This week in Medicare updates—10/23/19
Updated OIG Work Plan
On October 15, the OIG updated its Work Plan with the following new items:
- Review of Hospice Inpatient and Aggregate Cap Calculations
- Medicare Part B Payments for Speech-Language Pathology
- Review of Medicare Payments for Power Mobility Device Repairs
- Review of Medicare Part B Urine Drug Testing Services
- Supplier Compliance with Medicare Requirements for Replacement of Positive Airway Pressure Device Supplies
Coding Encounters Related to E-Cigarette, or Vaping, Product Use
On October 17, the CDC published a Supplement regarding coding for healthcare encounters and deaths related to E-cigarette or Vaping Product Use Associated Lung Injury (EVALI). The supplement contains guidance on ICD-10-CM codes to use for lung-related complications, poisoning/toxicity, substance use/abuse/dependence, and signs and symptoms. The CDC advised that this guidance should be used in conjunction with the current official coding guidelines and said the list is not all-inclusive of what may be used for these types of encounters.
FY 2020 State Performance Standards System (SPSS) Guidance
On October 17, CMS published a Memorandum to state survey agency directors regarding revisions to the SPSS oversight process for ensuring Medicare/Medicaid certified providers and suppliers are compliant with federal requirements. These changes will include the establishment of state performance indicators to help identify causes for inadequate performance in certain measures. They also include increased monitoring through more frequent reviews of state survey agencies, increased accountability for state survey agencies related to cases of immediate jeopardy, and better access for state survey agencies to centralized CMS data in an attempt to avoid redundant or duplicative data reporting so state agencies can focus on inspecting nursing homes rather than unnecessary administrative tasks. CMS published a Press Release on the revisions on the same date.
Effective date: Immediately. This information should be communicated to all survey and certification staff, their managers, and the state/regional office training coordinators within 30 days of this memorandum.
Regional Medicare Swing-Bed SNF Rates
On October 17, CMS published Provider Reimbursement Manual Transmittal 480 regarding updates to the Medicare payment rates for routine SNF-type services by swing bed hospitals during CY 2020. These rates should be used to carve out swing-bed costs on the hospital cost report.
Effective date: For services furnished on or after January 1, 2020.
Correction on Comment Request
On October 18, CMS published a Correction in the Federal Register regarding a comment request issued on September 25, 2019, for an information collection titled, “Elimination of Cost-Sharing for Full Benefit Dual Eligible Individuals Receiving Home and Community-Based Services.” CMS is correcting the name of the contact who is fielding policy requests on the information collection.
Comment Request: PACE State Plan Amendment Preprint; Testing Experience and Functional Tools: Functional Assessment Standardized Items Based on the CARE Tool; more
On October 18, CMS published a Comment Request in the Federal Register regarding the following information collections:
- PACE State Plan Amendment Preprint
- Testing Experience and Functional Tools: Functional Assessment Standardized Items (FASI) Based on the CARE Tool
- Implementation of the Medicare Prescription Drug Plan (PDP) and Medicare Advantage (MA) Plan Disenrollment Reasons Survey
- Applicable Integrated Plan Coverage Decision Letter
Comments are due December 17, 2019.
Comment Request: Organ Procurement Organization’s (OPOs) Health Insurance Benefits Agreement and Supporting Regulations
On October 18, CMS published a Comment Request in the Federal Register regarding the submission for OMB review of an information collection titled “Organ Procurement Organization’s (OPOs) Health Insurance Benefits Agreement and Supporting Regulations.” Comments are due to the OMB desk officer by November 18.
Updates to Medicare Financial Management Manual Chapter 4, Section 50-50.6 Extended Repayment Schedules
On October 18, CMS published Medicare Financial Management Transmittal 328, which rescinds and replaces Transmittal 312, dated April 5, 2019, to revise the extended repayment schedule (ERS) document request timeframes. The original transmittal was issued regarding updates and clarification to the ERS, including changes to steps that should be implemented upon receipt of an ERS, multiple changes to the steps for reviewing and establishing an ERS, details on good faith payments, and more.
Effective date: October 1, 2019
Implementation date: October 7, 2019
Updating CY 2020 Medicare Diabetes Prevention Program (MDPP) Payment Rates
On October 18, CMS published One-Time Notification Transmittal 2374 regarding updated payment rates for 15 MDPP HCPCS G-codes for 2020. These rates will be in effect for dates of service from January 1, 2020 through December 31, 2020.
CMS published MLN Matters 11455 on the same date to accompany the transmittal.
Effective date: January 1, 2020
Implementation date: January 6, 2020