This week in Medicare updates—9/9/2021

September 9, 2021
Medicare Insider

CMS Announces Support for Louisiana and Mississippi in Response to Hurricane Ida

On September 1, CMS published a Press Release on actions it is taking to support Hurricane Ida recovery efforts in Louisiana and Mississippi. These actions include steps to ensure dialysis patients can obtain services, waived requirements to help ensure access to certain DMEPOS items, suspension of survey and enforcement activities, certain IPPS hospital blanket waivers, and more. Providers should review the press release and CMS’ non-COVID emergency website for more details.


Medicare Beneficiaries Hospitalized With COVID-19 Experienced a Wide Range of Serious, Complex Conditions 

On September 1, the OIG published a Report on the types of conditions Medicare beneficiaries with COVID-19 had and who was more likely to be hospitalized with COVID-19. It focused on surges of COVID-19 hospitalizations over a three-week period in six locations (New York City, Detroit, Phoenix, Houston, New Orleans, and Miami) and analyzed diagnoses on claims from those locations to identify conditions for which these beneficiaries required complex care. The OIG found: 

  • 91% of beneficiaries in those localities were hospitalized for acute respiratory conditions (86% had viral pneumonia)
  • 51% received ICU care and/or mechanical ventilation
  • 60% were treated for acute respiratory failure
  • 47% were treated for acute kidney failure
  • 44% were treated for acute circulatory conditions
  • 65% were treated for acute endocrine, nutritional, or metabolic issues
  • 48% had type 2 diabetes
  • 36% were diagnosed with sepsis

The OIG also found that dually eligible, Black, Hispanic, or older beneficiaries were disproportionately hospitalized with COVID-19 relative to the general Medicare population in that area. The average length of stay for Medicare beneficiaries with COVID-19 was 12 days, four days longer than the average length of stay for beneficiaries without COVID-19. The OIG said this information can help the federal, state, and local efforts to provide guidance for hospitals during surges, and it can help hospitals, physicians, and other practitioners to prepare for the complex needs and resources these patients may require during continued surges.


EUA Updated for Bamlanivimab and Etesevimab Administered Together

On September 2, the FDA updated the EUA for Bamlanivimab and Etesevimab administered together as a treatment for COVID-19 to note that these products are not authorized for use in states where the most recently published combined frequency of variants resistant to the products exceeds 5%. The FDA also published a Table to show where the combination product is authorized for use. CMS updated its Monoclonal Antibody COVID-19 Infusion webpage to reflect this information. 


CMS Could Take Action to Improve Completeness and Accuracy of COVID-19 Data from Nursing Homes

On September 3, the OIG published a Review of whether CMS’ COVID-19 data for nursing homes were complete and accurate following the requirement for nursing homes to report certain COVID-19 information effective May 8, 2020. The OIG found that 95% of nursing home data was complete and accurate, but for the 5% that was not, nursing home data either did not include all data points as required or were not complete or accurate after CMS had performed quality assurance checks. The OIG said CMS could take additional action to ensure complete and accurate COVID-19 data by providing technical assistance to nursing homes that fail quality assurance checks, make efforts to ensure CMS’ data elements and state data elements are comparable, and ensure the data reported to the states is not substantially different than what is reported to CMS. 

The OIG included six specific recommendations on how CMS can ensure more complete and accurate data. CMS said it would assess the costs and benefits of implementing three of those recommendations but did not concur with the other three recommendations.