steps could be taken to keep the providers interested in value-based pay.

A sweeping proposal by House Democrats unveiled Tuesday (May 12) would provide funding to states to expand testing and again replenish the provider relief fund, although Republicans have made it clear the bill won’t go far.

House Democrats’ latest COVID-19 stimulus bill would give providers at least a year to start repaying Medicare Part A and Part B loans, lower the interest rate and allow providers to pay back a smaller amount at a time until the funds are repaid.

CMS pulled back from its plans to update the overall hospital star ratings program in the proposed fiscal 2021 hospital inpatient pay rule, released Monday (May 11), as the agency says it limited annual rulemaking to essential policies due to the COVID-19 pandemic.

House Ways & Means Committee Chair Richard Neal (D-MA) called on CMS to slow down allowing hospitals and health systems to reopen for non-emergency services until facilities meet certain requirements.

HHS on Thursday (May 7) distributed $583 million to over a thousand community health centers to bolster COVID-19 testing.

An analysis by the law firm Foley Hoag says CMS has the authority to use multiple years of data to calculate Medicare Advantage plans’ risk adjustment and to further increase those risk adjustment scores by changing the normalization factor -- policies requested by the Better Medicare Alliance to account for uncertain 2021 costs due to COVID-19 disruptions -- through various waivers and demonstrations.