CMS Updates

CMS Announces Plans to End the Blanket Waiver Requiring Nursing Homes to Submit Staffing Data

The Centers for Medicare & Medicaid Services (CMS) announced plans to end the emergency blanket waiver requiring all nursing homes to resume submitting staffing data through the Payroll-Based Journal (PBJ) system by August 14, 2020. The PBJ system allows CMS to collect nursing home staffing information which impacts the quality of care residents receive. The …

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CMS Announces Relief for Clinicians Participating in the Quality Payment Program in 2020

In response to the 2019 Coronavirus (COVID-19) public health emergency, the Centers for Medicare & Medicaid Services (CMS) is announcing flexibilities for clinicians participating in the Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) in 2020: Clinicians significantly impacted by the public health emergency may submit an Extreme & Uncontrollable Circumstances Application to reweight …

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CMS Unveils Major Organizational Change to Reduce Provider and Clinician Burden and Improve Patient Outcomes

New office to continue agency’s work of reducing regulatory burden to allow providers to focus on patients instead of paperwork and reducing health care costs Today, the Centers for Medicare & Medicaid Services (CMS) is announcing the creation of the Office of Burden Reduction and Health Informatics to unify the agency’s efforts to reduce regulatory …

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CMS Issues Call to Action Based on New Data Detailing COVID-19 Impacts on Medicare Beneficiaries

The Centers for Medicare & Medicaid Services (CMS) is calling for a renewed national commitment to value-based care based on Medicare claims data that provides an early snapshot of the impact of the coronavirus disease 2019 (COVID-19) pandemic on the Medicare population. The data released today includes the total number of reported COVID-19 cases and …

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Medicare Coverage of COVID-19 Testing for Nursing Home Residents and Patients

June 19, 2020 – The Centers for Medicare & Medicaid Services (CMS) instructed Medicare Administrative Contactors and notified Medicare Advantage plans to cover coronavirus disease 2019 (COVID-19) laboratory tests for nursing home residents and patients. This instruction follows the Centers for Disease Control and Prevention’s (CDC) recent update of COVID-19 testing guidelines for nursing homes …

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CMS Released Weekly Update of Nursing Home COVID-19 Data as of June 7, 2020

In case you missed it, the Centers for Medicare & Medicaid Services (CMS) posted the second set of coronavirus disease 2019 (COVID-19) nursing home data today. The data will be updated weekly going forward; for more information on nursing homes, including a link to the COVID-19 nursing home data, visit Nursing Home Compare. CMS also …

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QIN-QIOs Partner with CMS to Create New COVID-19 Toolkit for Nursing Homes

The Centers for Medicare & Medicaid Services (CMS) developed a toolkit full of innovative solutions deployed at the state level to protect our nation’s vulnerable nursing home residents during the COVID-19 pandemic—all scouted and sourced by the IPRO QIN-QIO and other Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) serving every state and territory. Governors, long term …

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Nursing Home COVID-19 Data and Inspections Results Available on Nursing Home Compare

Today, the Centers for Medicare & Medicaid Services (CMS) is posting the first set of underlying coronavirus disease 2019 (COVID-19) nursing home data. On April 19, 2020, CMS announced the requirement that nursing homes to inform residents, their families, and their representatives of COVID-19 cases in their facilities. In addition to this, nursing homes are …

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CMS COVID-19 Stakeholder Engagement Calls – Week of 6/1/20

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.  Call details …

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CMS Programs & Payment for Care in Hospital Alternate Care Sites

In response to the COVID-19 public health emergency, state and local governments, hospitals, and others are developing alternate care sites to expand capacity and provide needed care to patients. This newly published fact sheet provides state and local governments developing alternate care sites with information on how to seek payments through CMS programs – Medicare, …

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Medicare Diabetes Prevention Program (MDPP) Billing and Claims Webinar

May 21, 2020 @ 1pm EDT This webinar will provide an overview on the Medicare Diabetes Prevention Program (MDPP) Billing and Claims process. During this webinar, participants will become familiar with the key terms and entities involved in the billing and claims process, understand the MDPP payment structure and how it applies to billing, and …

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CMS Gives States Additional Flexibility to Address Coronavirus Pandemic

