Publications

Members only publications are marked with a lock icon:
Filter By
Policy Snapshot
May 8, 2020

As the COVID-19 pandemic has forced health care providers to limit in-person visits, telehealth has expanded rapidly. In response to the need to obtain informed consent from patients for virtual visits, the Agency for Healthcare Research and Quality (AHRQ) has created a ...

Policy Snapshot
May 8, 2020

Section 3708 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116-136) amended sections 1814(a) and 1835(a) of the Social Security Act to allow nurse practitioners (NPs), certified clinical nurse specialists (CNSs), and physician assistants (PAs) to certify beneficiaries for eligibility under the Medicare home health benefit and oversee their plan of care. This is a permanent change.

Effective for claims with dates of service on or after March 1, 2020, these non-physician practitioners may bill the following codes:

  • G0179: Physician
  • ...
Policy Snapshot
May 8, 2020

During the COVID-19 Public Health Emergency, CMS is relaxing billing requirements for laboratory tests (PDF) required for a COVID-19 diagnosis. Any health care professional authorized under state law may order tests. Medicare will pay for tests without a written order from the treating physician or other practitioner:

  • If an order is not written, an ordering or referring National Provider Identifier (NPI) is not required on the claim
  • If an order is written, include the NPI of
  • ...
Policy Snapshot
May 1, 2020

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a second round of emergency declaration waivers including:

Further Expansion of Telehealth in Medicare:

  • CMS previously announced that Medicare would pay for certain services conducted by audio-only telephone between beneficiaries and their doctors and other clinicians. Now, CMS is broadening that list to include many behavioral health and patient education services. CMS is also increasing payments for these telephone visits to match payments for similar office and outpatient visits. This
  • ...
Policy Snapshot
May 1, 2020

Last week, the Society—through its membership in the Leadership Council of Aging Organizations (LCAO)—sent letters of support for the Advancing Connectivity during the Coronavirus to Ensure Support for Seniors Act (ACCESS Act, H.R. 6487 and S. 3517).

The ACCESS Act would provide grants to nursing homes to obtain and use technologies and services necessary to support virtual visits during the current public health emergency. The grants would help enable more residents and their loved ones to stay connected, including being able to see each other via video. “Such communication would...

Policy Snapshot
May 1, 2020

The Centers for Medicare & Medicaid Services (CMS) issued a letter thanking clinicians for their ongoing efforts to treat patients and combat COVID-19 and shared additional details on the new Merit-Based Incentive Payment System (MIPS) improvement activity. As announced last month, clinicians who participate in a COVID-19 clinical trial and report their findings to a clinical data repository or registry many now earn credit in MIPS under the Improvement Activities performance category for the 2020 performance period by attesting to this new activity....

Policy Snapshot
May 1, 2020

In a recent memo to state survey agencies, the Centers for Medicare & Medicaid Services (CMS) announced that the inspection domain of the Nursing Home Compare website will be held constant temporarily due to the prioritization and suspension of certain surveys, to ensure the rating system reflects fair information for consumers. In addition, CMS is releasing information that shows the average number of staff each nursing home has on-site, each day (nursing staff and total staff), and aggregated by state and nationally. Along with these announcements CMS released a list of Frequently...

Policy Snapshot
May 1, 2020

Last week, the Centers for Medicare & Medicaid Services (CMS) announced a new independent commission that will conduct a comprehensive assessment of the nursing home response to the COVID-19 pandemic. The commission will provide independent recommendations to the contractor to review and report to CMS to help inform immediate and future responses to COVID-19 in nursing homes.

“Safeguarding the health and, promoting the well-being and quality of life, of the most vulnerable and fragile citizens is a top priority for CMS,” said CMS Administrator Seema Verma.  “CMS has...

Policy Snapshot
April 23, 2020

One Week Left to Submit Data for the 2019 MIPS Performance Period

The data submission deadline for Merit-based Incentive Payment System (MIPS)-eligible clinicians participating in the 2019 performance period of the Quality Payment Program (QPP) is less than 1 week away. Data can be submitted and updated any time until 8:00 PM ET on April 30, 2020.

QPP Flexibilities: 2019 Novel Coronavirus (COVID-19) Response

For the MIPS 2019 performance period, the Centers for Medicare & Medicaid Services (CMS)...

Policy Snapshot
April 23, 2020

The Centers for Medicare & Medicaid Services (CMS) is encouraging clinicians who participate in the Quality Payment Program (QPP), such as physicians, physician assistants, nurse practitioners, and others, to contribute to scientific research and evidence to fight the COVID-19 pandemic. Clinicians may now earn credit in the Merit-based Incentive Payment System (MIPS), a performance-based track of QPP that incentivizes quality and value, for participation in a clinical trial and reporting clinical information by attesting to the new COVID-19 Clinical Trials improvement activity. This...