This week in Medicare updates—10/19/2022
Point of Care Antigen Testing FAQ
On October 7, CMS updated an FAQ regarding point of care antigen testing for COVID-19. The FAQ addresses requirements under CLIA for facilities performing point of care antigen testing and any enforcement discretion allowed during the COVID-19 PHE.
Notice of New Interest Rate for Medicare Overpayments and Underpayments - 1st Qtr FY 2023
On October 13, CMS published Medicare Financial Management Transmittal 11643 regarding the updated interest rate for Medicare overpayments and underpayments. The latest private consumer rate has been changed to 10.125%, a significant jump from the previous quarter’s interest rate of 8.75%.
Effective date: October 18, 2022
Implementation date: October 18, 2022
CY 2023 Participation Enrollment and Medicare Participating Physicians and Suppliers Directory
(MEDPARD) Procedures
On October 13, CMS published Medicare Claims Processing Transmittal 11640 regarding information for the contractors on CY 2023 participation enrollment. The transmittal includes the form for the Medicare participating physician or supplier agreement.
Effective date: October 13, 2022
Implementation date: November 15, 2022, following the close of the annual participation enrollment process for BRs related to MEDPARD and the processing of participation elections and withdraws; November 15 for BRs related to disclosure reports, MPFS, and postcard mailing; November 8, 2022 for all other requirements
Ambulance Inflation Factor (AIF) for CY 2023 and Productivity Adjustment
On October 13, CMS published Medicare Claims Processing Transmittal 11642 regarding information in the manual about the ambulance inflation factor. The 2023 AIF is 8.7%
Effective date: January 1, 2023
Implementation date: January 3, 2023
Update to Medicare Deductible, Coinsurance, and Premium Rates for CY 2023
On October 13, CMS published Medicare General Information, Eligibility, and Entitlement Transmittal 11641 regarding updates to the claims processing system to add in the new CY 2023 Medicare rates. This included the Part A deductible ($1,600), Part B Standard Premium ($164.90 per month), Part A Base Premium ($506 per month) and more.
CMS published MLN Matters 12903 on the same date to accompany the transmittal.
Effective date: January 1, 2023
Implementation date: January 3, 2023
Vacating Differential Payment Rate for 340B-Acquired Drugs in 2022 OPPS Final Rule
On October 13, CMS published a Note in MLN Connects regarding the ruling prohibiting CMS from applying a different payment rate for 340B-acquired drugs at average sales price (ASP) minus 22.5%. CMS will revert to paying the default rate (ASP plus 6%) for these drugs for the rest of the year. CMS will also reprocess claims that the CMS contractors paid on or after September 28, 2022, using the default rate.