Medicare

Lawmakers, providers and hospitals want additional funding for Medicaid and behavioral health included in the upcoming coronavirus stimulus package, as well as funding for providers, although they don’t say how much.

The American Hospital Association told CMS on Saturday (May 2) that it shouldn’t require hospitals to divert time and attention away from COVID-19 to deal with a 340B drug acquisition cost survey -- which 340B hospitals are expected to fill out by May 15 -- and the group reiterated its concerns that the survey violates Medicare and Administrative Procedures Act statute.

CMS set up an independent commission to assess the response of nursing homes to COVID-19 the same day the Trump administration promised more personal protective equipment for those providers, though the nursing lobby says the administration’s promise is not enough.

The White House Office of Management and Budget on Wednesday (April 29) began its review of final 2021 and 2022 regulatory changes to Medicare Advantage and Part D -- a rule proposed earlier this year in lieu of the call letter that has typically been released alongside the annual MA and Part D rate notice.

In another set of wide-ranging emergency waivers and policy changes aimed at tackling the coronavirus pandemic, CMS announced Thursday (April 30) that it is expanding how Medicare pays for COVID-19 diagnostic tests, encouraging hospitals to increase their capacity, and codifying a new requirement for nursing homes to inform residents and their families of any confirmed or suspected COVID-19 cases in their facilities.

The Federal Emergency Management Agency (FEMA) will deliver “care packages” containing four items of personal protective equipment to 15,000 nursing homes nationwide, said FEMA Administrator Peter Gaynor on Thursday (April 30).

Lawmakers and provider groups are calling on HHS to raise Medicare reimbursement for providers who provide audio-only telehealth services as well as allow providers to submit diagnoses from those visits for risk adjustment purposes.

A federal appeals court should revive a controversial overpayment rule in Medicare Advantage because, without the rule in place, CMS has limited ability to stop MA plans from engaging in one-sided medical reviews that artificially inflate their payments, the agency says in a recent legal brief.

The Better Medicare Alliance is asking CMS to take steps to stabilize Medicare Advantage rates for 2021, including putting out guidance for plans around the COVID-19 pandemic and paying for all vaccines and COVID-19 treatments separately from MA.