CMS has approved over 200 requests for state relief in response to the COVID-19 pandemic, including recent approvals for Alaska, Iowa, Hawaii, New Jersey, North Carolina, Pennsylvania, Rhode Island, Utah, and Virginia. These approvals help to ensure that states have the tools they need to combat COVID-19. This is done through a wide variety of …

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Medicare Payment for COVID-19 Diagnostic Tests

Earlier this year, CMS took action to ensure America’s patients, health care facilities, and clinical laboratories were prepared to respond to COVID-19. To help increase testing, CMS developed two codes that laboratories can use to bill for certain COVID-19 lab tests, including serology tests. CMS has updated its guidance to include payment details for additional …

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CMS Releases Additional Waivers for Hospitals and Ground Ambulance Organizations

CMS continues to release waivers for the healthcare community that provide the flexibilities needed to take care of patients during the COVID-19 public health emergency (PHE). CMS recently provided additional blanket waivers for the duration of the PHE that: Modify existing physical environment waivers to allow for increased flexibilities for surge capacity and patient quarantine …

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Trump Administration Issues Guidance to Ensure States Have a Plan in Place to Safely Reopen Nursing Homes

CMS announced new guidance for state and local officials to ensure the safe reopening of nursing homes across the country. The guidance released today is part of President Trump’s Guidelines for Opening Up America Again. It details critical steps nursing homes and communities should take prior to relaxing restrictions implemented to prevent the spread of …

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CMS Accepting Proposals for New Measures for the Medicare Promoting Interoperability Program Until July 1

The Centers for Medicare & Medicaid Services (CMS) wants to remind eligible hospitals and critical access hospitals that the Annual Call for Measures for the Medicare Promoting Interoperability Program is still open. Submit a measure proposal by July 1, 2020. Proposals submitted by the deadline will be considered for inclusion in future rulemaking. CMS is …

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Quality Payment Program: 2019 Performance Period Suppressed MIPS Quality Measures

In the Calendar Year (CY) 2019 Physician Fee Schedule Final Rule (83 FR 59847), the Centers for Medicare & Medicaid Services (CMS) established a policy that provides for the suppression of measures in certain circumstances. Starting with the 2019 performance period, for measures significantly impacted by clinical guideline changes or other changes where we believe …

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Register for the webinar: Long-term Care Facilities’ Response to COVID-19

Wednesday, May 27, 2020 2-3pm EDT For May’s LTSS webinar, join UNITE (Uniting Tribal Nursing Homes in Excellence) in a panel discussion with nursing home and assisted living facility administrators. The panelists will share their experience in responding to COVID-19, including providing care, programming, and staffing. By the end of the webinar, participants will learn: …

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CMS Issues Nursing Homes Best Practices Toolkit to Combat COVID-19

CMS released a new toolkit developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to these facilities, with additional resources to aid in the fight against the coronavirus disease 2019 (COVID-19) pandemic within nursing homes. The toolkit builds upon previous actions taken by the Centers for …

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Letter From CMS Administrator to Nursing Home Workers

Today, the Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma penned a letter to nursing home management and staff. Administrator Verma shared her gratitude for the unwavering dedication and commitment of nursing home management and staff in keeping residents safe and for continuing to compassionately care for those who rely on them during …

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May 11-15: CMS COVID-19 Stakeholder Engagement Calls

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts. Call details …

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CMS Releases Additional Waivers for Hospitals and Other Facilities

CMS continues to release waivers for the healthcare community that provide the flexibilities needed to take care of patients during the COVID-19 public health emergency (PHE). CMS recently provided additional blanket waivers for the duration of the PHE that: Expand hospitals’ ability to offer long-term care services (“swing beds”); Waive distance requirements, market share, and …

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diabetes testing and insulin

Join Us For An Enrollment Tutorial Webinar

Want to help people with Medicare stay healthy and prevent diabetes? Become a Medicare Diabetes Prevention Program (MDPP) supplier. As a supplier, you’ll help people with Medicare make lasting behavior changes through group-based training & individual support. There have been some changes to the MDPP enrollment process due to COVID-19. Specifically, the emergency declaration waives the PECOS …

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COVID-19: IRF Flexibilities During the PHE

