ICYMI, here is recent communication from CMS.
Final FY 2024 Payment Rules
- New CMS Rule Promotes High-Quality Care and Rewards Hospitals that Deliver High-Quality Care to Underserved Populations
- Hospice Payment Rate Update
- Medicare Inpatient Psychiatric Facility Prospective Payment System & Quality Reporting
- Inpatient Rehabilitation Facility Prospective Payment System
- Skilled Nursing Facility Prospective Payment System
Events
Today!
Save the date! @CMSGov Deputy Administrator Jon Blum will provide an overview of the new States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model on 9/18, 3-4P ET. Sign up: https://t.co/Aclo2w4sog pic.twitter.com/XZCaAeUtxT
— CMS Innovation Ctr (@CMSinnovates) September 11, 2023
News
Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation
CMS announced the list of 34 prescription drugs for which Part B beneficiary coinsurances may be lower between October 1 – December 31, 2023. Some people with Medicare who take these drugs may save between $1 and $618 per average dose starting October 1, 2023, depending on their individual coverage. Through the Inflation Reduction Act, President Biden and his Administration are lowering prescription drug costs for millions of American seniors and their families.
CMS Issues Fact Sheet on the Process for the Medicare Drug Price Negotiation Program
CMS issued a fact sheet with key information on the process for the first round of negotiations for the Medicare Drug Pricing Negotiation Program, following the Historic Announcement of the First Selected Drugs for Medicare Drug Price Negotiation.
Z codes are used to collect social determinants of health (#SDOH) data, with new codes becoming effective each April 1 and October 1.
Review our new resource to learn how Z codes are addressing health disparities: https://t.co/arXljlaeMJ pic.twitter.com/2zuqhrYN8P
— CMSGov (@CMSGov) September 12, 2023
CMS is #hiring #leadership #healthcarepolicy #professionals to serve in our #Baltimore office. Visit https://t.co/feCYZjqr9o to learn more about this executive leadership opportunity! Apply by 10/09/2023. pic.twitter.com/vI5ZPO5E6C
— CMSGov (@CMSGov) September 7, 2023
MIPS News
Unable to attend our August 17 webinar discussing the Qualified Clinical Data Registry (QCDR) and qualified registry self-nomination processes for the 2024 #MIPS performance period? Watch the recording on our #QPP Webinar Library: https://t.co/JBfPgTbzRr pic.twitter.com/qjuuZZZ4d4
— CMSGov (@CMSGov) September 12, 2023
Reminder: 2023 MIPS Value Pathway (MVP) Registration is Open
The Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) registration window is open for the 2023 performance year. Individuals, groups, subgroups, and Alternative Payment Model (APM) Entities that wish to report an MVP can register until November 30, 2023, at 8 p.m. ET. For the 2023 performance year, MVPs are a new, voluntary way to meet MIPS reporting requirements. Each MVP includes a subset of measures and activities that are related to a specialty or medical condition to offer more meaningful participation in MIPS.
- Visit Explore MVPs to review the available MVPs finalized for the 2023 performance year.
- Not sure how you’ll report for MIPS in 2023? You can learn more about the MVP reporting option on the QPP website.
