Archive for Centers for Medicare & Medicaid Services


Physicians Push Back Against Medicare Telemedicine Proposal

A proposal to enable Medicare to make greater use of telemedicine as a means of serving patients is receiving surprising pushback from physicians.

The Centers for Medicare & Medicaid Services has proposed paying doctors $14 for what would amount to a five-minute telephone “check-in” call with patients.

Some physicians note that they already have such telephone conversations patients – and do not charge for those calls.  Others fear the new service will increase their patients’ health care costs because they would incur a co-pay for such conversations.  The chairman of the Medicare Payment Advisory Commission (MedPAC), himself a physician, has written that “Direct-to-consumer telehealth services…appear to expand access, but at a potentially significant cost and without evidence of improved quality.”

Learn more about CMS’s telemedicine proposal, what Medicare hopes to accomplish by expanding access to telehealth services, and why some providers do not share CMS’s enthusiasm for telemedicine in this Kaiser Health News article.


CMS Proposes Easing Regulatory Requirements

In a newly proposed rule, the Centers for Medicare & Medicaid Services proposes easing the regulatory burden on health care providers.

The proposed regulation, which weighs in at 285 pages, covers a broad range of government regulation of health care providers and would, CMS projects, save hospitals more than $1 billion a year while cutting millions of hours of administrative work.

Learn more about what CMS proposes by reading its fact sheet on the proposed regulation or going here to see the proposed regulation itself.


Medicare Joint Replacement Program Produces Savings

The first reporting period for Medicare’s Comprehensive Care for Joint Replacement Model found that participating providers cut costs for episodes of care by more than $900, or 3.3 percent.

Most of the savings, the Centers for Medicare & Medicaid Services reports, were achieved by sending patients to less-expensive post-acute-care settings or by reducing patients’ length of stay in such facilities.

CMS also found that the program’s mandatory participants, located in 67 metropolitan statistical areas, achieved these savings without compromising quality of care as measured by post-discharge emergency room visits, hospital readmissions, and deaths.

Learn more about CJR’s early results in this report in Becker’s Hospital Review or go here to see the report CMS commissioned on the program’s first nine months in operation.…

Ways and Means Praises CMS for Red Tape Efforts, Seeks More

Leaders of the House Ways and Means Committee have written to Centers for Medicare & Medicaid Services administrator Seema Verma to praise her agency’s work in eliminating Medicare red tape – but also asking her to “…take further steps to improve patient care by alleviating administrative and regulatory burdens for Medicare providers.”

In three separate letters, committee chairman Kevin Brady (R-TX) and Health Subcommittee chairman Peter Roskam (R-IL) expressed their pleasure with CMS’s recent efforts but specified areas where they would like to see further action.

For hospitals, they wrote that they seek further red-tape cutting in the areas of Medicare conditions of participation, facility co-location, hospital quality star ratings, and meaningful measures.

For post-acute-care providers, they want CMS to address the long-term acute-care hospital 25 percent rule, to hold more inpatient rehabilitation facility open-door forums, and to address skilled nursing facility consolidated billing, documentation to satisfy home health eligibility, and hospice medical review audits.

And for physicians, they urged CMS to continue working to improve the Medicare physician fee schedule, the outpatient prospective payment system, and payments for durable medical equipment and other medical equipment and supplies.

Go here to see the Ways and Means letter addressing hospital issues, …

HHS Seeks Feedback on Anti-Kickback Challenges

The Office of the Inspector General of the U.S. Department of Health and Human Services has issued a request for information from health care stakeholders on how the federal government might modify current safe-harbor and anti-kickback laws and regulations in ways that might promote the provision of better health care at lower costs.

The RFI explains that

The Office of Inspector General (OIG) seeks to identify ways in which it might modify or add new safe harbors to the anti-kickback statute and exceptions to the beneficiary inducements civil monetary penalty (CMP) definition of “remuneration” in order to foster arrangements that would promote care coordination and advance the delivery of value-based care, while also protecting against harms caused by fraud and abuse. Through internal discussion and with the benefit of facts and information received from external stakeholders, OIG has identified the broad reach of the anti-kickback statute and beneficiary inducements CMP as a potential impediment to beneficial arrangements that would advance coordinated care. To inform our efforts, we welcome public comment on the safe harbors to the anti-kickback statute and the exceptions to the beneficiary inducements CMP definition of “remuneration” as they relate to the goals of the Regulatory Sprint outlined