CMS is exercising regulatory flexibilities for Inpatient Rehabilitation Facilities (IRFs) during the COVID-19 Public Health Emergency (PHE) to waive the 60 percent rule. We are also waiving IRF coverage and classification requirements if all of these criteria are satisfied: Patient is admitted to a freestanding IRF to alleviate acute care hospital bed capacity issues IRF …

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Medicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 Testing

A new MLN Matters Special Edition Article SE20017 on Medicare Pharmacies and Other Suppliers May Temporarily Enroll as Independent Clinical Diagnostic Laboratories to Help Address COVID-19 Testing is available. Learn how to temporarily enroll to be an additional laboratory resource to meet the urgent need to increase COVID-19 testing capability.

May is Mental Health Awareness Month

May is Mental Health Awareness Month, and The Centers for Medicare & Medicaid services (CMS) wants to remind people with Medicare that the program covers mental health services to support them during these stressful times including: Telehealth counseling services during the COVID-19 public health emergency – learn more here: https://www.medicare.gov/coverage/telehealth Other outpatient mental health services, …

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Updated eCQM Specifications and eCQM Materials for 2021 Reporting Now Available

The Centers for Medicare & Medicaid Services (CMS) has posted the electronic clinical quality measure (eCQM) specifications for the 2021 reporting period for eligible hospitals and critical access hospitals, and the 2021 performance period for eligible professionals and eligible clinicians. CMS updates the specifications annually to align with current clinical guidelines and code systems so …

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New Guidance Available on Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes

CMS issued a memo and frequently asked questions addressing the new requirement that nursing homes and long term care facilities report COVID-19 facility data to the Centers for Disease Control and Prevention (CDC) and to residents, their representatives, and their families. This action, included in the recent Interim Final Rule with Comment Period, will support …

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FAQs: Medicare FFS Billing

Several changes in the IFC allow additional Medicare payment; CMS has issued FAQs addressing Medicare Fee-for-Service Billing issues. The FAQs in this document supplement the following previously released FAQs: 1135 Waiver FAQs and Without 1135 Waiver FAQs. We note that in many instances, the general statements of the FAQs referenced above have been superseded by …

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CMS Hospitals without Walls Initiative

CMS is allowing healthcare systems and hospitals to provide services in locations beyond their existing walls to help address the urgent need to expand care capacity and to develop sites dedicated to COVID-19 treatment. Slides: COVID-19 Regulations & Waivers To Enable Health System Expansion (PDF)

Additional Resources & Calls for Stakeholders

CMS has developed a toolkit for stakeholder partners to help you stay informed on CMS and HHS materials available on COVID-19. Check back often for the most up-to-date information; please refresh your browser often to see the most up-to-date information. Upcoming COVID-19 Stakeholder Calls Conference lines are limited, so we highly encourage you to join …

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CMS Releases Updated Fact Sheets

CMS has updated multiple fact sheets that summarize changes made through regulatory actions in response to COVID-19. View more resources available on CMS waivers and flexibilities here. A full list of emergency declaration blanket waivers for health care providers implemented to date is available here. Additional fact sheets include: Clinicians:  Physicians and Other Practitioners (PDF) …

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CMS COVID-19 Calls: May 5-8, 2020

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts. Call details …

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CMS Announces Independent Commission to Address Safety and Quality in Nursing Homes

Commission will comprehensively examine best practices in responding to COVID-19 in nursing homes As a part of President Trump’s Opening Up America Again effort, the Centers for Medicare & Medicaid Services (CMS) announced a new independent Commission that will conduct a comprehensive assessment of the nursing home response to the 2019 Novel Coronavirus (COVID-19) pandemic. …

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COVID-19 Update from the Department of Health and Human Services

The Department of Health and Human Services (HHS) is processing payments from the Provider Relief Fund to hospitals with large numbers of COVID-19 inpatient admissions through April 10, 2020, and to rural providers in support of the national response to COVID-19. “These new payments are being distributed to healthcare providers who have been hardest hit …

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Second Round of Sweeping Changes to Support U.S. Healthcare System During COVID-19 Pandemic

At President Trump’s direction, and building on its recent historic efforts to help the U.S. healthcare system manage the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services today issued another round of sweeping regulatory waivers and rule changes to deliver expanded care to the nation’s seniors and provide flexibility to the …

