This week in Medicare updates—3/30/2022
Continued Approval of the American Association for Accreditation of Ambulatory Surgery Facilities’ (AAAASF) Rural Health Clinic Accreditation Program
On March 21, CMS published a Final Notice in the Federal Register to announce that it has approved the AAAASF for continued recognition as a national accrediting organization for rural health clinics that wish to participate in Medicare or Medicaid.
Dates: This notice is effective from March 23, 2022, to March 23, 2026.
Medicare Modernization of Payment Software
On March 21, CMS revised an MLN Fact Sheet regarding the modernization of grouping and code editor software. Changes include a link to an updated version of the ICD-10 MS-DRG Grouper software and the MCE ICD-10 software, the addition of 2020-2022 Web Pricer information, and an updated Java Conversion Schedule summary.
Announcement of the Re-Approval of the American Association for Laboratory Accreditation (A2LA) as an Accreditation Organization Under CLIA
On March 22, CMS published a Notice in the Federal Register to announce that it has approved an application from A2LA to serve as an accreditation organization for clinical laboratories under the CLIA program.
Dates: This notice is effective from March 23, 2022, to March 22, 2028.
CLIA CMS Location and State Agency Updates to COVID-19 Survey Prioritization Guidance
On March 22, CMS published a Memorandum to state survey agency directors regarding update guidance on actions to take to fully resume CLIA survey activities. Steps discussed in the memo include guidance for on-site surveys as well as guidance for enforcement actions and PT desk reviews.
Effective date: Immediately. This policy should be communicated with all survey and certification staff, their managers, and the state/regional office training coordinators within 30 days of this memorandum.
April 2022 Update of the Hospital Outpatient Prospective Payment System (OPPS)
On March 24, CMS published Medicare Claims Processing Transmittal 11305 regarding the April updates to the OPPS. Changes include updates to codes for COVID-19 vaccines and monoclonal antibody treatments, five new HCPCS codes for drugs/biologicals receiving pass-through status, a handful of status indicator updates, and more.
Effective date: April 1, 2022
Implementation date: April 4, 2022
April 2022 Integrated Outpatient Code Editor (I/OCE) Specifications Version 23.1
On March 24, CMS published Medicare Claims Processing Transmittal 11304 regarding the April 2022 updates to the I/OCE.
Effective date: April 1, 2022
Implementation date: April 4, 2022
April 2022 Update of the Ambulatory Surgical Center (ASC) Payment System
On March 24, CMS published Medicare Claims Processing Transmittal 11303 regarding the April 2022 updates to the ASC payment system. Changes include nine new skin substitute HCPCS codes, updates to make rabies immune globulin and the hepatitis vaccine retroactively payable, nine new HCPCS codes for drugs/biologicals/radiopharmaceuticals, and more.
CMS published MLN Matters 12679 on the same date to accompany the transmittal.
Effective date: April 1, 2022
Implementation date: April 4, 2022
Fifth General Update to Provider Enrollment Instructions in Chapter 10 of the Program Integrity Manual
On March 25, CMS published Medicare Program Integrity Transmittal 11307 regarding the clarification of several provider enrollment model letters, deactivation policies, procedures for processing certain federally qualified health center applications, and more.
Effective date: March 4, 2022
Implementation date: April 25, 2022