Tag: CMS

CMS reminds providers to protect Medicare enrollment information

Providers should follow three steps in securing their Medicare enrollment information, according to CMS: Keep your Medicare Provider Enrollment, Chain, and Ownership System (PECOS) user ID and password secure and don’t share with others. Only an individual provider, Authorized or Delegated Official of an organizational provider, or Authorized Surrogate may view and update your enrollment […]

CMS releases July 2021 OASIS quarterly Q&As

CMS answers questions about the 5-day assessment time frame and assessing ambulation at the start of care in the recently released OASIS Q&As. This update includes 13 questions offering guidance on things such as: When to assess self-care and mobility for GG items. What constitutes a valid referral for M0104. How to code GG0100C – […]

CMS announces new director of Center for Medicare

Meena Seshamani, MD, PhD will serve as Deputy Administrator and Director of Center for Medicare and will lead the Center’s efforts for those who rely on Medicare coverage. The Centers for Medicare & Medicaid Services (CMS) announced a new director of the Center for Medicare on Tuesday. Meena Seshamani, MD, PhD will serve as Deputy […]

Breaking: 2022 proposed rule could mean national HHVBP and changes to PDGM

CMS has announced a national expansion of the Home Health Value-Based Purchasing (HHVBP) model beginning Jan. 1, 2022. It’s one of several changes introduced in the CY 2022 Home Health Prospective Payment System proposed rule, released Monday, June 28, 2021. Previously, the nine-state HHVBP model focused on payment adjustments higher and lower compared to other […]

MACs announce fix for HIPPS code payment error

Medicare Administrative Contractors (MACs) have addressed a payment error impacting some claims that were tied to the generic HIPPS code used on RAPs. The HIPPS code on the RAP is only used by the CMS system to pair RAPs with the final claim. Under PDGM, the CMS payment system is expected to determine the actual […]

CMS bolsters payments for in-home COVID-19 vaccinations

In an attempt to vaccinate homebound individuals, CMS announced June 9 an additional payment for administrating the COVID-19 vaccine in-home for Medicare beneficiaries who have a hard time leaving home. “There are approximately 1.6 million adults 65 or older who may have trouble accessing COVID-19 vaccinations because they have difficulty leaving home,” the CMS press […]

Medical reviews begin for pandemic claims

Medicare Administrative Contractors (MACs) have resumed post-payment medical reviews on claims during the public health emergency, according to Palmetto GBA and the latest MLN Connects newsletter. Since August, MACs have limited medical reviews to claims with dates of service before March 2020. “MACs may now begin conducting post-payment medical reviews for later dates of service,” […]

CMS outlines changes for notice of admission replacing RAPs in 2022

The notice of admission (NOA), expected to replace RAPs beginning January 1, 2022, will be submitted just once establishing the agency as the primary provider. That will cover all contiguous 30-day periods until discharge, according to updates to the Medicare Claims Processing Manual released May 11. This will end a monthly routine for agencies that […]

CMS extends comprehensive care model for joint replacement

CMS recently issued a final rule extending and changing the Comprehensive Care for Joint Replacement (CJR) Model, which was implemented to support better and more efficient care for beneficiaries who are undergoing inpatient surgeries for hip and knee replacements. The CJR program is an opportunity for home health agencies to form and deepen strategic partnerships […]

CMS seeking HOPE beta test participants

CMS and its contractor, Abt Associates, are now recruiting Medicare-certified hospice providers to participate in a beta test of the draft hospice patient assessment instrument called Hospice Outcomes & Patient Evaluation (HOPE). Recruitment ends June 14, with data collection anticipated to begin in fall 2021, according to an announcement May 12. The detailed recruitment announcement […]