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Weekly COVID-19 Care Site-Specific Calls

CMS hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows. Home Health and Hospice (Tuesdays at 3:00 PM Eastern) Tuesday, …

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Lessons from the Front Lines: COVID-19 (Fridays at 12:30 – 2:00 PM Eastern)

Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask …

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Cancelled: April 30 CMS COVID-19 Office Hours Calls

Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to: Increase Hospital Capacity – CMS Hospitals Without Walls; Rapidly Expand the Healthcare Workforce; Put Patients Over Paperwork; and Further Promote Telehealth in Medicare

Updated Accelerated and Advanced Payments Fact Sheet

In order to increase cash flow to providers of services and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) has expanded current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. The expansion of this program is …

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Nursing Home Five Star Quality Rating System Updates, Nursing Home Staff Counts, and FAQs

CMS is committed to taking critical steps to ensure America’s nursing homes are prepared to respond to the threat of the COVID-19. Nursing Home Compare website & Nursing Home Five Star Quality Rating System: We are announcing that the inspection domain will be held constant temporarily due to the prioritization and suspension of certain surveys, …

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CMS Gives States Additional Flexibility to Address Coronavirus Pandemic

CMS approved its first Medicaid COVID-19 emergency demonstration, making the state of Washington the first to receive approval. The approval provides new flexibility and resources so the state of Washington can deliver the most effective care to their Medicaid beneficiaries. In addition to new payment and reimbursement arrangements, the demonstration allows the state to target …

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CMS Releases Additional Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities

CMS continues to release waivers for the healthcare community that provide the flexibilities needed to take care of patients during the COVID-19 public health emergency. CMS recently provided additional blanket waivers related to caring for patients in Long-Term Care Hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs), …

CMS Releases Additional Waivers for Long-Term Care Hospitals, Rural Health Clinics, Federally Qualified Health Centers and Intermediate Care Facilities Read More »

Updated Guidance Available for Plan Issuers on Prior Authorization, CARES Act Implementation

CMS issued guidance to issuers of individual, small group, Medicare Advantage, and Part D plans, addressing the flexibilities available related to utilization management and prior authorization during the COVID-19 public health emergency. New guidance for individual and small group health plans encourages issuers to utilize flexibilities related to utilization management processes, as permitted by state …

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Trump Administration Launches New Toolkit to Help States Navigate COVID-19 Health Workforce Challenges

CMS and the Assistant Secretary of Preparedness and Response (ASPR) released a new toolkit to help state and local healthcare decision makers maximize workforce flexibilities when confronting COVID-19 in their communities. Developed by the Healthcare Resilience Task Force as part of the unified government’s response to COVID-19, the toolkit includes a full suite of available …

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CMS Issues Guidance Allowing Independent Freestanding Emergency Departments to Provide Care to Medicare and Medicaid Beneficiaries during the COVID-19 Public Health Emergency

CMS issued critical guidance allowing licensed, independent freestanding emergency departments (IFEDs) in Colorado, Delaware, Rhode Island, and Texas to temporarily provide care to Medicare and Medicaid patients to address any surge resulting from COVID-19. This action by the Trump Administration increases hospital capacity to ensure these states can quickly and effectively care for their most …

CMS Issues Guidance Allowing Independent Freestanding Emergency Departments to Provide Care to Medicare and Medicaid Beneficiaries during the COVID-19 Public Health Emergency Read More »

Educational Webinar: Supporting Family Caregivers of Older Adults through Times of Stress and Isolation

Hosted by the Centers for Medicare & Medicaid Services (CMS), Medicare-Medicaid Coordination Office (MMCO) Supporting Family Caregivers of Older Adults through Times of Stress and Isolation Date/Time: Thursday, April 30, 2020, 12:00pm–1:30 pm EDT This webinar will offer strategies for supporting caregivers and their loved ones, up-to-date information on facilitating access to health and social …

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COVID-19 Update: Additional Blanket Waivers

CMS continues to release additional blanket waivers to the healthcare community in order to provide the flexibilities needed to take care of patients during this public health emergency. Today, CMS is providing additional blanket waivers related to care for patients in Long-Term Care Hospitals (LTCHs), temporary expansion locations of Rural Health Clinics (RHCs) and Federally …

