Tag archives: CMS

CMS Administrator Publishes Blog Post on Expansion of Medicare Telehealth Services

By Thomas Dowdell (US), Jeff Wurzburg (US) and Rachel Park (US) on July 17, 2020 Posted in Coronavirus, General, Regulatory

On Wednesday, July 15, 2020, Administrator of the Centers for Medicare & Medicaid Services (CMS), Seema Verma, published a blog post on the Health Affairs Blog discussing CMS’ efforts to expand telehealth for Medicare beneficiaries during the COVID-19 pandemic and reviewing the potential of adopting some flexibilities as permanent measures. Historically Medicare has covered telehealth … Continue reading

COVID-19 Update: The Joint Commission Resumes Laboratory Survey Activities

By Yvonne Puig (US), Daphne Andritsos Calderon (US) and Jeff Wurzburg (US) on June 29, 2020 Posted in Coronavirus, General

In a special LabFocus The Joint Commission revealed they have resumed some laboratory survey activities. TJC stated that “[a]ccount executives are contacting organizations due for a survey to assess the impact that the coronavirus pandemic had on their operations and their current state.” To determine which organizations will be surveyed, TJC is looking at “a … Continue reading

COVID-19 Update: CMS releases guide encouraging patients to seek in-person healthcare

By Thomas Dowdell (US) and Hayley Coley (US) on June 11, 2020 Posted in Coronavirus, Regulatory

On Tuesday, June 9, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released a guide for patients who are considering their in-person care options following certain healthcare facilities re-opening for all medical services. As COVID-19 cases decline in some areas of the country, CMS created this guide to give patients recommendations, and to help … Continue reading

CMS Announces COVID-19 Adjustments for CMMI Models

By Jeff Wurzburg (US) and Thomas Dowdell (US) on June 3, 2020 Posted in Coronavirus, General, News from DC

On June 3, 2020, Centers for Medicare & Medicaid Services (“CMS”) Administrator Seema Verma announced adjustments to the Center for Medicare and Medicaid Innovation (“CMMI”) models in light of the COVID-19 public health emergency. Despite the accommodations being provided, Administrator Verma praised value-based incentives in a Health Affairs blog post, stating that “[t]hese models are … Continue reading

CMS Proposed Rule Includes Significant Changes to Medicare GME Funding

By Andrew Roth (US) and Thomas Dowdell (US) on May 20, 2020 Posted in General, News from DC, Regulatory

On May 11, 2020, the Centers for Medicare & Medicaid Services (CMS) issued its Fiscal Year (FY) 2021 hospital inpatient prospective payment system (IPPS) and long term care hospital (LTCH) prospective payment system (PPS) proposed rule. We previously reported on the hospital IPPS and LTCH PPS proposed changes. See link here . In this rulemaking, … Continue reading

CMS Issues FY 2021 Hospital IPPS and LTCH PPS Proposed Rule

By Thomas Dowdell (US) on May 13, 2020 Posted in Coronavirus, General, Regulatory

On May 11, 2020, the Centers for Medicare & Medicaid Services (CMS) issued its Fiscal Year (FY) 2021 hospital inpatient prospective payment system (IPPS) and long term care hospital (LTCH) prospective payment system (PPS) proposed rule. Under the proposed rule Medicare IPPS payment rates would increase an estimated net 3.1 percent for hospitals that successfully … Continue reading

COVID-19 Update: FBI Warns of Hackers Targeting COVID-19 Research

By Yvonne Puig (US), Daphne Andritsos Calderon (US) and Jeff Wurzburg (US) on May 13, 2020 Posted in Coronavirus, General, News from DC

In a Public Service Announcement issued May 13, 2020, the U.S. Federal Bureau of Investigation (“FBI”) and Cybersecurity and Infrastructure and Security Agency (“CISA”) warned of the targeting and compromise of U.S. organizations conducting COVID-19 research. More specifically, the announcement warns that “actors have been observed attempting to identify and illicitly obtain valuable intellectual property … Continue reading

U.S. Supreme Court Rules that the Federal Government “Shall” Pay Health Insurers $12 Billion Under the Risk Corridors Program

By Thomas Dowdell (US), Jeff Wurzburg (US) and Hayley Coley (US) on May 6, 2020 Posted in Enforcement, General, News from DC

On Monday, April 27, 2020, the U.S. Supreme Court ruled, in an 8-1 decision, that the federal government is required to pay health insurers $12 billion under the Patient Protection and Affordable Care Act’s (ACA) risk corridors program. Background of the Case Congress in the ACA created three premium stabilization programs to support insurers during … Continue reading

