CMS could have saved its beneficiaries an additional $2.9 million in 2017 had it implemented a more expansive price substitution policy for Part B drugs, according to an Office of Inspector General (OIG) report.
CMS released the fiscal year (FY) 2020 IPPS final rule on August 2, increasing inpatient operating payment rates by 3.1%, significantly altering rural health payments, and expediting opportunities to pay for new technologies. Policy updates affect approximately 3,300 acute care hospitals and apply to discharges occurring on and after October 1.
CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, while also asking for comments on how to potentially undo its policy that reduced payments for drugs purchased under the 340B drug discount program by nearly 30%.
CMS recently announced that it updated the national coverage policy for transcatheter aortic valve replacement (TAVR), requiring covered hospitals and physicians to begin or maintain a TAVR program and adhere to updated volume requirements.
There are some changes to the Beneficiary and Family Centered Care-Quality Improvement Organization’s (BFCC-QIO) program, and if you’re one of the organizations affected by the changes, you may need to update your patient notices to reflect them.
CMS proposed one mandatory and four voluntary alternative payment models (APM) for Medicare beneficiaries who receive treatment for chronic kidney disease and end-stage renal disease.
CMS released MLN Matters SE19007 on June 28, announcing that it completed round three testing of the activation of systematic validation edits for OPPS providers with multiple service locations. To allow enough time to analyze collected data, the agency is postponing implementation of the edits until October.
CMS recently released two quarterly updates effective July 1: Medicare Claims Processing Transmittal 4313, which is the July update to the OPPS, and Medicare Claims Processing Transmittal 4314, which is the related July update to the Integrated Outpatient Code Editor (I/OCE) Specifications, Attachment B.