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CMS Issues Recommendations to Re-Open Health Care Systems in Areas with Low Incidence of COVID-19

Today, the Centers for Medicare & Medicaid Services issues new recommendations specifically targeted to communities that are in Phase 1 of the Guidelines for President Trump’s Opening Up America Again with low incidence or relatively low and stable incidence of COVID-19 cases. The recommendations update earlier guidance provided by CMS on limiting non-essential surgeries and …

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Trump Administration Announces New Nursing Homes COVID-19 Transparency Effort

Agencies partner with nursing homes to keep nursing home residents safe Today, under the leadership of President Trump, the Centers for Medicare & Medicaid Services (CMS) announced new regulatory requirements that will require nursing homes to inform residents, their families and representatives of COVID-19 cases in their facilities. In addition, as part of President Trump’s …

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Long-Term Services and Supports Solutions Newsletter — April 2020

Upcoming webinar: COVID-19 in Indian CountryWednesday, April 22Long-Term Services and SupportsSOLUTIONSTechnical assistance for culturally competent care LTSS Technical Assistance CenterVisit the online LTSS TA Center for videos, best practices, toolkits, a resource library, and a step-by-step planning roadmap. COVID-19 and LTSS in Indian CountryBelow are tips for long-term services and supports (LTSS) facilities and home-based …

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CMS Approves Additional State Medicaid Waivers and Amendments to Give States Flexibility to Address Coronavirus Pandemic

CMS has approved 52 COVID- related emergency waivers, 31 state amendments, 11 COVID-related Medicaid Disaster Amendments and one CHIP COVID-related Disaster Amendment in record time. States are using a toolkit CMS developed to expedite the application and approval of Medicaid state waivers and State Plan Amendments. CMS recently approved two additional COVID-related emergency Medicaid waivers, …

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CMS Implements CARES Act Hospital Payment and Inpatient Rehabilitation Facility Waivers

The Coronavirus Aid, Relief, and Economic Security (CARES) Act increases payment for Inpatient Prospective Payment System (IPPS) and long-term care hospital (LTCH) inpatient hospital care attributable to COVID-19. CMS provided guidance for IPPS hospitals and LTCHs on how to code claims to receive the higher payment. The CARES Act also waives the requirement that Medicare …

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CMS Lessons from the Front Lines: COVID-19

On behalf of CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force, we invite you to join CMS Lessons from the Front Lines: COVID-19 on Friday, April 17th from 12:30 – 2 PM EST. This call series is an opportunity to hear physicians and other clinical leaders share …

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Today! Medicare Diabetes Prevention Program (MDPP) Enrollment Tutorial

Join the Center for Medicare & Medicaid Innovation (CMMI) for an Enrollment Tutorial Webinar Join CMMI on Thursday, April 16, 2020 at 1pm Eastern time for an Enrollment Tutorial Webinar. The CMMI team will be on hand to answer your questions related to the Enrollment Process.  Webinar Details Access the webinar: At the time of the event, click …

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CMS Increases Medicare Payment for High-Production Coronavirus Lab Tests

CMS helps expand testing capacity and monitoring for COVID-19 in nursing homes and other settings with high volume testing needs The Centers for Medicare & Medicaid Services (CMS) today announced Medicare will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of 2019 Novel Coronavirus (COVID-19) cases. This …

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Webinar: Primary Care’s Role in Responding to COVID-19

When: Wed, Apr 15, 2020 2:00 PM – 3:00 PM EDT Learn more about the coronavirus outbreak, its impact on practices and patients, and how primary care is responding. This discussion with primary care leaders will address issues spanning primary care capacity, virtual visits, and community-based approaches to care in the midst of COVID-19. Attendees …

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CMS Conference Call @ 3:00, Tuesday, April 14

Please join the Centers for Medicare and Medicaid Services (CMS) for a call on COVID-19 with Home Health and Hospice Organizations today,, Tuesday, April 14th at 3:00 PM EST. CMS leadership will provide updates on the agency’s latest guidance and we will be joined by leaders in the field interested in sharing best practices with …

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