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  • CMS Encourages Companies to Promote Quality, Affordable Health Coverage for Gig Workers

    Centers for Medicare & Medicaid Services Encourages Companies to Promote Quality, Affordable Health Coverage for Gig Workers | site |


    (Information contained in Centers for Medicare & Medicaid Services press release dated: May 26, 2021) The Centers for Medicare & Medicaid Services (CMS) is encouraging online platform companies to share information with gig workers on their ability to enroll in affordable, quality, health coverage during the 2021 Marketplace Special Enrollment Period (SEP). Digital platforms – including Delivery Drivers, Inc., DoorDash, Lyft, Postmates, StyleSeat, Uber, and Wonolo – are participating in “Gig Workers’ Week of Action” to promote Marketplace healthcare plans to their workforces. Workers in the U.S., including those working with gig companies following COVID-19 related unemployment, may now be eligible for reduced premiums and increased savings for health insurance coverage on HealthCare.gov. Under the American Rescue...
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  • Centers for Medicare and Medicaid Services Data Shows Vulnerable Americans Forgoing Mental Health Care During COVID-19 Pandemic

    Centers for Medicare and Medicaid Services Data Shows Vulnerable Americans Forgoing Mental Health Care During COVID-19 Pandemic | site |



    (Information contained in Centers for Medicare and Medicaid Services press release dated: May 14, 2021)

    The Centers for Medicare & Medicaid Services (CMS) released data today highlighting the continued impact the COVID-19 Public Health Emergency (PHE) is having on Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries and utilization of health services. The data show that, from March through October 2020, beneficiaries have foregone millions of primary, preventive, and mental health care visits due to the COVID-19 PHE, compared to the same time period in 2019. Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound. This decline in utilization is occurring at a time when preliminary evidence shows menta...
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  • Centers for Medicare and Medicaid Services Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions

    Centers for Medicare and Medicaid Services Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions | site |


    New payment policy for at-home administration


    (Information contained in Centers for Medicare and Medicaid Services press release dated: May 6, 2021) As part of the ongoing response to address the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has increased the Medicare payment rate for administering monoclonal antibodies to treat beneficiaries with COVID-19, continuing coverage under the Medicare Part B COVID-19 vaccine benefit. Beneficiaries pay nothing out of pocket, regardless of where the service is furnished – including in a physician’s office, healthcare facility or at home. Effective today, the national average payment rate will increase from $310 to $450 for most health care settings. In support of providers’ efforts to prevent the spread of COVID-19, CMS will also establish...
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  • CMS Updates Nursing Home Guidance with Revised Visitation Recommendations

    CMS Updates Nursing Home Guidance with Revised Visitation Recommendations

    Centers for Medicare & Medicaid Services Updates Nursing Home Guidance with Revised Visitation Recommendations | site |



    (Information contained in Centers for Medicare and Medicaid Services press release dated: March 10, 2021) The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance today for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). This latest guidance comes as more than three million doses of vaccines have been administered within nursing homes, thanks in part to the CDC’s Pharmacy Partnership for Long-Term Care Program, following the U.S. Food and Drug Administration’s (FDA) authorization for emergency use of COVID-19 vaccines. According to the updated guidance, facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the reside...
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  • Centers For Medicare and Medicaid Services Offers Comprehensive Support to the State of Texas to Combat Winter Storm

    Centers For Medicare and Medicaid Services Offers Comprehensive Support to the State of Texas to Combat Winter Storm | site |



    (Information contained in Centers for Medicare and Medicaid Services [CMS] press release dated: February 22, 2021)

    The Centers for Medicare & Medicaid Services (CMS) announced today that efforts are underway to support Texas in response to severe winter storms that have affected the state over the past several days. On February 17, 2021, Health and Human Services Acting Secretary Norris Cochran declared a public health emergency (PHE) for Texas retroactive to February 11, 2021. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of the storm.

