Thursday, May 6, 2021
- New Program: HRSA COVID-19 Coverage Assistance Fund
- Ground Ambulance Services: Waiver for Treatment in Place
- Hospice Notices of Election: Option to Submit through Electronic Data Interchange
- COVID-19: Work of Hospital Allied & Supportive Care Providers
- IRF, LTCH, & SNF: Report Quality Data by May 17
- Asian American and Pacific Islander Heritage Month & National Mental Health Month
- Osteoporosis: Medicare Covers Bone Mass Measurements
- July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- New Waived Tests
On May 3, HHS, through the Health Resources and Services Administration (HRSA), announced the HRSA COVID-19 Coverage Assistance Fund (CAF). This program covers the cost of administering COVID-19 vaccines to patients enrolled in health plans that either don’t cover vaccination fees or cover them with patient cost-sharing.
“After securing enough COVID-19 vaccines for all adults, the Biden-Harris Administration is elevating work to boost access to them,” said HHS Secretary Becerra. “We listened to our health care providers on the frontlines of the pandemic. On top of increasing reimbursement rates tied to administering the shots, we are closing the final payment gap that resulted as vaccines were administered to underinsured individuals. No health care provider should hesitate to deliver these critical vaccines to patients over reimbursement cost concerns.”
Effective March 1, 2020, where the following criteria are satisfied, Medicare pays for ground ambulance services without a transport during the COVID-19 Public Health Emergency (PHE):
- The ground ambulance service was furnished in response to a 911 call (or the equivalent in areas without a 911 call system); and
- The patient would have been transported to a destination permitted under Medicare regulations, but the transport did not occur as a result of community-wide emergency medical service protocols due to the COVID-19 PHE; and
- The patient’s condition required the level of service provided and would normally require transport by ambulance, absent the community-wide EMS protocols (in other words, any other means of transportation would have been contraindicated).
- Waiver for Medicare Ground Ambulance Services Treatment in Place (PDF) fact sheet
- COVID-19 Emergency Declaration Blanket Waivers & Flexibilities for Health Care Providers (PDF)
- Frequently Asked Questions to Assist Medicare Providers (PDF)
CMS encourage hospices to take advantage of the option to submit notices of election through electronic data interchange. Advantages:
- Reduces keying errors
- Makes it easier to export data from electronic medical records or software systems
- Reduces manual effort if you’re serving Medicare Advantage Value-Based Insurance Design Model patients
See the announcement for more information.
The Office of the Assistant Secretary for Preparedness and Response (ASPR) Technical Resources, Assistance Center, and Information Exchange (TRACIE) released a new edition of the TRACIE Exchange. Stakeholders share stories about allied hospitals and supportive care workers during the COVID-19 pandemic. Topics include:
- COVID-19 and acute hospital care, home care, and hospice
- Engineering and environmental support
Inpatient Rehabilitation Facilities (IRFs), Long-Term Care Hospitals (LTCHs), and Skilled Nursing Facilities (SNF) must report fourth quarter 2020 quality reporting program data by May 17:
- IRF- Patient Assessment Instrument (PAI) and LTCH Continuity Assessment Record and Evaluation (CARE) assessment data
- IRF and LTCH data submitted to CMS via the CDC National Healthcare Safety Network (NHSN)
- IRF and LTCH annual NHSN Influenza Vaccination among Healthcare Personnel measure
- SNF Minimum Data Set (MDS) data
List of Measures:
- IRF Quality Reporting Data Submission Deadlines webpage
- LTCH Quality Reporting Data Submission Deadlines webpage
- SNF Quality Reporting Program Data Submission Deadlines webpage
CMS recommends that you run analysis reports prior to each quarterly reporting deadline to make sure you submitted all required data.
To change your email address, contact QRPHelp@swingtech.com and include your facility name and CMS certification number. We’ll notify you if you don’t meet annual payment update thresholds.
CMS is committed to making sure vulnerable populations can effectively get and use health care through policy and equity initiatives. During the month of May, we recognize Asian American and Pacific Islander Heritage Month. The Asians and Native Hawaiians or Other Pacific Islanders (Asian and NHOPI) population includes a wide variety of subgroups, each with their own unique health disparities.
May is also National Mental Health Month. Recent increases in anti-Asian discrimination and violence, compounded with other pandemic-related stressors, have affected the Asian and NHOPI communities, which are less likely to seek professional help for mental health issues.
- Health Observances webpage
- Medicare Stratified Reporting webpage
- Achieving Health Equity web-based training course
- CMS Office of Minority Health webpage
Medicare covers bone mass measurements, and your patients pay nothing if you accept assignment. During National Osteoporosis Month, talk to your Medicare patients about their risk factors and bone health.
- Medicare Preventive Services educational tool
- Preventive Services webpage
- CDC Osteoporosis webpage
- National Osteoporosis Foundation website
- Information for your patients on bone mass measurements
An Office of Inspector General report found that payments for chiropractic services didn’t comply with Medicare billing requirements. Medical record documentation didn’t support medical necessity or corrective treatment. Review the Medicare Documentation Job Aid for Doctors of Chiropractic (PDF) educational tool to help you bill correctly. Additional resources:
- Medicare Benefit Policy Manual, Chapter 15 (PDF), Sections 30.5 and 240
- Medicare Claims Processing Manual, Chapter 12 (PDF), Section 220
Thursday, May 13 from 12-1 pm ET
During this webinar, learn how to speak persuasively about the COVID-19 vaccine. Topics:
- Information and resources to help you address vaccine hesitancy in your community: Dr. LaShawn McIver, Director of the CMS Office of Minority Health
- Overview of vaccines and their safety: Dr. Peter Marks, Director of the FDA Center for Biologics Evaluation and Research
Following the presentation, attendees have the opportunity to ask questions and share ideas about vaccine confidence.
July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
CMS issued a new MLN Matters Article MM12244 on July 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files (PDF). Learn about new and revised pricing files.
CMS issued a new MLN Matters Article MM12204 on New Waived Tests (PDF). Learn about new laboratory waived tests approved by the FDA.
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