Thursday, August 5, 2021
- Clinical Diagnostic Laboratories: Private Payor Rate-Based CLFS Resources
- Coverage to Care & Connected Care
View this edition as PDF (PDF)
News
Clinical Diagnostic Laboratories: Private Payor Rate-Based CLFS Resources
Are you an independent laboratory, physician office laboratory, or hospital outreach laboratory that meets the definition of an applicable laboratory under the Clinical Laboratory Fee Schedule (CLFS)? If so, you must report information, including laboratory test HCPCS codes, associated private payor rates, and volume data. CMS recently updated our resources:
- Summary (PDF): Key terms & concepts, whether your laboratory is an applicable laboratory, and timeline
- FAQs (PDF)
Timeline:
- Collect data: January 1-June 30, 2019
- Analyze data: July 1-December 31, 2019
- Report data: January 1-March 31, 2022
For more information, visit the PAMA Regulations webpage.
Coverage to Care & Connected Care
Help your patients understand their health coverage, and use it to get back on track with regular, primary care appointments. Find tools and resources for you and your patients:
- Coverage to Care helps patients understand their health coverage and connect to primary care and preventive services that are right for them
- Connected Care focuses on patients who are eligible for chronic care management services
Compliance
Hospices: Create an Effective Plan of Care
An Office of Inspector General report found that most hospices have at least 1 deficiency in their quality of care. Review the Creating an Effective Hospice Plan of Care (PDF) fact sheet to learn about principles of care planning, care coordination, and common deficiencies.
More Information:
- Hospice Conditions of Participation final rule
- Medicare Fee-for-Service Response to the Public Health Emergency on COVID-19 (PDF) MLN Matters Article
- Quality, Certification, and Oversight Reports database
- Quality, Safety & Education Portal
- State Operations Manual Appendix M – Guidance to Surveyors: Hospice (PDF)
Events
Price Transparency Stakeholder Webinar — August 11
Compliance with Hospital Price Transparency Final Rule: 8 Steps to a Machine-Readable File
Wednesday, August 11 from 2-3:30 pm ET
Effective January 1, 2021, each hospital operating in the United States is now required to provide publicly accessible standard charge information online about the items and services they provide in 2 ways:
- Comprehensive machine-readable file with all items and services
- Display of 300 shoppable services in a consumer-friendly format
This webinar focuses on how to meet the requirements of the Hospital Price Transparency Final Rule for posting standard charge information in the comprehensive machine-readable file. CMS experts will review 8 Steps to a Machine-Readable File of All Items & Services (PDF) and hospital compliance examples.
The presentation will be available on the Resources webpage approximately 1 week before the webinar. Send feedback and questions to PriceTransparencyHospitalCharges@cms.hhs.gov.
Participation Instructions:
- See your confirmation for audio instructions
- For TTY services dial 7-1-1 or 1-800-855-2880; a Relay Communications Assistant will help you
More Information:
- Hospital Price Transparency webpage
- FAQs (PDF)
- 10 Steps to a Consumer-Friendly Display (PDF)
- Quick Reference Checklist (PDF)
Ambulance Open Door Forum — August 12
Medicare Ground Ambulance Data Collection System
Thursday August 12 from 2-3:30 pm ET
Learn about the Medicare Ground Ambulance Data Collection System during this Open Door Forum:
- Current status and activities
- Information sampled organizations need to collect and report
- Proposed revisions and clarifications in the Calendar Year 2022 Physician Fee Schedule proposed rule
- CMS education activities and resources
The presentation will be available on the Ambulances Services Center webpage under Spotlights before the call.
Participation Instructions:
- Conference call only: Dial 888-455-1397; reference passcode 8604468
- You don’t need to RSVP
- Dial-in at least 15 minutes before call start time
- TTY services: Dial 7-1-1 or 800-855-2880
- Instant replay available 1 hour after the call ends: 866- 470-7051; no passcode needed
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