    Below are key administrative actions CMS is taking in response to the PHE declared in Texas:

    Waivers and Flexibilities for Hospitals and other Healthcare Facilities: CMS has
    ...
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  • CMS Announces New Model Opportunity for Medicaid Managed Care Organizations Serving Beneficiaries Dually Eligible for Medicare and Medicaid

    Centers for Medicare and Medicaid Services Announces New Model Opportunity for Medicaid Managed Care Organizations Serving Beneficiaries Dually Eligible for Medicare and Medicaid | site |



    (Information contained in Centers for Medicare and Medicaid Services press release: December 17, 2020)

    The Centers for Medicare & Medicaid Services’ (CMS) Center for Medicare & Medicaid Innovation is announcing a new opportunity to enable Medicaid Managed Care Organizations (MCOs) to better serve enrollees who are dually eligible for Medicare and Medicaid. This new Model opportunity is the first CMS initiative designed to harness the power of Medicaid MCOs to coordinate Medicare and Medicaid services and improve health outcomes for the population of dually eligible beneficiaries who are in both Medicaid managed care and Medicare fee-for-service (FFS). Currently, Medicaid MCOs do not have an incentive to coordinate care in a way that reduces Medicare FFS costs f...
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  • Trump Administration Finalizes Policies to Give Medicare Beneficiaries More Choices around Surgery

    Trump Administration Finalizes Policies to Give Medicare Beneficiaries More Choices around Surgery | site |


    (Information contained in Centers for Medicare and Medicaid Services press release: December 2, 2020) Today, the Centers for Medicare & Medicaid Services (CMS) is finalizing policy changes that will give Medicare patients and their doctors greater choices to get care at a lower cost in an outpatient setting. The Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rules will increase value for Medicare beneficiaries and reflect the agency’s efforts to transform the healthcare delivery system through competition and innovation. These changes implement the Trump Administration’s Executive Order on Protecting and Improving Medicare for Our Nation’s Seniors, and will take effect on January 1, 2021. “President Trump’s term in office has been marked by an unrelenting drive to level the playing field and boost competi...
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  • CMS Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge

    Centers for Medicare & Medicaid Services Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge | site |




    (Information contained in Centers for Medicare and Medicaid press release dated: November 25, 2020) Today, the Centers for Medicare & Medicaid Services (CMS) outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus disease 2019 (COVID-19) hospitalizations across the country. These flexibilities include allowances for safe hospital care for eligible patients in their homes and updated staffing flexibility designed to allow ambulatory surgical centers (ASCs) to provide greater inpatient care when needed. Building on CMS’s previous actions to expand the availability of telehealth across the nation, these actions are aimed at allowing health care services to be provided outside a h...
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  • CMS Announces Historic Changes to Physician Self-Referral Regulations

    CMS Announces Historic Changes to Physician Self-Referral Regulations

    Centers for Medicare & Medicaid Services Announces Historic Changes to Physician Self-Referral Regulations| site |



    (Information contained in Centers for Medicare & Medicaid Services press release: November 20, 2020) Today, the Centers for Medicare & Medicaid Services (CMS) finalized changes to outdated federal regulations that have burdened health care providers with added administrative costs and impeded the health care system’s move toward value-based reimbursement. The Physician Self-Referral Law, also known as the “Stark Law,” generally prohibits a physician from making referrals to an entity for certain healthcare services, if the physician has a financial relationship with the entity. The old federal regulations that interpret and implement this law were designed for a health care system that reimburses providers on a fee-for-service basis, where the financial incentives are to deliver more services. However, the 21st century American health care...
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  • CMS Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment

    Centers for Medicare and Medicaid Services Takes Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment | site |


    (November 10 - 13, 2020) - - In a release dated November 10, 2020 and updated November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) published the following information: The Centers for Medicare & Medicaid Services announced that starting today, 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. Food and Drug Administration yesterday. “Today, CMS is announcing a historic, first-of-its kind policy that drastically expands access to COVID-19 monoclonal antibodies to beneficiaries without cost sharing,” said CMS Administrator Seema Verma. “Our tim...
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  • Centers for Medicare and Medicaid Services Releases Toolkit to Accelerate State Efforts to Rebalance Long-term Care Systems

    Centers for Medicare & Medicaid Services Releases Toolkit to Accelerate State Efforts to Rebalance Long-term Care Systems and Enhance Home and Community-Based Services for Eligible Medicaid Beneficiaries | site |



    (November 2, 2020) - - Today, November 2, 2020, the Centers for Medicare and Medicaid Services published the following information: The Trump Administration and Centers for Medicare & Medicaid Services (CMS) are delivering on their commitment to foster innovation in Medicaid by providing states with new tools to help beneficiaries return home from institutional settings without sacrificing safety or quality of care. Today, CMS launched a new toolkit designed for state Medicaid agencies to strengthen their infrastructure and develop robust home and community-based services (HCBS) for eligible beneficiaries. This toolkit is the latest in a series of CMS efforts to promote high quality, person-centered HCBS to safely transition older adults and individ...
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  • CMS’ New One-Stop Nursing Home Resource Center Assists Providers, Caregivers, Residents

