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Policy Snapshot
March 12, 2020

On March 9, the Department of Health and Human Services (HHS) finalized two rules that will give patients safer, more secure access to their health data. The two rules, issued by the HHS Office of the National Coordinator for Health Information Technology (ONC) and the Centers for Medicare & Medicaid Services (CMS), implement interoperability and patient access provisions of the bipartisan 21st Century Cures Act and support the MyHealthEData initiative. These final rules require both public and private entities to share health information between patients and other parties, while...

Policy Snapshot
March 5, 2020

Congress has passed a coronavirus emergency spending bill that includes provisions waiving certain Medicare telehealth restrictions during the public health emergency. The waivers let qualified Medicare providers offer telehealth services during a coronavirus national emergency to beneficiaries they have seen within the past three years. The services could be offered in geographic areas where such an emergency has been declared.

The bill waives originating site requirements so that beneficiaries can receive the care they need at home. It also waives restrictions on using telephones...

Policy Snapshot
February 27, 2020

The data submission period is open for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2019 performance period of the Quality Payment Program. Submit and update your data until 8 PM ET on March 31. Please note that the data submission period for accountable care organizations and pre-registered groups and virtual groups also closes on March 31.

For more information:

Policy Snapshot
February 27, 2020

Please note that Skilled Nursing Facility (SNF) Patient Driven Payment Model (PDPM) initial claims that are processed out of sequence are not paying the correct Variable Per Diem (VPD)-adjusted rate. Also, all adjustment claims are not processing correctly. Claims need to process in date of service order for each stay for the VPD to calculate correctly. The issue will be corrected in October. In the interim:

  • Submit claims in sequence by waiting at least two weeks before billing subsequent claims
  • To adjust claims, cancel the initial claim and all subsequent claims
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Policy Snapshot
February 27, 2020

The National Partnership to Improve Dementia Care in Nursing Homes (NPIDCNH) will hold a call on Tuesday, March 3 from 1:30 to 3 PM ET. During this call, learn about new Centers for Medicare & Medicaid Services (CMS) toolkits for nursing homes:

  • Head-to-toe infection prevention: Easy to access best practices for direct care staff to prevent infections before they occur
  • Developing a
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Policy Snapshot
February 27, 2020

Due to ongoing interest, the Centers for Medicare & Medicaid Services (CMS) is hosting a second webinar on Tuesday, March 3, from 2:00 to 3:00 PM ET to provide an overview of the MIPS Value Pathways (also referred to as MVPs) participation framework, which was outlined in the...

Policy Snapshot
February 20, 2020

The Centers for Medicare & Medicaid Services (CMS) has posted the following Quality Payment Program (QPP) resources to the QPP Resource Library to help clinicians understand how to participate in QPP in the 2020 performance period:

  • 2020 Merit-based Incentive Payment System (MIPS)
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Policy Snapshot
February 20, 2020

In a recent report, the Office of Inspector General (OIG) determined that the Centers for Medicare & Medicaid Services (CMS) improperly paid practitioners for some telehealth claims associated with services that did not meet Medicare requirements. CMS released the Medicare Telehealth Services video to help you bill correctly. Here are some additional resources:

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Policy Snapshot
February 13, 2020

Last week the president released his 2021 fiscal year budget. The proposal would cut almost a trillion dollars from Medicaid over 10 years, give the Centers for Medicare & Medicaid Services (CMS) more power to collect improper payments, impose a mandatory work requirement in Medicaid, and reform graduate medical education payments. The proposal also addresses payments for post-acute care providers by establishing a unified payment system based on patients’ clinical needs rather than site of service....