Archive for December, 2020


Coronavirus Update for Wednesday, December 23

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Wednesday, December 23.

Provider Relief Fund


Centers for Medicare & Medicaid Services

Coronavirus Update for Friday, December 18

The following is the latest COVID-19 information from the federal government as 3:30 p.m. on Friday, December 18.

Centers for Medicare & Medicaid Services

  • CMS has issued an Interim Final Rule with Comment Period that establishes a New COVID-19 Treatments Add-on Payment (NCTAP) under the Medicare inpatient prospective payment system effective from November 2, 2020 until the end of the public health emergency for COVID-19.  To mitigate potential financial disincentives for hospitals to provide new COVID-19 treatments during the COVID-19 emergency, Medicare will provide an enhanced payment for eligible inpatient cases that involve use of certain new products with current FDA approval or emergency use authorization to treat COVID-19.  See the NCTAP web page for more information.
  • CMS has announced that in response to the COVID-19 emergency, the Centers for Disease Control and Prevention’s National Center for Health Statistics is introducing six new diagnosis codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), effective January 1, 2021.  Learn more about the new codes here.
  • CMS has updated its FAQs and guidance for CLIA labs during the COVID-19 emergency.
  • CMS has extended its third quarter 2020 submission deadlines for selected Medicare quality reporting and value-based purchasing

States, Feds Not Adequately Monitoring Medicaid MLTSS

With more states delegating their programs of Medicaid managed long-term services and supports to managed care entities, state Medicaid programs and the federal government are not adequately overseeing the work of those managed care plans.

As a result, they sometimes fail to notice quality and access problems for beneficiaries, according to the U.S. Government Accountability Office.

When states delegate to managed care plans decisions about the amount and types of services that adults and children with physical, cognitive, and mental disabilities will receive, federal guidelines require states to monitor those decisions for appropriateness.  In too many cases, the GAO has concluded, states are not doing this job well.  To address this shortcoming, the GAO recommends that the Centers for Medicare & Medicaid Services develop a national strategy for overseeing MLTSS and “assess the nature and prevalence of MLTSS quality and access problems across the states.”  CMS rejected these recommendations.

Learn more about the challenges inherent in managed care plans administering Medicaid MLTSS in the GAO report Medicaid Long-Term Services and Supports:  Access and Quality Problems in Managed Care Demand Improved Oversight.

Coronavirus Update for Thursday, December 17

The following is the latest COVID-19 information from the federal government as 3:00 p.m. on Thursday, December 17.

CDC Webinar on Pfizer-BioNTech and Moderna Vaccines

  • The CDC will hold a clinical outreach and communication activity webinar on Friday, December 18 at 2:00 (eastern) to give clinicians an overview of the Pfizer-BioNTech and Moderna COVID-19 vaccines.  Clinicians will learn about vaccine characteristics and administration, vaccinating special populations, and contraindications.  They will also get answers to a number of clinical questions CDC has received about these new vaccines.  Go here for further information about the webinar and to register to participate.


Centers for Medicare & Medicaid Services


CMS COVID-19 Stakeholder Calls 

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19.  These sessions are open to members of the health …

Coronavirus Update for Wednesday, December 16

The following is the latest COVID-19 information from the federal government as 2:45 p.m. on Wednesday, December 16.

Provider Relief Fund

  • HHS announced that it has completed its review of Phase 3 applications from the Provider Relief Fund program and will distribute $24.5 billion to more than 70,000 providers.  HHS said this distribution will satisfy up to 88 percent of each applicant’s reported net lost revenues and net change in expenses caused by COVID-19 in the first half of 2020.  See HHS’s announcement here.
  • Phase 3 was originally announced as a $20 billion distribution.  According to HHS, “As HHS began analyzing applications, it realized the submissions for lost revenues and net changes in expenses would exceed the $20 billion budgeted for the Phase 3 allocation.  In an effort to meet the demand, HHS worked to add another $4 billion to the allocation bringing the new total to over $24 billion.”
  • More than 35,000 applicants for Phase 3 grants will not receive additional payments either because they experienced no change in revenues or net expenses attributable to COVID-19 or because they have already received funds that equal or exceed reimbursement for 88 percent of reported losses.
  • Payments to Phase 3