Archive for Medicare reimbursement policy

 

Federal Health Policy Update for January 20

The following is the latest health policy news from the federal government for the week of January 13-20.  Some of the language used below is taken directly from government documents.

Centers for Medicare & Medicaid Services

  • CMS has published updates to the Healthcare Common Procedure Coding System (HCPCS) codes on the Required Face-to-Face Encounter and Written Order Prior to Delivery List.  The update adds ten codes to the list of items that require a face-to-face encounter between provider and patient and a written order prior to delivery as a condition of payment.  Go here for a summary of the update and a link to a formal Federal Register notice.  The update takes effect on April 17.
  • CMS has published a technical update of codes used for billing by ambulatory surgical centers.  Find it here.
  • The latest edition of MLN Connects, CMS’s online newsletter with information about Medicare reimbursement matters, includes features on the latest FY 2023 ICD-10 codes and grouper software effective April 1; January 2023 integrated outpatient code editor files, including updates; tip sheets for post-acute-care quality reporting programs during the COVID-19 public health emergency; and more.  Find it here.
  • CMS has updated and expanded its

Federal Health Policy Update for January 12

The following is the latest health policy news from the federal government for January 6-12.  Some of the language used below is taken directly from government documents.

Renewal of COVID-19 Public Health Emergency Declaration

HHS Secretary Xavier Becerra has signed an order extending the previous declaration of a COVID-19 public health emergency.  This declaration extends the emergency to April 11.  The administration continues to assure stakeholders it will provide 60 days’ notice prior to the end of the public health emergency.

MedPAC Medicare Rate Recommendations

  • Every year MedPAC recommends to Congress rate increases for the different kinds of health care providers for the coming year.  While MedPAC’s recommendations are not binding, they are highly respected and often find their way into future public policy.  MedPAC commissioners are holding public meetings today and tomorrow (January 12 and 13) and so far have offered the following recommendations:
    • Hospital payments – an increase of what current law calls for plus one percent, a transition to beginning to distribute Medicare DSH and uncompensated care payments through a new Medicare safety-net index (MSNI), and an increase of $2 billion in the MSNI pool.
    • Physician payments – an update of 50 percent of the projected

Federal Health Policy Update for January 5

The following is the latest health policy news from the federal government for December 23 through January 5.  Some of the language used below is taken directly from government documents.

No Surprises Act

  • HHS, the Department of Labor, and the Department of the Treasury have announced increases in the administrative fee for initiating the No Surprises Act’s Independent Dispute Resolution (IDR) process and for certified IDR entities.  Learn more about the administrative fee change here and about the certified IDR entity fee change here.  Both changes took effect on January 1.
  • HHS, the Department of Labor, and the Department of the Treasury have released their initial report on the No Surprises Act’s IDR process.  This report includes information on the number of disputes initiated; the number of disputes closed; the types of parties engaged in disputes; the types of services under dispute; and the states in which disputed items and services were provided.  The report notes that the process is being used far more often than federal officials anticipated and documents the backlog of disputes that still await resolution.  Go here to find the report, which the agencies note is incomplete and will be updated at a later date.

Centers

Federal Health Policy Update for December 22

The following is the latest health policy news from the federal government for the week of December 19-22.  Some of the language used below is taken directly from government documents.

Congress

As of this writing, Congress continues to work on an FY 2023 omnibus spending bill:  the Senate has passed it but the House has not yet addressed it.  Highlights of what negotiators have agreed to – but that have not yet been adopted – include:

  • Preventing the additional four percent Medicare sequester for two years.
  • Reducing by more than half the 4.5 percent cut in Medicare payments to physicians that was scheduled to take effect on January 1.  The agreement calls for reducing that 4.5 percent cut to just two percent in 2023 and then imposing a 3.5 percent cut in 2024.
  • Extending COVID-19 public health emergency Medicare telehealth policies for two years, through 2024.
  • Ending the maintenance-of-effort requirement from the Families First Coronavirus Response Act that prohibited states from removing ineligible individuals from their Medicaid rolls.  Under that law, states were prohibited from reviewing the eligibility of Medicaid beneficiaries for the duration of the COVID-19 public health emergency in exchange for a 6.2 percentage point increase in FMAP. 

Federal Health Policy Update for December 15

The following is the latest health policy news from the federal government for the week of December 12-15.  Some of the language used below is taken directly from government documents.

White House

  • The White House has unveiled its “COVID-19 Winter Preparedness Plan,” the major components of which are expanding easy access to free COVID-19 testing options in the winter; making vaccinations and treatments readily available as cases rise; preparing personnel and resources; and focusing on protecting the highest-risk Americans.  Learn more about the plan from this White House fact sheet and go here for a transcript of the White House press briefing about the plan.

Congress

  • Yesterday the House passed a one-week continuing resolution (CR) that will prevent the federal government from shutting down when the current CR ends tomorrow, December 16; the Senate will take up that bill although some senators have expressed their objection to a short-term CR.  Appropriators have agreed on the spending limits for FY 2023 spending bills and hope to pass an omnibus spending bill encompassing all 12 appropriations bills before next Friday, December 23.  House minority leader Kevin McCarthy, backed by other House Republicans, objects to passing an omnibus spending bill before the end of