CMS Launches Accelerated/Advance Payments for Medicare Providers due to COVID-19

The Centers for Medicare & Medicaid Services (CMS) has expanded the current Accelerated and Advance Payment Program for the duration of the COVID-19 public health emergency with the goal of extending financial hardship relief to a broader group of Part A providers and Part B suppliers. Most providers and suppliers will be able to request…

CMS Issues Proposals for Medicare Advantage Plans

The Centers for Medicare & Medicaid Services (CMS) has released a proposed rule titled: Medicare and Medicaid Programs; Contract Year 2021 and 2022 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicaid Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly. Also released, is Part…

President’s Budget Reinforces Goal of Unified Post-Acute Payment System, Takes Aim at Hospice in Nursing Homes

On Monday, February 10, 2020, a general outline of the President’s fiscal year (FY) 2021 budget was submitted to Congress. The FY2021 budget proposes to reduce spending on programs administered by the Centers for Medicare & Medicaid Services (CMS) by $1.6 trillion over the next 10 years, including $500 billion from Medicare and $920 billion…

CMS Updates Enrollment Decision Appeals Procedure

The Centers for Medicare & Medicaid Services (CMS) updated Chapter 15 – Medicare Enrollment –  of the Medicare Program Integrity Manual via Change Request (CR) 11210/Transmittal 936 Provider Enrollment Appeals Procedure. This CR deals with provider enrollment appeals and  provides instructions to the Medicare Administrative Contractor (MAC) on handling  reconsideration requests and Corrective Action Plans…

House Committee Debates Measure to Simplify Medicare Enrollment

The Health Subcommittee of the Energy and Commerce Committee in the House of Representatives debated a bill earlier this month to assist new Medicare beneficiaries in signing up for Medicare Part B. During the hearing “Legislation to Improve Americans’ Health Care Coverage and Outcomes,” witnesses and members of Congress considered H.R. 2477, the Beneficiary Enrollment…

Legislation to Extend Key Home Care Programs Proposed in Senate

Bipartisan leadership of the Senate Finance Committee has announced proposed legislation providing for the extension of several programs within Medicare and Medicaid. Commonly referred to as an “extenders package” the legislation provides for the continuation of programs that are currently on track to exhaust their current funding allocation. Notable to home care and hospice providers…

Improper Payment Rates for Home Health and Hospice Providers Decreased in 2019

The improper payment rate for home health providers in 2019 dropped 5.5 percent to 12.1 percent, from last years’ rate of 17.6 percent. Non-hospital based hospices had an overall improper payment rate of 8.9 percent, a 2.1 percent drop from 11 percent in 2018 and hospital based hospices had an 18.9 percent improper payment rate,…

CMS Releases Long-awaited Details on MA/Hospice Carve-in

Demonstration Planned for CY2021 Late December 19, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a Request for Applications (RFA) for the Value-Based Insurance Design (VBID) Model Incorporation of the Medicare Hospice Benefit into Medicare Advantage (MA), through which it is seeking participation by MA plans.  Eligible MA plans in all states and…

NAHC Tells Congress to Reject Deep Cuts to Health Care Spending

The National Association for Home Care & Hospice (NAHC) has joined a group of like-minded health care organizations in urging the United States Senate to reject the Bipartisan Congressional Budget Reform Act, legislation that could result in deep spending cuts to health care programs that are vital to the well-being of hundreds of millions of…

MedPAC Staff Recommend 7 Percent Cut in Medicare Payment to Home Health Providers

On December 5, the Medicare Payment Advisory Commission (MedPAC) convened for a session titled Assessing Payment Adequacy and Updating Payments: Home Health Care. This is an annual process where the commission receives a presentation evaluating payment adequacy for services rendered, as well as a report on patient access to home health services, and quality of…