CMS Issues Second Round of Regulatory Waivers and Rule Changes

By Thomas Dowdell (US), Mark Faccenda (US), Rachel Park (US) and Jeff Wurzburg (US) on April 30, 2020 Posted in Coronavirus, General, Regulatory

Today, the Centers for Medicare & Medicaid Services (CMS) released an additional round of regulatory waivers and rule changes to support the healthcare system during the COVID-19 pandemic. The changes include new rules to expand COVID-19 diagnostic testing, increase care capacity and the healthcare workforce, and further promote telehealth services. Medicare no longer requires an … Continue reading

CMS Pauses Accelerated and Advanced Payments Programs

By Thomas Dowdell (US), Mark Faccenda (US), Rachel Park (US) and Jeff Wurzburg (US) on April 27, 2020 Posted in Coronavirus, General, Regulatory

CMS announced on Sunday, April 26, that it is suspending payments under the Advanced Payments Program to Part B suppliers immediately and reevaluating payment amounts under the Accelerated Payment Program. The Accelerated and Advanced Payments Programs enable Medicare providers and suppliers to receive advance Medicare payments and address cash flow issues during a disruption in … Continue reading

COVID-19 Update: CMS Issues Recommendations for Re-Opening Facilities for Non-Emergent Care

By Yvonne Puig (US), Thomas Dowdell (US), Daphne Andritsos Calderon (US) and Jeff Wurzburg (US) on April 20, 2020 Posted in Coronavirus, General, Regulatory

On Sunday April 19, 2020, CMS issued guidance for permitting non-emergent, non-COVID-19 healthcare in states that have passed the Gating Criteria provided in the Guidelines for Opening Up America Again. CMS reiterated support for telehealth, stating that “[m]aximum use of all telehealth modalities is strongly recommended.” Decisions should be” consistent with public health information and … Continue reading

COVID-19 Update: Provider Relief Fund Attestation Portal Opens

By Mark Faccenda (US), Frances Morgan (US) and Jeff Wurzburg (US) on April 17, 2020 Posted in Coronavirus, General, News from DC

On April 10, 2020, CMS made $30 billion in aggregate Public Health and Social Services Emergency Fund (“Relief Fund”) payments to providers, with each provider receiving a proportionate distribution based on how much that provider billed Medicare fee-for-service in 2019. Providers receiving Relief Fund payments authorized by the CARES Act must submit an attestation to … Continue reading

COVID-19 Update: Behavioral healthcare regulatory changes and considerations during the COVID-19 outbreak

By Purvi Maniar (US), Sarah Jean Kilker (US) and Hayley Coley (US) on April 17, 2020 Posted in Coronavirus, General, Regulatory

Throughout the COVID-19 pandemic, there have been a multitude of regulatory changes and strategies adopted in an effort to provide the American healthcare system with added flexibilities during this public health crisis. With the stress of these uncertain and isolating times, mental health and substance-use disorder (SUD) patients are particularly at risk. In a recent … Continue reading

COVID-19 Update: American Medical Association and Other Physician Organizations Request Liability Protections

By Yvonne Puig (US), Daphne Andritsos Calderon (US) and Jeff Wurzburg (US) on April 16, 2020 Posted in Coronavirus, General

In an April 15, 2020 letter to Congress, the American Medical Association and other physician organizations requested additional protection from “increased liability risk facing physicians and other clinicians” responding to the COVID-19 pandemic. The organizations request liability protections broader than the protections provided to health care volunteers in section 3215 of the CARES Act. The … Continue reading

COVID-19 Update: CMS releases additional guidance to states on how the FFCRA and CARES Act provisions apply to Medicaid and CHIP

By Thomas Dowdell (US), Jeff Wurzburg (US), Frances Morgan (US) and Hayley Coley (US) on April 14, 2020 Posted in Coronavirus, General, Regulatory

On Monday, April 13, 2020, CMS released an updated FAQ on the enhanced Federal Medical Assistance Program (FMAP) and the Families First Coronavirus Response Act (FFCRA) implementation, as well as new guidance on CMS’ Coronavirus Aid, Relief, and Economic Security (CARES) Act implementation. In these new resources, CMS explains the following changes, among others, to … Continue reading

COVID-19 Update: CMS Issues Additional Waivers to Assist Providers

By Thomas Dowdell (US), Mark Faccenda (US), Jeff Wurzburg (US) and Rachel Park (US) on April 10, 2020 Posted in Coronavirus, General, Regulatory

The Centers for Medicare & Medicaid Services (CMS) temporarily suspended a number of rules to boost frontline medical staff at healthcare facilities during the COVID-19 pandemic. The new waivers expand on the workforce flexibilities announced by CMS on March 30, 2020 (previously covered by the HL Pulse here). The new waivers include: Physicians in Critical … Continue reading

