This week in Medicare updates—3/10/2021
Intravenous Immune Globulin (IVIG) Demonstration Fact Sheet
On March 1, CMS published an MLN Fact Sheet regarding the IVIG demonstration, which has been extended by Congress and will now end on December 31, 2023. The fact sheet provides information for suppliers regarding supplier eligibility and participation, beneficiary eligibility and participation, and billing and coding requirements.
Health Professional Shortage Area Physician Bonus Program
On March 1, CMS updated an MLN Fact Sheet regarding the bonus payments for physicians in Health Professional Shortage Areas (HPSA). There are no substantive content updates; CMS revised the document to give the complete URL for each resource link.
STAT Op-Ed: Why Drug Prescriptions Should Include Diagnoses
On March 1, the OIG published a link to an Op-Ed in Stat written by the OIG’s Principal Deputy Inspector General Christi A. Grimm and Chief Medical Officer Julie K. Taitsmen regarding why adding patient diagnoses to prescriptions is important. The Op-Ed explains how the significant increase in prescriptions for hydroxychloroquine in the spring of 2020 is difficult for the OIG to analyze because for outpatients, neither prescriptions nor Medicare claims include diagnoses explaining why the drug was prescribed. The Op-Ed discusses how including diagnoses could help in other cases to identify possible safety issues or cases of fraud or abuse.
Notice of Withdrawal of Development of Computed Tomography (CT) Image Quality and Safety Hospital Measures Funding Opportunity
On March 1, CMS published a Withdrawal Notice in the Federal Register to withdraw a funding opportunity notice, “Development of CT Image Quality and Safety Hospital Measures,” dated January 5, 2021. The notice was withdrawn because current delays for CMS will not allow adequate time for the measures to be developed to meet internal deadlines. CMS will no longer provide support through a single-source cooperative agreement for the planning, technical assistance, and reporting needs related to submission of radiology measures for the 2021 Measures Under Consideration List.
Dates: The notice published at 86 FR 306 on January 5, 2021, is withdrawn as of February 25, 2021.
Application From the Accreditation Commission for Health Care (ACHC) for Continued Approval of its Home Health Agency Accreditation Program
On March 1, CMS published a Final Notice in the Federal Register to announce its decision to approve ACHC for continued recognition as a national accrediting organization for home health agencies wishing to participate in Medicare or Medicaid.
Dates: The decision announced in this final notice is effective February 24, 2021 through February 24, 2025.
Comment Request Withdrawal: Annual Report on Home and Community Based Services Waivers and Supporting Regulations
On March 2, CMS published a Withdrawal Notice in the Federal Register regarding an information collection published on February 25 titled, “Annual Report on Home and Community Based Services Waivers and Supporting Regulations.” CMS is withdrawing the comment request in its entirety as it was published in error. It will be resubmitted for publication and public comment when ready.
Acute Hospital Care At Home Approved List
On March 3, CMS updated a List of approved hospitals participating in the Acute Care Hospital at Home program as of March 3, 2021. The program expanded to include a total of 109 hospitals across 48 systems in 29 states.
CY 2020 OPPS Claims Data From January Through September
On March 4, CMS published Data from OPPS claims dating back to January through September 2020 for the Advisory Panel on Hospital Outpatient Payment (HOP Panel) to use in their 2020 meetings and analysis.
COVID-19 FAQs on Medicare Fee-for-Service Billing
On March 5, CMS updated an FAQ regarding the latest guidance on billing for COVID-19. This round of updates included a large number of updates to information pertaining to the Medicare Shared Savings Program, ACOs, and MIPS. There is also information about whether CMS will pay for Remdesivir if it is administered in an outpatient setting as well as a link to a list of health care providers who are eligible to administer the COVID-19 vaccine to Medicare beneficiaries.
CMS continues to update this document on a regular basis. Providers should review frequently for new information.
Updated COVID-19 Fraud Alert
On March 5, the OIG updated its Fraud Alerts to notify the public about a fraud scheme pertaining to COVID-19. This scheme involves scammers using telemarketing calls, text messages, social media, and door-to-door visits to offer COVID-19 tests, HHS grants, and Medicare prescription cards in exchange for personal details, including Medicare information. The OIG offers a series of tips on how to protect against involvement in any of these versions of the scheme.