Reports: Biden to Nominate Chiquita Brooks-LaSure as CMS Admin

According to reports, President Joe Biden will select Chiquita Brooks-LaSure to be the next administrator of the Centers for Medicare & Medicaid Services (CMS), the largest component of the Department of Health & Human Services (HHS), with ten offices around the country, more than 6000 employees, and over $1 trillion in annual expenditures. CMS has…

Please Respond to Fed Survey on Accuracy in Medicare Payments

The U.S. Bureau of Labor Statistics (BLS) conducts numerous surveys of hospitals and health care providers that are used by the government to make economic decisions that affect the entire medical care system. Key users include the Centers for Medicare & Medicaid Services (CMS), the Federal Reserve Bank, and the U.S. Congress. The Centers for…

MedPAC Tees Up Hospice Freeze and Aggregate Cap Cut for FY2022 Recommendations

Last week the Medicare Payment Advisory Commission (MedPAC) reviewed the latest available data on Medicare hospice utilization and discussed potential hospice payment recommendations for FY2022 with an eye toward their inclusion in the annual March Report to Congress.   Commission members expressed preliminary support for inclusion of the following recommendations: For fiscal year 2022, eliminate…

New Innovation Model Tests Flexibility in Home Health and Hospice Benefits

The Centers for Medicare & Medicaid Services (CMS) has announced a new payment and care delivery model being tested by the CMS Innovation Center.  The Geographic Direct Contracting Model (also known as the “Model” or “Geo”) will test whether a geographic-based approach to value-based care can improve quality of care and reduce costs for Medicare beneficiaries…

Study: Medicare Home Health Benefit Not Sufficient to Meet Needs of Post-Acute Beneficiaries

Policy changes could increase value of home health benefit in COVID-19 era Home health care would be very effective providing services to Medicare beneficiaries, but the current design of the home health benefit is insufficient to meet the needs of post-acute beneficiaries, concludes a new study from the Commonwealth Fund. The report’s authors believe policy…

Medicare Fee-for-Service Estimated Improper Payments Fall $15B since 2016

The Centers for Medicare & Medicaid Services (CMS) announced today that the Medicare Fee- For-Service (FFS) improper payment rate has continued to decline, the fourth year Medicare FFS improper payment rate has been below 10 percent, the threshold for compliance established in the Payment Integrity Information Act of 2019. The Medicare FFS estimated improper payment…

COVID -19 Therapeutic Receives Emergency Use Authorization

The Centers for Medicare & Medicaid Services announced that starting November 12, 2020, Medicare beneficiaries can receive coverage of monoclonal antibodies to treat coronavirus disease 2019 (COVID-19) with no cost-sharing during the public health emergency (PHE). CMS’ coverage of monoclonal antibody infusions applies to bamlanivimab, which received an emergency use authorization (EUA) from the U.S.…

Third Evaluation of Medicare Care Choices Model Finds High Satisfaction and Savings

Last month the Centers for Medicare & Medicaid Services (CMS) released its third annual report evaluating findings of the Medicare Care Choices Model (MCCM).  Broadly speaking, the evaluation indicates that the model holds great promise – beneficiaries enrolled in the model were 20 percent more likely to enroll in hospice and entered hospice one week…

New Target Area for Hospice PEPPER

The 2021 release of the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER), anticipated spring  2021, will include at least one new target area – Average Number of Part D Claims per Hospice Episode.  This target area will measure the count of Medicare Part D claims for beneficiaries billed during hospice episodes in the…

CMS Releases Interim Final Rule for COVID-19 Vaccine & Treatment, and CARES Act Provisions

Late in the day on Wednesday, October 29, the Centers for Medicare & Medicaid Services (CMS) released an Interim Final Rule with Comment Period (IFC) primarily addressing COVID-19 vaccine coverage. The provisions of the IFC are effective immediately on the date of posting in the Federal Register or as otherwise specified in the rule. The…