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Thursday, September 7, 2023



MLN Matters® Articles



From Our Federal Partners

Information for Patients




New Version of CMS.gov

CMS is excited to share an evolution in the design and navigation of our website, CMS.gov. Today, we’re launching a new version of CMS.gov that features an updated information architecture and streamlined navigation, as well as a refreshed home page. We worked with stakeholders throughout the development of these website improvements and their input is reflected in the new website navigation and other updates.

What we need from you

We’d like you to visit CMS.gov and look around. Note: You may need to refresh your browser if you recently visited these webpages. Get comfortable with the redesigned home page and orient yourself to the navigation improvements. Visitors are welcome to provide input via a Feedback button available on every page on the site. This feedback is regularly monitored by our triage team, but we won’t send individual responses.

Thanks in advance for your consideration

We appreciate your partnership and any further input you’re able to provide regarding the new website organization.


HHS Proposes Minimum Staffing Standards to Enhance Safety and Quality in Nursing Homes

On September 1, HHS, through CMS, issued a proposed rule that seeks to establish comprehensive staffing requirements for nursing homes—including, for the first time, national minimum nurse staffing standards—to ensure access to safe, high-quality care for the over 1.2 million residents living in nursing homes each day. This proposed rule builds on the President’s historic Action Plan for Nursing Home Reform launched in the 2022 State of the Union.

More Information:


CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Florida

On August 31, CMS announced additional resources and flexibilities available in response to Hurricane Idalia in the state of Florida. CMS is working closely with the state of Florida to put these flexibilities in place to ensure those affected by this natural disaster have access to the care they need – when they need it most.

On August 28, President Biden determined that an emergency exists in the state of Florida due to the emergency conditions resulting from Hurricane Idalia beginning August 27 and continuing.

CMS stands ready to assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by the consequences of the hurricane.

More Information:


Laboratory Tests for Blood Counts: Comparative Billing Report in September

This month, CMS will issue a Comparative Billing Report (CBR) on Medicare Part B claims for laboratory tests for blood counts. Use the data-driven report to compare your billing practices with those of peers in your specialty and across the nation.

Look for an email from cbrpepper.noreply@religroupinc.com to access your report.

More Information:

  • View a webinar recording
  • Visit the CBR website, and register for a live webinar September 27 from 3–4 pm ET


Expanded Home Health Value-Based Purchasing Model: Submit Technical Expert Panel Nominations by September 27

CMS wants input from a wide range of home health stakeholders on potential refinements to the Expanded Home Health Value-Based Purchasing Model. Find out about current technical expert panel opportunities.


Physicians & Non-Physician Practitioners: Revised Medicare Enrollment Application Required November 1

If you don’t use PECOS, use the revised CMS-855I (Medicare Enrollment Application - Physicians and Non-Physician Practitioners) to enroll or update your information. Medicare Administrative Contractors will accept current and revised versions of the form through October 31, 2023. Starting November 1, 2023, you must use the revised form.

Form updates:

  • Combines the CMS-855I and CMS-855R paper applications and discontinues the CMS-855R
  • Removes physician assistant employer arrangements
  • Recognizes physicians and non-physicians who provide acupuncture services
  • Identifies compact licenses
  • Adds new physician specialties
  • Expands practice location types to include telehealth

Visit Medicare Enrollment for Providers & Suppliers for more information, including an CMS-855I instructional guide. To enroll and update your information more quickly and easily, use PECOS.


DMEPOS: New Benefit Category Determinations

CMS updated Section 110.8 of the Medicare Benefit Policy Manual, Chapter 15 with new benefit category determinations from the second biannual 2022 HCPCS coding cycle. Visit HCPCS Public Meetings for more information on the items and services we evaluated.

See the instruction to your Medicare Administrative Contractor.


Short-Term Acute Care Hospitals: Program for Evaluating Payment Patterns Electronic Reports

Second quarter FY 2023 Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) are available for short-term acute care hospitals. These reports summarize provider-specific data for Medicare services that may be at risk for improper payments. Use the data to support auditing and monitoring activities.

Target Area Update

The Spinal Fusion target area now includes outpatient claims, in addition to inpatient claims. See the User’s Guide to learn more.

More Information:


Healthy Aging: Recommend Services for Your Patients

Medicare covers many services. During Healthy Aging® Month, encourage your patients to adopt a healthy lifestyle. Recommend appropriate services, including:

Information for Your Patients:


MLN Matters® Articles


Changes to the Laboratory National Coverage Determination Edit Software: January 2024 Update

Learn about changes for January 2024, including new and changed codes.


Inpatient Psychiatric Facilities Prospective Payment System: FY 2024 Updates

Learn about FY 2024 updates, including:

  • Market basket
  • Wage index
  • Quality reporting program




Evaluation and Management Services Guide — Revised

Learn about what’s changed, including information on the 2023 Medicare Physician Fee Schedule final rule. See page 3 for a complete list of updates.




Medicare Ground Ambulance Data Collection System Video

Watch the short sections or the entire video (2:49:23) for an overview of the Medicare Ground Ambulance Data Collection System (GADCS), which includes the questions that selected ground ambulance organizations must respond to when they report under the GADCS.


From Our Federal Partners


Severe Vibrio vulnificus Infections in U.S. Associated with Warming Coastal Waters

The CDC issued a Health Alert Network Health Advisory to notify health care providers, laboratories, and public health departments about recent reports of fatal Vibrio vulnificus (V. vulnificus) infections, including wound and foodborne infections. Consider V. vulnificus as a possible cause of infected wounds in patients who were exposed to warmer coastal waters.


Increased Respiratory Syncytial Virus Activity in Parts of Southeastern U.S.: New Prevention Tools Available to Protect Patients

The CDC issued a Health Alert Network Health Advisory to notify clinicians and caregivers about increases in respiratory syncytial virus (RSV) activity across some parts of the Southeastern U.S. in recent weeks, suggesting a continued shift toward seasonal RSV trends observed prior to the COVID-19 pandemic. As we head into respiratory virus season this fall, it’s important to understand new prevention tools, recommend them to patients who could benefit, and use them effectively to prevent severe RSV disease.


Information for Patients


CMS Hosts Patient-Focused Listening Sessions this Fall 

CMS will host a series of  Patient-Focused Listening Sessions this fall as part of the Medicare Drug Price Negotiation Program. The virtual public listening sessions will provide an opportunity for patients, caregivers, consumer and patient organizations, and other interested parties to share input relevant to the drugs selected for the first round of negotiations.  


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