Tag: Medicare

Biden names acting administrator for CMS

The Biden administration has named Liz Richter the acting administrator for CMS. Richter has served since 1990 and most recently served as deputy director of the Center for Medicare, according to CMS. Richter began in the Bureau of Policy Development working on inpatient hospital payment policy. She later worked on a variety of Medicare payment […]

Ensure patients are up to date on vaccines for influenza, pneumonia

In the midst of the COVID-19 public health emergency and the height of flu season, it is important to ensure patients in home health and hospice care are up to date on their influenza and pneumonia vaccines. A post on a Celerian Group Company (CGS)’s website reminds providers: Home health agencies can provide the influenza […]

MACs announce RAP workaround due to error message

An issue with RAP processing under the new no-pay RAP policies has led to some RAPs being returned to agencies, but Medicare Administrative Contractors (MACs) have determined a workaround, according to a message from CGS to providers last week. While its optional for you to report a Core-Based Statistical Area (CBSA) code using value code […]

CMS announces expansion of Home Health Value-Based Purchasing Model

CMS will expand the Home Health Value-Based Purchasing (HHVBP) Model, officials announced January 8, 2021. Currently implemented in nine states, the model has saved Medicare an average of $141 million annually, with an average improvement in quality scores of 4/6%, according to a news release. The HHVBP Model adjusts payments to agencies based on quality […]

Medicare codes issued for Moderna vaccine

The FDA recently issued an Emergency Use Authorization the Moderna COVID-19 vaccination, and Medicare will be covering the administration of the vaccine for the duration of the Public Health Emergency.  SNFs should only bill for administration codes when submitting claims to Medicare, and should not use these codes while the vaccine is free. CMS will […]

CMS unveils new model for Medicaid Managed Care Organizations

CMS’ Center for Medicare & Medicaid Innovation has an opportunity for Medicaid Managed Care Organizations (MCOs) to participate in the Global and Professional Options of the Direct Contracting Model. The model seeks to encourage “Medicaid MCOs to partner with providers and suppliers and implement care coordination programs that can improve quality and reduce Medicare fee-for-service […]

Home health agencies must enroll with state Part B Medicare Administrative Contractor to provide home infusion therapy

Beginning Jan. 1, home health agencies that wish to provide and bill Medicare Home Infusion Therapy (HIT) professional services for calendar year 2021, will be required to enroll with the Part B Medicare Administrative Contractor (A/B MAC) in their state. Home health agencies will no longer be able to bill professional HIT services on the […]

COVID-19 Vaccine Latest: Moderna vaccine approved, older adults 75+ next in line for shots

The Food and Drug Administration has issued an emergency use authorization (EUA) for Moderna’s COVID-19 vaccine for persons 18 and older. Meanwhile, a federal advisory committee voted Sunday to put seniors 75 and older among those next in line to get vaccinated. Unlike the Pfizer-BioNTech vaccine approved Dec. 11, which required specialty freezers, the Moderna […]

Legislation would delay 2% Medicare sequestration payment reductions

The Medicare Sequester COVID Moratorium Act, H.R. 8840 legislation, was introduced by Reps. Brad Schneider, D-Ill., and David McKinley , R-W.Va., “to extend the suspension of the two percent Medicare sequestration payment reductions through the COVID-19 public health emergency (PHE),” according to a December 3, 2020, National Hospice and Palliative Care Organization (NHPCO) press release. […]

New reports show increase in home health referrals during pandemic

New data on home health referrals during the pandemic notes what industry leaders have been saying for months: home health clinicians are on the front lines during the COVID-19 pandemic, treating an increasing number of patients, including those with the coronavirus. A updated CMS Snapshot report on beneficiaries hospitalized with COVID-19 found that 14% of […]