Medicare

CMS Administrator Seema Verma warned in an op-ed earlier this month that nursing homes restricting visitors without a reasonable health or safety reason will face citations, after the agency issued guidance telling nursing homes to again allow visitation.

Key House and Senate Democrats say the Medicare loan programs instituted during the pandemic could cost $6 billion more than lawmakers were initially told and could cause Part B premiums to increase by as much as $50 per month absent congressional intervention, and they ask CMS to respond by Oct. 2 on how it is handling those loans.

Two Democratic senators released a report Tuesday (Sept. 22) lambasting the Trump administration for lacking a comprehensive plan to protect nursing home residents, saying data collected both from CMS and the Centers for Disease Control and Prevention found 11 nursing homes residents died every hour from COVID-19 in July and August.

House Democrats on Monday (Sept. 21) introduced a continuing resolution to fund the government through Dec. 11 that includes Medicare and Medicaid funding extensions supported by the White House.

CMS on Friday (Sept. 18) announced it will start on Jan. 1 a mandatory demonstration aimed at increasing the use of home dialysis and kidney transplants -- which the agency says should give providers plenty of time to prepare -- and also revealed it will include 30% of dialysis facilities and providers managing adults with End-Stage Renal Disease in the model rather than its proposed 50% while rejecting the idea of a voluntary approach.

Beneficiary advocates say an independent report on the federal response to the COVID-19 pandemic in nursing homes puts too little responsibility on nursing homes and on CMS’ role in mitigating the crisis, even as CMS says the report validates its own actions.

CMS on Thursday (Sept. 17) announced it was revising guidance on visitations in nursing homes during the COVID-19 pandemic to allow both indoor and outdoor visits with residents, citing the emotional toll that isolating nursing home residents has taken.

The American Hospital Association, Association of American Medical Colleges and America’s Essential Hospitals asked the full U.S. Court of Appeals for the District of Columbia Circuit to rehear their lawsuit over cuts to hospitals’ Medicare reimbursement for 340B drugs, arguing the court’s initial decision doesn’t match up with previous court rulings and doesn’t take into account the exceptional importance of the issue at hand.

CMS Administrator Seema Verma on Tuesday (Sept. 15) said CMS is looking at creating a new, outcomes-based reimbursement strategy for COVID-19 tests and hinted any policy changes on reimbursement will move quickly.