CMS

COVID-19 Vaccines and Monoclonal Antibody Infusion: Enforcement Discretion Relating to SNF Consolidated Billing

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To facilitate the efficient administration of COVID-19 vaccines to Skilled Nursing Facility (SNF) residents, CMS is exercising enforcement discretion with respect to statutory provisions requiring consolidated billing by SNFs as well as any associated statutory references and implementing regulations, including as interpreted in pertinent guidance. Through the exercise of this discretion, CMS will allow Medicare-enrolled …

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CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment

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The U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the investigational monoclonal antibody therapy, casirivimab and imdevimab, administered together, for the treatment of mild-to-moderate COVID-19 in adults and pediatric patients with positive COVID-19 test results who are at high risk for progressing to severe COVID-19 and/or hospitalization. Casirivimab and imdevimab, administered …

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CMS Policies Give Medicare Beneficiaries More Choices around Surgery

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CMS Memo | December 3, 2020 – Today, the Centers for Medicare & Medicaid Services (CMS) is finalizing policy changes that will give Medicare patients and their doctors greater choices to get care at a lower cost in an outpatient setting. The Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rules will …

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Finalized Permanent Expansion of Medicare Telehealth Services and Improved Payment for Time Doctors Spend with Patients

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CMS Memo | December 1, 2020 – Today, the Centers for Medicare & Medicaid Services (CMS) released the annual Physician Fee Schedule (PFS) final rule, prioritizing CMS’ investment in primary care and chronic disease management by increasing payments to physicians and other practitioners for the additional time they spend with patients, especially those with chronic …

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HHS/ASPR Training to Help Older Adults During a Disaster

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The U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR) developed the Addressing the Needs of Older Adults in Disasters web-based training. HHS/ASPR designed this free, publicly accessible course to improve public health and emergency medical responders’ capability to address the access and functional needs of community-dwelling older …

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Behavioral Health Resources for Indian Country

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For more resources on supporting the behavioral health of elders and Indian Country as a whole, explore the new CMS Tribal Behavioral Health. Who is it for? This site is intended for people seeking behavioral health care for themselves or loved ones, health care providers, tribal leaders, and tribal health directors who would like to …

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CMS Comprehensive Strategy: Enhance Hospital Capacity Amid COVID-19 Surge

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Agency outlines flexibilities to maximize Acute Hospital Care at Home, Ambulatory Surgical Centers to decompress hospitals treating COVID-19 patients CMS Memo | November 25, 2020 – Today, the Centers for Medicare & Medicaid Services (CMS) outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside …

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CMS Request for Application: Value in Opioid Use Disorder Treatment Initiative

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CMS is announcing the Request for Application (RFA) open period (November 19, 2020 to January 3, 2021) for the Value in Opioid Use Disorder Treatment (ViT) Initiative The Centers for Medicare & Medicaid Services (CMS), Center for Medicare and Medicaid Innovation (Innovation Center) is announcing the Request for Application (RFA) for a new initiative that …

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CMS Will Retire the Original Compare Tools on December 1

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CMS will retire the original Compare Tools on December 1. Use Medicare.gov’s Care Compare to find and compare health care providers. In early September, the Centers for Medicare & Medicaid Services (CMS) released Care Compare on Medicare.gov, which streamlines our eight original health care compare tools.  Since then, you’ve had the opportunity to use and …

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CMS Releases Toolkit to Accelerate State Efforts to Rebalance Long-term Care Systems and Enhance Home and Community-Based Services for Eligible Medicaid Beneficiaries

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The Trump Administration and Centers for Medicare & Medicaid Services (CMS) are delivering on their commitment to foster innovation in Medicaid by providing states with new tools to help beneficiaries return home from institutional settings without sacrificing safety or quality of care.   Today, CMS launched a new toolkit designed for state Medicaid agencies to strengthen …

CMS Releases Toolkit to Accelerate State Efforts to Rebalance Long-term Care Systems and Enhance Home and Community-Based Services for Eligible Medicaid Beneficiaries Read More »

IPRO to Provide Hospital Quality Improvement Services for the Centers for Medicare & Medicaid Services

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Lake Success, NY, October 19, 2020 – The Centers for Medicare & Medicaid Services (CMS) has awarded a four-year contract to IPRO to serve as a Hospital Quality Improvement Contractor (HQIC) within its Network of Quality Improvement and Innovation Contractors (NQIIC). HQICs will provide targeted quality improvement assistance to small, rural and critical access hospitals …

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CMS Releases Long-Term Care Hospital Quality Reporting Program Web-Based Training

