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Policy Snapshot
November 19, 2020

Last week, in advance of the approaching holiday season, the Centers for Medicare & Medicaid Services (CMS) urged nursing home staff, residents, and visitors to follow established guidelines for visitation and adherence to the core principles of infection prevention. These guidelines include remaining six feet apart from individuals, wearing a face covering, and limiting the number of visitors in the nursing home at any one time. Adherence to these principles is critical in preventing the spread of COVID-19 in America’s nursing homes. While the holiday season is typically a time for...

Policy Snapshot
November 19, 2020

The Centers for Medicare & Medicaid Services (CMS) thanks nursing homes whose staff members have completed the agency’s free training but urges remaining homes to take advantage of this resource.

Last week, CMS publicly recognized the 1,092 nursing homes at which 50% or more of their staff have completed the training designed to help staff combat the spread of COVID-19 in nursing homes. CMS applauds these facilities for taking this critical step to equip their staff with the latest information regarding infection control, vaccine distribution, and other topics.

Read the...

Policy Snapshot
November 19, 2020

In early September, the Centers for Medicare & Medicaid Services (CMS) released Care Compare on Medicare.gov, which streamlines its eight original health care compare tools. These original compare tools will retire on December 1, ending this transition period.

Care Compare's new design makes it easier to find the same information that’s on the original compare tools. It gives...

Policy Snapshot
November 19, 2020

On November 16, 2020, the Centers for Medicare and Medicaid Services (CMS) announced an estimated $15 billion decline in improper Medicare fee-for-service (FFS) payments since 2016. The Medicare FFS estimated improper payment rate decreased to 6.27% in FY 2020, from 7.25% in FY 2019. CMS determined this decline was largely due to changes implemented in home health documentation requirements and changes to skilled nursing...

Policy Snapshot
November 19, 2020

In response to the hardships experienced by clinicians due to the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) is allowing Merit-based Incentive Payment System (MIPS) eligible clinicians to apply for an exemption for one or more of the MIPS performance categories for Performance Year 2020. This will impact their 2022 MIPS payment adjustments.

With the Extreme and Uncontrollable Circumstances policy, CMS will reweight one or more MIPS performance categories to 0% for approved applicants. Eligible clinicians can submit applications citing COVID-19 as the...

Policy Snapshot
November 12, 2020

The Centers for Medicare & Medicaid Services (CMS) announced that as of November 10, 2020, Medicare beneficiaries are receiving coverage of monoclonal antibodies to treat 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 FDA on November 9.

CMS anticipates that this monoclonal antibody product will initially be given to health care providers at no charge. Medicare will not pay for the monoclonal antibody products that...

Policy Snapshot
November 12, 2020

An Office of Inspector General (OIG) report found that Medicare improperly paid for Skilled Nursing Facility (SNF) services when patients didn’t meet the Medicare 3-Day inpatient hospital stay requirement. Review the Skilled Nursing Facility 3-Day Rule Billing fact sheet to help you bill correctly. Additional resources:

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Policy Snapshot
November 12, 2020

The Centers for Medicare & Medicaid Services (CMS) issued a new MLN Matters Article MM11992 on Updates to Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) Claims. Learn about a claims processing instruction update....

Policy Snapshot
November 6, 2020

The October refresh of Skilled Nursing Facility (SNF) Quality Reporting data is available. Visit the Nursing Home Compare website, Care Compare website, and Provider Data Catalog to view the data.

For more information:

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Policy Snapshot
November 6, 2020

Flu shots are free for your Medicare patients if you accept assignment. Medicare Part B covers one flu shot per flu season and additional flu shots if medically necessary.

Every patient visit is an opportunity to promote the flu shot. The Centers for Disease Control and Prevention (CDC) recommends annual flu shots for everyone 6 months and older. 

For more information: