This week in Medicare updates–09/14/2016
2017 Medicare EHR Incentive Program payment adjustment for hospitals
On September 2, CMS posted a fact sheet discussing the EHR Incentive Program payment adjustment for 2017.
View the fact sheet.
Office for Civil Rights (OCR) clearance
On September 2, CMS posted a survey and certification letter regarding a revision to the OCR clearance process for new providers and Changes of Ownership (CHOW). The new process requires that providers successfully submit electronically an attestation of compliance with the civil rights requirements to the OCR before the State Survey Agencies and Regional Offices (RO) may process requests for initial surveys or CHOWs. Confirmation from OCR of successful submission of the attestation will meet the requirements for OCR clearance and eliminates the need for CMS ROs to issue provisional provider agreements. OCR began receiving electronic attestations on September 1.
View the survey and certification letter.
Adjustment of civil monetary penalties for inflation
On September 6, HHS posted a notice in the Federal Register issuing a new regulation to adjust for inflation the maximum civil monetary penalty amounts for the various civil monetary penalty authorities for all agencies within HHS. HHS is taking this action to comply with the Federal Civil Penalties Inflation Adjustment Act of 1990, as amended by the Federal Civil Penalties Inflation Adjustment Act Improvements Act of 2015. In addition, this interim final rule includes updates to certain agency-specific regulations to identify their updated information, and note the location of HHS-wide regulations.
View the notice in the Federal Register.
CMS should address Medicare's flawed payment system for DME infusion drugs
On September 7, the OIG posted a report again recommending that CMS take action to address payment issues associated with DME infusion drugs. The agency could seek a legislative change that would require payments for DME infusion drugs to be based on average sales prices, as is the case with most other Part B drugs. CMS could address the OIG’s recommendation by using its existing authority to include DME infusion drugs in the competitive bidding program.
View the report.
Accountable Health Communities (AHC) Model Track 1–Awareness
On September 8, CMS posted a fact sheet announcing an Accountable Health Communities (AHC) Model to address a critical gap between clinical care and community services in the current healthcare delivery system. Track 1 of the AHC model will test whether increased awareness of and referral to services addressing health-related social needs will impact total healthcare costs and utilization for Medicare and Medicaid beneficiaries in targeted communities.
View the fact sheet.
CMS finalizes rule to bolster emergency preparedness of certain facilities participating in Medicare and Medicaid
On September 8, CMS finalized a rule to establish consistent emergency preparedness requirements for healthcare providers participating in Medicare and Medicaid, increase patient safety during emergencies, and establish a more coordinated response to natural and manmade disasters.
View the rule.
View the press release.
NCA for percutaneous image-guided lumbar decompression for lumbar spinal stenosis
On September 8, CMS posted a proposed decision memorandum regarding the NCA for percutaneous image-guided lumbar decompression for lumbar spinal stenosis.
View the proposed decision memorandum.
Influenza vaccine payment allowances:Annual update for 2016-2017 season
On September 9, CMS released a recurring update notification providing the availability of payment allowances for seasonal influenza virus vaccines as updated on an annual basis effective August 1 of each year. Payment allowances are still pending for all vaccines.
Effective date: August 1, 2016
Implementation date: No later than November 1, 2016
View Transmittal R3611CP.
Update related to investigative instructions for ZPICs
On September 9, CMS released a change request to revise certain program integrity investigation instructions related to Zone Program Integrity Contractors.
Effective date: December 12, 2016
Implementation date: December 12, 2016
View Transmittal R675PI.
Revisions to survey procedures for life safety code surveys
On September 9, CMS released a change request to reinstate guidance to life safety code surveyors regarding the survey procedures for Task 4, Information Gathering, and add more specific information regarding sharing specific regulatory references or tags during the exit conference within Appendix I of the SOM.
Effective date: September 9, 2016
Implementation date: September 9, 2016
View Transmittal R159SOMA.
Ambulance staffing requirements
On September 9, CMS released a transmittal manualizing the CY 2016 revisions to the ambulance staffing requirements (80 FR 71078-71080) and provides clarifications on the definitions for ground ambulance services for Advanced Life Support, Level 1 (ALS1), ALS assessment, application for ALS, Level 2 (ALS2), Specialty Care Transport (SCT), Paramedic Intercept (PI), emergency response and interfacility transportation.
Effective date: January 1, 2016
Implementation date: December 12, 2016
View Transmittal R225BP.
Comments sought on Medicare Self-Referral Disclosure Protocol
On September 9, CMS posted a notice in the Federal Register stating that it is accepting comments on CMS–10328, Medicare Self-Referral Disclosure Protocol. Comments are due October 11.
View the notice in the Federal Register.
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