    Centers for Medicare & Medicaid Services New One-Stop Nursing Home Resource Center Assists Providers, Caregivers, Residents | site |


    (October 30, 2020) - - The Centers for Medicare & Medicaid Services published today, October 30, 2020, the following information: Today, the Centers for Medicare & Medicaid Services (CMS) launched a new online platform - the Nursing Home Resource Center - to serve as a centralized hub bringing together the latest information, guidance and data on nursing homes that is important to facilities, frontline providers, residents and their families, especially as the fight against coronavirus disease 2019 (COVID-19) continues. Previously, individuals seeking information specific to nursing homes needed to navigate to several disparate webpages and spent valuable time looking for answers. With the onset of the COVID-19 Public Health Emergency (PHE), quick access to up-to-date information and resources, including the 24 guidance documents r...
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  • Provider Groups urge Congress to Extend the Medicare Sequester Cuts

    Provider Groups urge Congress to Extend the Medicare Sequester Cuts

    Provider Groups urge Congress to Extend the Medicare Sequester Cuts | site |




    (October 21, 2020) - - Today, October 21, 2020, the American Hospital Association (AHA) published the following information:




    Provider groups urge Congress to extend the Medicare sequester cuts



    Washington, D.C., October 21, 2020

    Joint AHA, AMA, AHCA and NAHC Statement on Medicare Sequester Cuts


    The American Hospital Association, the American Medical Association, the American Health Care Association and the National Association for Home Care and Hospice wrote congressional leaders today urging them to extend the congressionally enacted moratorium on the application of the Medicare sequester cuts into 2021 and through the duration of the public health emergency. Together, these organizations provide health care to more than 62 million Medicare patients, and the persistently high COVID-19 rates across
    ...
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  • CMS Approves Nebraska Medicaid Demonstration to Provide Pathway to Enhanced Benefits for Eligible Adults

    Centers for Medicare and Medicaid Services approves Nebraska Medicaid Demonstration to Provide Pathway to Enhanced Benefits for Eligible Adults | site |



    (October 20, 2020) - - The Centers for Medicare and Medicaid Services published today, October 20, 2020, the following information:

    Today, the Centers for Medicare & Medicaid Services (CMS) announced its approval of Nebraska’s new Medicaid Section 1115 demonstration called “Heritage Health Adult.” This demonstration is designed to create a pathway for certain Nebraska adults with newly gained Medicaid coverage to access additional benefits if they participate in certain activities to promote health and independence. This demonstration is effective October 20, 2020, through March 31, 2026, with implementation beginning April 1, 2021.


    “Governor Ricketts and his team deserve credit for responding to President Trump’s invitation to design innovative state-led solutions that promote
    ...
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  • Trump Administration Announces Historically Low Premiums and New Insulin Benefit as Medicare Open Enrollment Begins

    Trump Administration Announces Historically Low Premiums and New Insulin Benefit as Medicare Open Enrollment Begins | site |



    Medicare Parts A & B


    (October 15, 2020) - - Today, October 15, 2020, the Centers for Medicare & Medicaid Services published the following information: Today, the Centers for Medicare & Medicaid Services (CMS) announced that 2021 Medicare Open Enrollment is officially open and will run through December 7, 2020. More than 60 million people with Medicare can review health and drug plans, and make changes to their healthcare coverage for next year, based on their financial and medical needs, from the comfort of their homes. With Medicare Advantage (or private Medicare health plans) and Part D prescription drug plan premiums at historic lows – and hundreds of healthcare plans now offering $35 monthly co-pays for insulin – there are plenty of reasons to compare coverage options. As part of this year’s open enro...
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  • Staff Reporter 1
    CMS Encourages Companies to Promote Quality, Affordable Health Coverage for Gig Workers
    by Staff Reporter 1
    Centers for Medicare & Medicaid Services Encourages Companies to Promote Quality, Affordable Health Coverage for Gig Workers | site |


