This week in Medicare updates—5/23/18
Implementation of Bipartisan Budget Act of 2018 Extensions of Low Volume Hospital, Medicare Dependent Hospital and LTCH Special Payments
On May 10, CMS published Medicare Claims Processing Transmittal 4046, providing information and implementation instructions for multiple sections of the ACCESS Act of 2018 related to hospital payment programs and updates for low volume hospitals, Medicare Dependent Hospitals, and Long Term Care Hospitals (LTCH).
On May 14, CMS published MLN Matters 10547 to accompany the transmittal.
Effective date: October 1, 2017
Implementation date: April 2, 2018
CMS Unveils Enhanced “Drug Dashboards” to Increase Transparency on Drug Prices
On May 15, CMS published a Press Release regarding the redesigned version of the Drug Spending Dashboards, which now contain information on changes in drug spending per drug over time. The press release also contains tables of drugs with this highest total spending in each program and drugs with annual increases of at least 5% in spending per dose under Part B and 10% spending per dose under Part D or Medicaid. CMS also announced that it updated the Part D Prescriber Public Use File with data for 2016 as part of its effort to increase transparency on drug prices.
CMS also published a Fact Sheet on the same date to explain the redesigned versions of the Drug Spending Dashboards in more detail.
Updated OIG Work Plan
On May 15, the OIG updated its Work Plan with the following new items:
- Noninvasive Home Ventilators - Compliance With Medicare Requirements
- Medicare Part B Outpatient Cardiac and Pulmonary Rehabilitation Services
National Coverage Analysis (NCA) Tracking Sheet for Chimeric Antigen Receptor (CAR) T-cell Therapy for Cancers
On May 16, CMS published a Tracking Sheet to initiate an NCA for CAR T-cell Therapy for cancers. The creation of the tracking sheet initiates a 30-day public comment period, which will end on June 15, 2018. CMS is especially interested in comments relating to clinical studies and other scientific information related to CAR T-cell Therapy.
Standardization of Case File Transmittal and Provider Information Processes, Bankruptcy, Payment Hold, and Cancellation Reporting Between the MAC and RAC
On May 18, CMS published One-Time Notification Transmittal 2089 to provide instructions for standardization in the case file request/transfer/naming convention processes, the RAC reporting processes, and the appeals process. These changes come after a MAC and RAC consistency workgroup collaborated to standardize the case file request/transfer/naming convention process.
Effective date: Effective date is the receipt date of the appeal; MCS, VMS, and MAS changes effective with implementation date; October 1, 2018
Implementation date: October 1, 2018
Provider Cost Reporting Forms and Instructions, Chapter 46, Form CMS-222-17
On May 18, CMS published Provider Reimbursement Manual Transmittal 1 to introduce the Chapter 46, Rural Health Clinic (RHC) Cost Report, Form CMS-222-17. The new instructions and forms included in the release must be filed by freestanding RHCs and RHCs previously reporting as part of a Skilled Nursing Facility complex or Home Health Agency complex. RHCs in a hospital healthcare complex would use Form CMS-2552-10 instead.
Effective date: Cost reporting periods ending on or after September 30, 2018
Quarterly Update to the Medicare Physician Fee Schedule Database - July 2018 Update
On May 18, CMS published Medicare Claims Processing Transmittal 4053 regarding amendments to the payment files issued to contractors based on the 2018 Medicare Physician Fee Schedule Final Rule. These files pertain to the July quarterly update to the database.
Effective date: January 1, 2018
Implementation date: July 2, 2018
Provider Cost Reporting Forms and Instructions, Chapter 45, Form CMS 2088-17
On May 18, CMS published Provider Reimbursement Manual Transmittal 1 to introduce the Chapter 45, Community Mental Health Center (CMHC) Cost Report Form CMS-2088-17. The transmittal also revises Form CMS-2088-92 and contains a number of revisions to ancillary worksheets.
Effective date: Cost Reporting Periods Ending On or After September 30, 2018.
Complying with Medicare Signature Requirements
On May 18, CMS published an MLN Fact Sheet regarding compliance with Medicare signature requirements. The fact sheet contains a list of FAQs regarding signatures for medical records documentation and contains a table with additional resources which providers can refer to when seeking to understand the requirements for signatures.