Centers for Medicare and Medicaid Services

The Centers for Medicare and Medicaid (CMS) expanded Medicare reimbursement for telehealth within the annual Physician Fee Schedule (PFS) final rule for 2021. During the pandemic Public Health Emergency (PHE), CMS has temporarily reimbursed many telehealth services. In light of the success of unprecedented telehealth utilization during the PHE, more than 60 services have been formally added to the Medicare telehealth list which will endure beyond the end of the PHE.
Continue Reading CMS Permanently Expands Telehealth as Far as Congress Has Allowed

The use of telehealth has become indispensable across the country in recent months due to the COVID-19 public health emergency (PHE) and Centers for Medicare and Medicaid Services (CMS)’s temporary expansion of payment for telehealth services. CMS reports that virtual visits for Medicare beneficiaries have jumped from approximately 14,000 per week pre-PHE to almost 1.7 million in the last week of April.
Continue Reading CMS Proposes Permanent Expansion of Telehealth Beyond the Public Health Emergency

In light of the public health emergency and the urgent need to help individuals and small employers experiencing economic hardship, CMS announced on August 4, 2020 that it has adopted a temporary policy to allow health plan issuers to offer premium credits for 2020 coverage. In its guidance, CMS encouraged states to adopt a similar

On April 23, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released a new COVID-19 toolkit. While the toolkit is directed to the states, it should serve the American telehealth community as a focal point for the organization and alignment of the infinite number of state and federal regulations relevant to telehealth. So, it serves as a great organizing tool for provider’s own operational use but also as an architecture for providers to catalogue the changes they would like to suggest to the states in order to improve access to telehealth.
Continue Reading CMS’s New Telehealth Toolkit Arrives at Just the Right COVID-19 Time for Providers and Policy Makers

The U.S. Department of Health and Human Services (HHS) will soon make targeted distributions of the next tranche of the Provider Relief Fund to hospitals and other facilities that have been particularly affected by caring for those with the coronavirus. By 11:59 p.m. ET, hospitals will need to complete the HHS information request on ICU beds, COVID-19 positive patients, etc. Specifically, to be eligible to receive a portion of the $10 billion of the next $70 billion in funding from the CARES Act, providers need to submit the information via a CMS portal. This is not a guarantee of payment—rather, CMS is using this information to decide how to allocate the remaining funds.
Continue Reading COVID-19 Hotspot Provider Relief Fund Registration Deadline Today

Two new federal rules will make it easier for consumers to access, use and transmit their personal healthcare information using an app on their smartphone or tablet.  The regulations implement prior legislation and advance the current Administration’s intent to empower patients to be better consumers and transform the healthcare industry.

The two final rules were released on March 9 by the Department of Health and Human Services (DHHS):  from the Office of the National Coordinator for Health Information Technology (ONC), the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program final rule; and, from the Centers for Medicare and Medicaid Services (CMS), the final rule on Interoperability and Patient Access.
Continue Reading New Rules Promotes Patient Access to Personal Healthcare Information

There is a common saying in healthcare – “if it isn’t documented, it didn’t happen.” In the healthcare industry, and particularly in the long-term care (“LTC”) sector, clinical and operational documentation has long been critical for purposes of ensuring appropriate patient care and demonstrating compliance with the myriad regulatory requirements imposed by the Centers for Medicare & Medicaid Services (“CMS”), as well as state licensing and Medicaid agencies.

COVID-19 clearly presents unique challenges to LTC facilities. Although infection control and emergency planning protocols are not new to LTC facilities, the rapidly changing landscape of guidance issued by federal, state, and local regulatory bodies relating to COVID-19 has placed LTC facilities in a position where they must implement, and simultaneously communicate to staff, residents, and resident family members, new or updated clinical and operational protocols on a daily, if not hourly, basis. Given the urgency in ensuring appropriate protocols are in place, there is often an emphasis on action, as opposed to documenting the actions taken.
Continue Reading LTC Facility Documentation during COVID-19

On April 14, 2020, CMS released a ruling that will increase the reimbursement for tests conducted to detect SARS–CoV–2 (the diagnosis of the virus that causes COVID–19) for tests utilizing “high throughput technologies.” The reimbursement under Medicare Part B for these laboratory tests will be raised from about $51 per test to $100 per test. This increase will begin with tests performed on or after March 18, 2020 and end when the national emergency is over.
Continue Reading CMS Doubles Payment for Diagnostic Lab COVID-19 Testing

As many of you are aware, the Centers for Medicare and Medicaid Services (CMS) along with many states have waived licensing and other requirements to allow healthcare providers to use non-hospital space to treat COVID-19 and non-COVID-19 patients, conduct testing and perform other clinical operations.  Healthcare providers across the country are exploring options to increase

On March 22, 2020, and as subsequently clarified on March 27, 2020, the Centers for Medicare and Medicaid Services (“CMS”) temporarily lifted the requirements for hospices to submit Hospice Item Set (“HIS”) data and hospice Consumer Assessment of Healthcare Providers and Systems (“CAHPS”) survey data.  Prior to CMS’s action, failure to comply with these data reporting requirements of the Hospice Quality Reporting Program (“HQRP”), absent an exception, resulted in a 2 percent reduction to a hospice’s annual Medicare payment update.
Continue Reading COVID-19 Hospice How-To Series: Taking Advantage of the Temporary Quality Reporting Data Submission Relief