Quality Payment Program
Interested in learning more about 2024 payment adjustments based on your #MIPS final score for the 2022 performance year? Our #QPP resource provides an overview: https://t.co/7RFa9moDhZ pic.twitter.com/lOg2t3psYh
— CMSGov (@CMSGov) September 8, 2023
Remember: If you believe there’s an error in the calculation of your 2022 #MIPS final score, you can request a targeted review until October 9, 2023. Our #QPP demo video will walk you through the process: https://t.co/LExzhQgmOZ pic.twitter.com/Bc2Pf4YHoI
— CMSGov (@CMSGov) August 31, 2023
Administrative Simplification
When covered entities comply with electronic health care transaction standards, operations become more efficient and information quality and accuracy improve. Review health care transaction basics in our fact sheet: https://t.co/MYfapFpCBZ #AdminSimp pic.twitter.com/XvJNbn2P86
— CMSGov (@CMSGov) September 14, 2023
The Administrative Simplification Enforcement and Testing Tool (ASETT) allows users to test electronic health care transactions for compliance with #HIPAA transaction standards. Reference our infographic for an outline of how to use ASETT: https://t.co/FKXbUw6BPz #AdminSimp pic.twitter.com/RBnE133SoZ
— CMSGov (@CMSGov) September 13, 2023
CMS has issued a new guidance letter to clarify misconceptions surrounding health plans requiring an organizational health care provider to obtain unique National Provider Identifiers (NPIs) for subparts of the organization. Read it here: https://t.co/ovnmlnYniB #AdminSimp pic.twitter.com/moyN57OdWD
— CMSGov (@CMSGov) September 12, 2023
Not sure if your organization is a HIPAA covered entity? Check out our Covered Entity Decision Tool to determine whether you’re required to comply with #HIPAA’s Administrative Simplification provisions: https://t.co/UMJF7n0EO7 #AdminSimp pic.twitter.com/Ldf2TCu0ph
— CMSGov (@CMSGov) September 11, 2023
MLN Matters Articles
- Ambulatory Surgical Center Payment System: October 2023 Update
- DMEPOS Fee Schedule: October 2023 Quarterly Update
- Hospital Outpatient Prospective Payment System: October 2023 Update
- Changes to the Laboratory National Coverage Determination Edit Software: January 2024 Update
- Inpatient Psychiatric Facilities Prospective Payment System: FY 2024 Updates
- Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: Quarterly Update
- Activation of Validation Edits for Providers with Multiple Service Locations — Revised
- Hospice Payments: FY 2024 Update
- ICD-10 & Other Coding Revisions to National Coverage Determinations: January 2024 Update
- National Coverage Determination 30.3.3 – Acupuncture for Chronic Low Back Pain
- Power Seat Elevation Equipment on Power Wheelchairs
- HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement: October 2023 Update
- ESRD Prospective Payment System: October 2023 Update
- Patient Driven Payment Model Claim Edits
- Processing Services During Disenrollment from the Program of All-Inclusive Care for the Elderly
Claims, Pricers, & Codes
- National Correct Coding Initiative: October Update
- Integrated Outpatient Code Editor: Version 24.3
- HCPCS Application Summaries & Coding Decisions: Non-Drug & Non-Biological Items and Services
- Home Health Prospective Payment System Grouper: October Update
- Updated ICD-10 Medicare Severity Diagnosis-Related Group Version 41
- HCPCS Application Summaries & Coding Decisions: Non-Drug & Non-Biological Items & Services
- New Place of Service Code 27 – Outreach Site/Street
- COVID-19: CPT Codes for Vaccines No Longer Authorized
- Inpatient Rehabilitation Facility Prospective Payment System: FY 2024 Pricer Update
- Skilled Nursing Facility Prospective Payment System: FY 2024 Pricer Update
- Outpatient Rehabilitation Claims with Reason Code W7072: Do You Need to Resubmit Claims?
- HCPCS Application Summaries & Coding Decisions: Drugs & Biologicals
CMS Innovation Center
Check out the evaluation findings for the first 3 years of the PA Rural Health Model: https://t.co/f5qzju396P. Key findings show that the model’s increased focus on community engagement helped participating hospitals better address & support the social needs of communities. pic.twitter.com/TpSt6hldXf
— CMS Innovation Ctr (@CMSinnovates) September 14, 2023
Check out the final summative evaluation report on the original Home Health Value-Based Purchasing (HHVBP) Model: https://t.co/TBo97RHLHV. The original model led to improved quality & the expanded model builds on the past model’s successes: https://t.co/QSZXb4V44S pic.twitter.com/3uJj0kZqH0
— CMS Innovation Ctr (@CMSinnovates) September 13, 2023
Check out a new resource from the Accountable Health Communities (AHC) Model featuring communications strategies used by 3 AHC awardees to help advance their activities to address #healthrelatedsocialneeds: https://t.co/5edncToqG9 pic.twitter.com/oRsqB7C0z5
— CMS Innovation Ctr (@CMSinnovates) September 12, 2023
Missed the Guiding an Improved Dementia Experience (GUIDE) webinar? Review the slides, transcript, and watch a recording of the event: https://t.co/dDN6UFu4vZ pic.twitter.com/tAviWe75m2
— CMS Innovation Ctr (@CMSinnovates) September 8, 2023