Archive for Accountable Care Organization

 

Federal Health Policy Update for Friday, April 1

The following is the latest health policy news from the federal government as of 2:30 p.m. on Friday, April 1.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • After April 5, this program also will stop accepting claims for administering vaccines to uninsured individuals.  See this notice for further information about both deadlines for submitting claims.

Proposed Medicare Payment Regulations for FY 2023

  • CMS has published its proposed inpatient rehabilitation facility (IRF) prospective payment system and IRF quality reporting program for FY 2023.  The agency proposes a 2.8 percent net increase in Medicare rates; a permanent cap of five percent on year-over-year wage index losses for any reason; an increase from $9491 to $13,038 in the outlier threshold; and changes in the IRF quality reporting program in future years – but not 2023 – that address patient vaccinations and health equity.  CMS also is soliciting comments on incorporating discharge to home health in an IRF transfer policy.  Learn more from this CMS news release and from the proposed rule itself.  Interested parties have until May 31 to submit formal comments.
  • CMS has published its proposed FY 2023 Medicare hospice payment rule, which

Federal Health Policy Update for Wednesday, March 30

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, March 30.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • The Provider Relief Fund last week distributed more than $413 million to more than 3600 providers across the country, the fourth round of Phase 4 payments since those payments began last November.  This is in addition to nearly $7.5 billion in American Rescue Plan (ARP) Rural payments over the past four months.  HHS’s Health Resources and Services Administration (HRSA), which administers the Provider Relief Fund, has now processed 89 percent of the applications it received for Phase 4 grants and HHS reports that “Remaining applications require additional manual review and HRSA is working to process them as quickly as possible.”  Learn more about this latest round of Phase 4 Provider Relief Fund grants and find links to a state-by-state breakdown of payments and a list of all recipients in this HHS news release.
  • The Provider Relief Fund Uninsured Program, which has reimbursed providers at Medicare rates for testing uninsured individuals for COVID-19 and treating those diagnosed with the virus, has stopped accepting such claims

Federal Health Policy Update for Tuesday, March 22

The following is the latest health policy news from the federal government as of 2:30 p.m. on Tuesday, March 22.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • As of March 22 at 11:59 p.m. (eastern) the HRSA (Health Resources and Services Administration) COVID-19 Uninsured Program will stop accepting claims for testing and treatment due to lack of funds and on April 5 at 11:59 p.m. (eastern) the HRSA COVID-19 Uninsured Program and COVID-19 Coverage Assistance Fund will stop accepting vaccination claims due to a lack of funds.  HRSA has released additional information about this significant change in federal COVID policy with the publication of two new documents:

o   HRSA COVID-19 Uninsured Program Shutdown FAQs

o   HRSA COVID-19 Coverage Assistance Fund Shutdown FAQs

Separately, HRSA advises that “Submitted claims will be paid subject to the availability of funds.”  This means that when the money is gone HRSA will no longer be able to pay claims.  The administration continues to encourage Congress to provide additional funding to support COVID-related activities and replenish this fund but it is not clear at this point if it will succeed in doing so.

  • Providers that received Provider Relief

Federal Health Policy Update for Wednesday, March 2

The following is the latest health policy news from the federal government as of 3:00 p.m. on Wednesday, March 2.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • The Provider Relief Fund FAQ has been updated with three modified questions that address 1099 forms and procedures involved in returning Provider Relief Fund money to the federal government.  Find the three updates, all marked “Modified 2/25/2022,” on pages 6 and 8 of the Provider Relief Fund FAQ.

Federal Response to Surprise Billing Regulation Court Decision

Last week a federal court decision invalidated a major aspect of federal implementation of the No Surprises Act, the 2020 law intended to protect consumers from surprise medical bills for out-of-network services.  Specifically, the court ruled that the regulation imposed a requirement for use in arbitrating payment disputes in an independent dispute resolution (IDR) process that was contrary to the enabling legislation’s intent.  Now, the Department of Labor, one of the agencies involved in creating the regulations implementing the No Surprises Act, has published a news release outlining how the federal agencies involved are responding to the court decision.  Specifically, the Labor Department wrote that:

  • Effective immediately,

Federal Health Policy Update for Friday, January 28

The following is the latest health policy news from the federal government as of 3:45 p.m. on Friday, January 28.  Some of the language used below is taken directly from government documents.

Provider Relief Fund

  • HHS and its Health Resources and Services Administration (HRSA) announced that this week they made more than $2 billion in Provider Relief Fund Phase 4 General Distribution payments to more than 7,600 providers.  Nearly $11 billion of the $17 billion allocated for Provider Relief Fund Phase 4 payments have now been distributed.  Phase 4 payments have an increased focus on equity, including reimbursing a higher percentage of losses for smaller providers and incorporating bonus payments for providers that serve Medicaid, CHIP, and Medicare beneficiaries.  Approximately 82 percent of all Phase 4 applications have now been processed.  Learn more from this HHS news release.
  • HRSA has updated the Provider Relief Fund FAQ with 11 new questions and answers.  The new information, found on pages 29, 30 (three questions), 31 (three questions), 38 (three questions), and 39 primarily address financial reporting requirements.
  • The reconsideration window for Provider Relief Fund Phase 4 payments and American Rescue Plan rural hospital payments will open on February 1, 2022,