ICYMI, here is recent communication from CMS.
CMS released its proposed policies for the 2021 performance year of the Quality Payment Program via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). Note: As with other rules, CMS is publishing this proposed rule to meet the legal requirements to update Medicare payment policies in the PFS on an annual basis. In recognition of the 2019 Coronavirus (COVID-19) public health emergency and limited capacity of healthcare providers to review and provide comment on extensive proposals, CMS has limited annual rulemaking required by statute to focus primarily on essential policies including Medicare payment to providers, as well as proposals that reduce burden and may help providers in the COVID-19 response.
CMS has released 2019 Merit-based Incentive Payment System (MIPS) performance feedback and final scores. If you submitted data for the 2019 performance period, you can view your MIPS performance feedback and final score on the Quality Payment Program website.
CMS issued a final rule that updates Medicare payment policies and rates for facilities under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) for fiscal year (FY) 2021. CMS is publishing this final rule consistent with the legal requirements to update Medicare payment policies for IRFs on an annual basis. This final rule also includes making permanent the regulatory change to eliminate the requirement for physicians to conduct a post admission visit since much of the information is included in the pre-admission screening documentation. This flexibility was offered during the Coronavirus Disease 2019 (COVID-19) public health emergency (and would make this flexibility permanent beyond the expiration of the PHE).
CMS is proposing several policies that would give Medicare beneficiaries more choices in where they seek care and lower their out-of-pocket costs for surgeries. The proposed rule takes steps that would allow hospitals and ambulatory surgical centers to operate with better flexibility and patients to have what they need to make informed decisions on where they receive care.
CMS is finalizing a Medicare payment rule that further advances efforts to strengthen the Medicare program by better aligning payments for inpatient rehabilitation facilities. The final rule updates Medicare payment policies and rates for facilities under the Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) for FY 2021. This final rule also includes making permanent the regulatory change to eliminate the requirement for physicians to conduct a post admission visit since much of the information is included in the pre-admission visit.
If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, you can now review your performance feedback, including your MIPS final score and payment adjustment factor(s), on the Quality Payment Program website.
Registration open for PFS Listening Session being held on Thursday, Augutst 13, 2020 at 1:30 pm ET. Proposed changes to the CY 2021 Physician Fee Schedule are aimed at reducing burden, recognizing clinicians for the time they spend taking care of patients, removing unnecessary measures, and making it easier for clinicians to be on the path towards value-based care. During this listening session, CMS experts briefly cover provisions from the proposed rule and address your clarifying questions to help you formulate your written comments for formal submission.
CMS finalized three Medicare payment rules that further advance our efforts to strengthen the Medicare program by better aligning payments for inpatient psychiatric facilities (IPF), skilled nursing facilities (SNF) and hospices. See fact sheets on each final rule, IPF PPS, SNF PPS, Hospices PPS.
In response to the COVID-19 pandemic, the CMS is implementing 12 new procedure codes to describe the introduction or infusion of therapeutics, including remdesivir and convalescent plasma, into the International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS), effective August 01, 2020.
As the 2021 Merit-Based Incentive Payment System (MIPS) Performance Period Self-Nomination period approaches, the Centers for Medicare & Medicaid Services (CMS) will host the 2021 Self-Nomination Application Virtual Office Hours on Thursday, August 13, 2020 from 1:00-2:30 p.m. ET. The purpose of this session is to give attendees the opportunity to ask questions about the self-nomination forms for the 2021 MIPS performance period in the Quality Payment Program website and the QCDR measure submission template for those QCDRs submitting QCDR measures. Qualified Registries and QCDRs are CMS-approved third party intermediaries that collect clinical data on behalf of clinicians for data submission. Register for this event.
CMS released its first monthly update of data that provides a snapshot of the impact of COVID-19 on the Medicare population. For the first time, the snapshot includes data for American Indian/Alaskan Native Medicare beneficiaries. The new data indicate that American Indian/Alaskan Native beneficiaries have the second highest rate of hospitalization for COVID-19 among racial/ethnic groups after Blacks. Previously, the number of hospitalizations of American Indian/Alaskan Native beneficiaries was too low to be reported.
CMS released a trends report that provides data on the number of individuals who signed up for coverage on HealthCare.gov through a special enrollment period (SEP) during the Coronavirus Disease 2019 (COVID-19) pandemic. As a result of the economic disruption that followed COVID-19 outbreaks, many consumers experienced life changes—particularly related to employment—that allowed them to enroll in health coverage through the Exchange. View the Special Trends Report.
As part of its ongoing efforts to provide financial relief to healthcare providers impacted by the coronavirus disease 2019 (COVID-19), HHS is announcing an application deadline extension for the Phase 2 general distribution to Medicaid, Medicaid managed care, Children’s Health Insurance Program (CHIP) and dental providers. HHS also plans to allow certain Medicare providers who experienced challenges in the Phase 1 Medicare General Distribution application period a second opportunity to receive funding. Both groups will have until Friday, August 28, 2020 to apply.
MLN Matter Articles
- Change to the Payment of Allogeneic Stem Cell Acquisition Services
- July 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) — Revised
- Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2020
- Influenza Vaccine Payment Allowances – Annual Update for 2020-2021 Season
- Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2021
- October 2020 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – July 2020 Update
- July 2020 Update of the Ambulatory Surgical Center (ASC) Payment System — Revised
- July 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) — Revised
- Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment — Revised
- Claim Status Category Codes and Claim Status Codes Update — Rescinded