The week in Medicare updates
Cardiac rehabilitation programs for chronic heart failure
On August 29, CMS rescinded and replaced the transmittals related to coverage of chronic heart failure for cardiac rehabilitation to make various changes, including to clarify that the new coverage for chronic heart failure is for cardiac rehabilitation only.
Effective date: February 18, 2014
Implementation date: August 18, 2014
View Transmittal R539PI.
View Transmittal R3058CP.
View Transmittal R193BP.
View MLN Matters article MM8758.
Sample collection fee adjustment for clinical laboratory fee schedule and laboratory services
On August 29, CMS released a change request providing instructions for adjusting payment for a sample collected from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency. This change request applies to Section 1833(h)(3)(A) of the Act, as amended by Section 216 of the Protecting Access to Medicare Act (P.L. 113-93), and Chapter 16, Section 60.1 of the Internet Only Manual.
Effective date: April 1, 2014
Implementation date: December 1, 2014
View Transmittal R3056CP.
View MLN Matters article MM8837.
Annual Clotting Factor Furnishing Fee update 2015
On August 29, CMS released an annual Recurring Update Notification (RUN) change request announcing the update to the Clotting Factor Furnishing Fee. The information related to this RUN is found in Pub. 100-04, Medicare Claims Processing Manual, Chapter 17, section 80.4.1.
Effective date: January 1, 2015
Implementation date: January 5, 2015
View Transmittal R3055CP.
View MLN Matters article MM8891.
Ventricular Assist Devices for bridge-to-transplant and destination therapy
On August 29, CMS released a change request specifying criteria for facility requirements for Ventricular Assist Devices (VADs). The change request also deleted the artificial heart section of the inpatient hospital claims manual and replaced it with a new multi-part section in Chapter 32 “Billing Requirements for Special Services”.
Effective date: October 30, 2013
Implementation date: September 30, 2014
View Transmittal R3054CP.
View Transmittal R172NCD.
View MLN Matters article MM8803.
Modifications to EHR Incentive Program for 2014 and revisions to the certified EHR technology definition and EHR certification changes related to standards
This final rule, posted in the Federal Register on September 4, changes the meaningful use stage timeline and the definition of certified electronic health record technology (CEHRT) to allow options in the use of CEHRT for the EHR reporting period in 2014. It sets the requirements for reporting on meaningful use objectives and measures as well as clinical quality measure (CQM) reporting in 2014 for providers who use one of the CEHRT options finalized in this rule for their EHR reporting period in 2014. It finalizes revisions to EHR Incentive Programs to adopt an alternate measure for the Stage 2 meaningful use objective for hospitals to provide structured electronic laboratory results to ambulatory providers; to correct the regulation text for the measures associated with the objective for hospitals to provide patients the ability to view online, download, and transmit information about a hospital admission; and to set a case number threshold exemption for CQM reporting applicable for eligible hospitals and critical access hospitals (CAHs) beginning with FY 2013. Lastly, this rule finalizes the provisionally adopted replacement of the Data Element Catalog and the Quality Reporting Document Architecture Category III standards with updated versions. It is effective October 1, 2014.
View the notice in the Federal Register.