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The Centers for Medicare & Medicaid Services (CMS) is offering a web-based training course for those who are new to the Long-Term Care Hospital (LTCH) Quality Reporting Program (QRP). This course is designed to provide a general overview of the program as well as a variety of links and resources for additional information. Specific topics …

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CMS Releases Interim Final Rule, Reporting Requirements Updates, and Additional Policy and Regulatory Revisions

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August 26, 2020 – The Centers for Medicare & Medicaid Services (CMS) is committed to taking critical steps to ensure America’s healthcare facilities are prepared to respond to the Coronavirus Disease 2019 (COVID-19) Public Health Emergency (PHE). On August 25, 2020, an interim final rule with comment period (IFC) went on display at the Federal …

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CMS Releases FAQs on MDPP Public Health Emergency Flexibilities

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Do you have questions about the Medicare Diabetes Prevention Program (MDPP) Expanded Model Public Health Emergency (PHE) Flexibilities? The Centers for Medicare & Medicaid Services (CMS) recently released Frequently Asked Questions (FAQs) to assist MDPP Suppliers as they continue to provide services to Medicare Beneficiaries. If you have additional questions, please contact CMS by visiting …

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CMS Announces Resumption of Routine Inspections of All Provider and Suppliers, Issues Updated Enforcement Guidance to States, and Posts Toolkit to Assist Nursing Homes

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Today, the Centers for Medicare & Medicaid Services (CMS) announced it will resume routine inspections of all Medicare and Medicaid certified providers and suppliers to improve the safety and quality of life of patients and residents. CMS had previously suspended certain routine inspections as part of its response to the coronavirus disease 2019 (COVID-19) pandemic …

CMS Announces Resumption of Routine Inspections of All Provider and Suppliers, Issues Updated Enforcement Guidance to States, and Posts Toolkit to Assist Nursing Homes Read More »

CMS Updates Medicare Payment Policies for Several Types of Healthcare Providers

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Three final rules will strengthen Medicare program July 31, 2020 – The Centers for Medicare & Medicaid Services (CMS) is finalizing three Medicare payment rules that further advance our efforts to strengthen the Medicare program by better aligning payments for inpatient psychiatric facilities (IPF), skilled nursing facilities (SNF) and hospices. Inpatient Psychiatric Facilities IPF PPS …

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OCR Issues Guidance on Civil Rights Protections Prohibiting Race, Color, and National Origin Discrimination During COVID-19

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Today, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) is issuing guidance to ensure that recipients of federal financial assistance understand that they must comply with applicable federal civil rights laws and regulations that prohibit discrimination on the basis of race, color, and national origin in HHS-funded …

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Updated eCQM Specifications and eCQM Materials for 2021 Reporting Now Available

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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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FAQs: Medicare FFS Billing

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

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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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CMS Issues Fiscal Year 2021 Proposed Medicare Payment and Policy Changes

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Fiscal Year 2021 Hospice Payment Rate Update Proposed Rule (CMS-1733-P) Today, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1733-P) that would update fiscal year (FY) 2021 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. This rule provides model examples of the hospice election statement and the …

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Helping families cope with COVID-19 outbreaks

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The worldwide spread of Coronavirus Disease 2019 (COVID-19) has brought unprecedented challenges. Given the resulting disruptions to daily life, helping children cope with stress can be especially difficult. Implementation of social distancing strategies to prevent illness increases families’ stress levels even further. In an effort to protect the mental health of children and their caregivers, …

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CMS Approves Over $51 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers in One Week

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The Centers for Medicare & Medicaid Services (CMS) has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the 2019 Novel Coronavirus (COVID-19). The funds have been provided through the expansion of the Accelerated and Advance Payment Program to ensure providers and suppliers have the resources needed to …

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CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 Mar 22, 2020 Data Hospitals Quality

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March 22 – the Centers for Medicare & Medicaid Services (CMS) announced unprecedented relief for the clinicians, providers, and facilities participating in Medicare quality reporting programs including the 1.2 million clinicians in the Quality Payment Program and on the front lines of America’s fight against the 2019 Novel Coronavirus (COVID-19). Specifically, CMS announced it is …

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Updated FAQs for State Medicaid and Children’s Health Insurance Program (CHIP) Agencies

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Today, the Centers for Medicare & Medicaid Services (CMS) is posting an update to its Frequently Asked Questions (FAQs) on the Medicaid.gov website to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the 2019 Novel Coronavirus (COVID-19) outbreak. CMS is taking this action to continue its efforts to protect the …

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CMS Sends More Guidance to Providers

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CMS took action to protect the health and safety of our nation’s patients and providers in the wake of the 2019 Novel Coronavirus (COVID-19) outbreak. This includes clear, actionable information on the screening, treatment, and transfer procedures to follow when interacting with patients.