New Facility-Specific Guidance for Providers for COVID-19: Infection Control, Supply Shortages, and Staff Management

By Frances Morgan (US) on April 9, 2020 Posted in Coronavirus, General, News from DC

On April 8, 2020, CMS issued follow up guidance to healthcare providers to address infection control for COVID-19 patients, including patient monitoring, isolation techniques, supply shortage guidance, and staff training to avoid infection. CMS intends this guidance to “empower hospitals and healthcare systems… by equipping providers and clinicians with clear guidance based on CDC recommendations.” … Continue reading

COVID-19 Update: CMS Issues Wide Ranging Blanket Waivers to Assist Providers

By Thomas Dowdell (US), Mark Faccenda (US), Jeff Wurzburg (US), Joseph Keillor (US) and Hayley Coley (US) on March 31, 2020 Posted in Coronavirus, General, Regulatory

On Monday, March 30, 2020, the Centers for Medicare & Medicaid Services (CMS) issued wide ranging blanket waivers and published an interim final rule intended to “equip the American healthcare system with maximum flexibility” to respond to COVID-19. The waivers will remain in effect until the end of the emergency declaration. CMS issued a summary … Continue reading

COVID-19 update: CMS publishes fact sheet describing process for providers and suppliers seeking CARES Act Medicare accelerated and advance payments

By Frances Morgan (US) and Thomas Dowdell (US) on March 30, 2020 Posted in Coronavirus, General, News from DC

On March 28, 2020, CMS released guidance related to the expanded accelerated and advance payments provided under the Coronavirus Aid, Relief, and Economic Security (CARES) Act signed into law by President Trump on March 27. These payments are typically available when there is a disruption in claims submission or claims processing, and are offered in … Continue reading

Update to Prior CMS Action: CMS Approves 11 New Medicaid Section 1135 Waivers; 13 States Total

By Mark Faccenda (US) and Frances Morgan (US) on March 24, 2020 Posted in Coronavirus, General, News from DC

On March 13, 2020, following President Trump’s declaration of a national emergency in response to the COVID-19 pandemic, CMS announced its approval of the first Section 1135 Waiver aimed at addressing the spread of COVID-19 (Coronavirus) in Florida. On March 19, CMS granted a Section 1135 Waiver to deal with the COVID-19 outbreak in Washington … Continue reading

CMS Announces Relief on Quality Reporting Program Measures Due to COVID-19 (Coronavirus)

By Thomas Dowdell (US), Frances Morgan (US) and Jeff Wurzburg (US) on March 24, 2020 Posted in Coronavirus, General, Regulatory

On March 22, CMS announced that for providers participating in quality reporting programs the agency is granting extensions on reporting deadlines and allowing the omission of certain time periods for most program reporting. CMS released a programmatic chart explaining the relief granted considering the “extreme and uncontrollable circumstances” resulting from the COVID-19 pandemic. Of particular … Continue reading

COVID-19 (Coronavirus) Update: CMS Announces Targeted Plan for Facility Inspections – Infection Control and Immediate Jeopardy

By Thomas Dowdell (US) and Frances Morgan (US) on March 24, 2020 Posted in Coronavirus, General, Regulatory

On March 23rd, 2020, CMS announced a newly “enhanced, focused inspection process” to be implemented nationally in light of the COVID-19 (coronavirus) pandemic and released guidance to state survey agency directors. Standard and Revisit Inspections for nursing homes, hospitals, home health agencies, intermediate care facilities for individuals with intellectual disabilities, and hospices will not be … Continue reading

Coronavirus | COVID-19 Update: CMS issues guidance to all PACE Organizations to implement policies and procedures to prevent the spread of COVID-19

By Yvonne Puig (US), Daphne Andritsos Calderon (US), Thomas Dowdell (US), Jeff Wurzburg (US) and Hayley Coley (US) on March 19, 2020 Posted in Coronavirus, General, Regulatory

On Tuesday, March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) released guidance to all Programs of All-Inclusive Care for the Elderly (PACE) Organizations (POs) on policies and standard practices to follow in regards to the COVID-19 public health emergency.… Continue reading

COVID-19 Update: Trump administration expands access to telehealth services for Medicare beneficiaries to combat COVID-19

By Yvonne Puig (US), Daphne Andritsos Calderon (US), Thomas Dowdell (US), Jeff Wurzburg (US) and Hayley Coley (US) on March 17, 2020 Posted in Coronavirus, General, Regulatory

On Tuesday, March 17, 2020, the Trump administration announced that it will immediately expand access to telehealth services for all Medicare beneficiaries during the COVID-19 outbreak. In coordination with this announcement, the Office for Civil Rights at the Department of Health & Human Services (HHS) released a notification stating that HHS has temporarily suspended certain … Continue reading