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  • Medicare Expired Legislative Provisions Extended and Other Bipartisan Budget Act of 2018 Provisions

    On February 9, 2018, President Trump signed into law the Bipartisan Budget Act of 2018. This new law includes several provisions related to Medicare payment. 

    With regard to payment for outpatient therapy services, the law repeals application of the Medicare outpatient therapy caps but retains the former cap amounts as a threshold above which claims must include the KX modifier as a confirmation that services are medically necessary as justified by appropriate documentation in the medical record; and retains the targeted medical review process, but at a lower threshold amount. It also extends several recently expired Medicare legislative provisions affecting health care providers and beneficiaries, including the Medicare physician fee schedule work geographic adjustment floor, add-on payments for ambulance services and home health rural services, changes to the payment adjustment for low volume hospitals, and the Medicare dependent hospital program. 

    In addition, with regard to Section 53111 – Medicare Payment Update for Skilled Nursing Facilities, the Centers for Medicare & Medicaid Services  has received questions from stakeholders about the impact of the FY 2019 Skilled Nursing Facility (SNF) update due to section 53111 of the BBA of 2018. To help answer these questions, we are providing information about the estimated market basket update for FY 2019 based on currently available data. This estimate may be updated in the Notice of Proposed Rulemaking for the FY 2019 SNF Prospective Payment System (PPS).

    Read the full summary.

  • New Option for Submission of Medicare Cost Reports

    As part of the Centers for Medicare & Medicaid Services (CMS) commitment to decrease the hours and dollars clinicians and providers spend on CMS-mandated compliance and increase the proportion of tasks that CMS customers can do digitally, a new web portal will be made available to submit a Medicare Cost Report (MCR).  Specifically, Part A providers will have the option to electronically transmit their MCR through the Medicare Cost Report e-Filing (MCReF) system.  MCReF will be available for cost reporting periods ending on or after December 31, 2017.

    New Option for Cost Report Submission [PDF, 17KB]  
  • April 2018 Average Sales Price Files Now Available 

    CMS posted the April 2018 Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks on the 2018 ASP Drug Pricing Files webpage. 

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  • Follow us on Twitter!  CMS has added the social media site Twitter to our communication and outreach program. Our main goal is to reach providers, suppliers, health professionals, and others interested in current and up-to-date information on the Medicare Fee-For-Service program. Messages on Twitter will include updates to rules & regulations, MLN products, notices of upcoming National Provider Calls, new web postings, and more.
    • #CMSMLN for all MLN tweets,
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    • #MLNProducts for all tweets related to MLN products.

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