    (Information contained in Centers for Medicare & Medicaid Services press release dated: May 26, 2021) The Centers for Medicare & Medicaid Services (CMS) is encouraging online platform companies to share information with gig workers on their ability to enroll in affordable, quality, health coverage during the 2021 Marketplace Special Enrollment Period (SEP). Digital platforms – including Delivery Drivers, Inc., DoorDash, Lyft, Postmates, StyleSeat, Uber, and Wonolo – are participating in “Gig Workers’ Week of Action” to promote Marketplace healthcare plans to their workforces. Workers in the U.S., including those working with gig companies following COVID-19 related unemployment, may now be eligible for reduced premiums and increased savings for health insurance coverage on HealthCare.gov. Under the American Rescue...
    05-27-2021, 04:21 PM
  • Staff Reporter 1
    Centers for Medicare and Medicaid Services Data Shows Vulnerable Americans Forgoing Mental Health Care During COVID-19 Pandemic
    by Staff Reporter 1
    Centers for Medicare and Medicaid Services Data Shows Vulnerable Americans Forgoing Mental Health Care During COVID-19 Pandemic | site |



    (Information contained in Centers for Medicare and Medicaid Services press release dated: May 14, 2021)

    The Centers for Medicare & Medicaid Services (CMS) released data today highlighting the continued impact the COVID-19 Public Health Emergency (PHE) is having on Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries and utilization of health services. The data show that, from March through October 2020, beneficiaries have foregone millions of primary, preventive, and mental health care visits due to the COVID-19 PHE, compared to the same time period in 2019. Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound. This decline in utilization is occurring at a time when preliminary evidence shows menta...
    05-15-2021, 11:25 PM
  • Staff Reporter 1
    Centers for Medicare and Medicaid Services Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions
    by Staff Reporter 1
    Centers for Medicare and Medicaid Services Increases Medicare Payment for COVID-19 Monoclonal Antibody Infusions | site |


    New payment policy for at-home administration


    (Information contained in Centers for Medicare and Medicaid Services press release dated: May 6, 2021) As part of the ongoing response to address the COVID-19 pandemic, the Centers for Medicare & Medicaid Services (CMS) has increased the Medicare payment rate for administering monoclonal antibodies to treat beneficiaries with COVID-19, continuing coverage under the Medicare Part B COVID-19 vaccine benefit. Beneficiaries pay nothing out of pocket, regardless of where the service is furnished – including in a physician’s office, healthcare facility or at home. Effective today, the national average payment rate will increase from $310 to $450 for most health care settings. In support of providers’ efforts to prevent the spread of COVID-19, CMS will also establish...
    05-07-2021, 02:28 AM
  • Staff Reporter 1
    CMS Updates Nursing Home Guidance with Revised Visitation Recommendations
    by Staff Reporter 1
    Centers for Medicare & Medicaid Services Updates Nursing Home Guidance with Revised Visitation Recommendations | site |



    (Information contained in Centers for Medicare and Medicaid Services press release dated: March 10, 2021) The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), issued updated guidance today for nursing homes to safely expand visitation options during the COVID-19 pandemic public health emergency (PHE). This latest guidance comes as more than three million doses of vaccines have been administered within nursing homes, thanks in part to the CDC’s Pharmacy Partnership for Long-Term Care Program, following the U.S. Food and Drug Administration’s (FDA) authorization for emergency use of COVID-19 vaccines. According to the updated guidance, facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the reside...
    03-14-2021, 05:04 AM
  • Staff Reporter 1
    Centers For Medicare and Medicaid Services Offers Comprehensive Support to the State of Texas to Combat Winter Storm
    by Staff Reporter 1
    Centers For Medicare and Medicaid Services Offers Comprehensive Support to the State of Texas to Combat Winter Storm | site |



    (Information contained in Centers for Medicare and Medicaid Services [CMS] press release dated: February 22, 2021)

    The Centers for Medicare & Medicaid Services (CMS) announced today that efforts are underway to support Texas in response to severe winter storms that have affected the state over the past several days. On February 17, 2021, Health and Human Services Acting Secretary Norris Cochran declared a public health emergency (PHE) for Texas retroactive to February 11, 2021. CMS is working to ensure hospitals and other facilities can continue operations and provide access to care despite the effects of the storm.

    Below are key administrative actions CMS is taking in response to the PHE declared in Texas:

    Waivers and Flexibilities for Hospitals and other Healthcare Facilities: CMS has
    ...
    02-25-2021, 09:14 AM

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