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Medicare

April 14, 2021 | Daily News

Information blocking rules that went into effect last Monday (April 5) are causing confusion among providers due to lack of guidance from the Office of the National Coordinator for Health Information Technology, health IT stakeholders say.

April 14, 2021 | Daily News

Medicaid and CHIP Payment and Access Commission staff will focus future Dual Eligible Special Needs Plans work on potentially limiting enrollment to full benefit duals and examining the pros and cons of requiring state review of D-SNP marketing materials, staff said at an April 8 meeting.

April 13, 2021 | Daily News

The House late Tuesday (April 13) overwhelming passed legislation to stave off a 2% Medicare sequester cut, sending the bill to President Joe Biden’s desk.

April 13, 2021 | Daily News

House Energy & Commerce Committee leaders from both parties are urging HHS Secretary Xavier Becerra to step up enforcement of hospital transparency requirements considering reports that some hospitals aren’t complying.

April 13, 2021 | Daily News

Close to 50 accountable care organizations, health systems and others, led by America’s Physician Groups, are pushing CMS to reconsider its decision not to accept additional applications for two tracks of the Direct Contracting demo, saying those interested in the demo were ready to apply and the agency’s move is a “serious blow” to those organizations.

April 13, 2021 | Daily News

A handful of accountable care organizations joined dozens of health systems and others, led by America’s Physician Groups, in pushing CMS to reconsider its decision not to accept additional applications for two tracks of the Direct Contracting demo, saying those interested in the demo were ready to apply and the agency’s move is a “serious blow” to those organizations.

April 13, 2021 | Daily News

Brand drug makers are now open to ending some patent-gaming industry practices, including “product hopping” and possibly “patent thicketing,” and lowering Medicare reimbursement to doctors for administering drugs, according to a legislative agenda released by the Pharmaceutical Research and Manufacturers of America Tuesday (April 13).

April 13, 2021 | Daily News

Brand drug makers are now open to ending some patent-gaming industry practices, including “product hopping” and possibly “patent thicketing,” and rebating Medicare for Part B drugs, according to a legislative agenda released by the Pharmaceutical Research and Manufacturers of America Tuesday (April 13).

April 13, 2021 | Daily News

Although the Congressional Progressive Caucus did not include extending the Affordable Care Act’s enhanced tax credits in its wish list for the next legislative package, a source familiar with the discussions says progressives do support making the American Rescue Package policies permanent -- but they want savings gleaned from drug-pricing reforms to go toward expanding public health programs and not just toward bolstering the ACA.

April 13, 2021 | Daily News

CMS will give providers and payers more time to apply to be part of the second round of the Primary Care First demonstration, coming as the agency puts other demonstrations and applications on hold.

April 09, 2021 | Daily News

State Medicaid officials told the Medicaid and CHIP Payment and Access Commission Friday (April 9) that while telehealth has been crucial throughout the COVID-19 public health emergency, refinements are needed before telehealth can be made permanent.

April 08, 2021 | Daily News

CMS proposes to increase skilled nursing facility’s pay a net 1.3%, or $444 million, in fiscal 2022, and to add two new quality reporting measures in fiscal year 2023: vaccination rates among health care personnel staff and health care acquired infections.

April 08, 2021 | Daily News

While CMS limited its annual hospice payment policies last year to essential policies due to the pandemic, the agency recommends a slew of changes in its proposed fiscal year 2022 hospice pay policies: make a COVID-19 waiver permanent, make several changes to the Hospice Quality Reporting Program and revise the labor shares.

April 08, 2021 | Daily News

Hospitals are calculating whether it would be better for them to immediately repay their Medicare loans or have the payments taken out of their claims after CMS announced it’s beginning to recoup payments under the Medicare Accelerated and Advance Payment Program.

April 08, 2021 | Daily News

The Medicare Payment Advisory Commission unanimously voted in favor of draft recommendations to cover all preventive vaccines under Part B for free to beneficiaries.

April 07, 2021 | Daily News

CMS plans to modify the inpatient psychiatric facilities’ quality reporting program by adding a measure that assesses COVID-19 vaccination rates among health care personnel and another that expands who can provide follow-up care for patients hospitalized with a mental illness, according to a proposed rule unveiled Wednesday (April 7) that would also increase next year’s pay for the facilities.

April 07, 2021 | Daily News

CMS proposes to increase inpatient rehabilitation facilities' fiscal year 2022 pay by 1.8%, or $160 million, relative to last year's payments, and to advance the Biden administration’s focus on health equity.

April 07, 2021 | Daily News

The American Medical Association joined dozens of specialty physician groups and patient advocates on Wednesday (April 7) in asking CMS to delay its decision to require prior authorization for two service areas under the calendar year 2021 Medicare hospital outpatient prospective payment rule and to put off any future prior authorization policies until more data are collected.

April 06, 2021 | Daily News

HHS Secretary Xavier Becerra faces a barrage of competing issues arising out of the pandemic, but children’s health care advocates’ priorities center around one central idea: thinking about kids first.

April 06, 2021 | Daily News

The White House is expected to roll out the health care priorities for its two-part infrastructure package sometime this Spring, and the health piece potentially could move separately now that the Senate parliamentarian has agreed Democrats have another shot passing their priorities through a simple majority.

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