CMS to Hold Interoperability and Patient Access Proposed Rule Listening Session

The Centers for Medicare & Medicaid Services (CMS) and Administrator Seema Verma will hold a listening session on Tuesday, March 5, 2019 from 2:00 PM to 3:30 PM ET to discuss the recently-released Interoperability and Patient Access proposed rule. The target audience for this listening session includes all Medicare fee-for-service providers and industry-wide stakeholders. GO…

CMS Development of “Serious Illness” Care Model Continues to Advance

Medicare coverage addresses a wide variety of preventive, acute and rehabilitative health care needs and also offers a comprehensive means for serving patients with terminal illness through the hospice benefit.  However, gaps remain relative to effectively treating beneficiaries with serious chronic or advanced illness.  Many believe that the key to successfully treating these beneficiaries is…

CMS Chief: Prior Authorization Needed to Fight “Fraud and Abuse”

CMS Administrator Seema Verma complained that the federal government needs more legal authority to conduct Medicare prior authorization reviews she says work well in the private sector during a speech to the America’s Health Insurance Plans 2018 National Conference on Medicare on Tuesday, October 16. Interestingly, according to a report from Inside Health Policy, Barbara…

CMS Testifies to Congress on Fraud, Overpayment Fights

On Tuesday, August 21st, the Senate Homeland Security and Government Affairs Committee held a hearing titled, Examining CMS’s Efforts to Fight Medicaid Fraud and Overpayments. Testifying before the committee was Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma and Comptroller General of the United States, the Honorable Eugene Dodaro. In his opening remarks,…

Heightened CMS Medicaid Oversight Could Lead to Audits, Red Tape

The Centers for Medicare & Medicaid Services (CMS) announced Tuesday, June 26, that it is moving forward with an initiative “to strengthen Medicaid program integrity,” with plans for stricter enforcement of federal rule compliance, tighter regulation of contracts between sates and private insurance, greater oversight of beneficiary eligibility, and a beefed-up audit system. Medicaid spending…

CMS Tells Providers to Use New Medicare Cards Immediately

As loyal NAHC Report readers know well by now, the Centers for Medicare & Medicaid Services (CMS) began issuing a new Medicare Card in April, without Social Security Numbers. The cards, which were mandated by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, will be mailed out to every Medicare beneficiary in the United…

Adam Boehler is the New Head of the CMMI

Secretary of Health and Human Services Alex Azar has named Adam Boehler as the new director of the Center for Medicare and Medicaid Innovation (CMMI), as well as a deputy administrator at the Center for Medicare and Medicaid Services (CMS). Boehler, the former CEO of Landmark Health, has been rumored to be the Trump administration’s…

Home Care Aid/Personal Care Services Allowed for Medicare Advantage Plans

Medicare Advantage plans may allow home care aid/personal care services as a supplemental benefit beginning in 2019, according to a final rule issued Monday by the Centers for Medicare & Medicaid Services (CMS). The rule is the first time CMS has permitted supplemental benefits that include daily maintenance in Medicare Advantage plans. According to the…

Members of Congress Ask CMS to Test New Models of Care

The authors of the Patient Choice and Quality Care Act (H.R. 2797/S. 1334) have written a letter to Seema Verma, the Administrator of the Centers for Medicare and Medicaid Services (CMS), asking her to test some of the new models of care for patients with advanced illnesses that are outlined in their legislation. As you…

CMS Says New Medicare Pay Rules Will Expand Telehealth

Soon-to-be-released Medicare payment rules will make it easier for providers to use telehealth services, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma told the National Rural Health Association policy conference in Washington, D.C. on Tuesday, February 6. “This year you are going to see a lot more from us in our payment rules,…