iqtsupport, Author at DeBrunner & Associates

Coronavirus Update for Monday, December 14

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Monday, December 14. Centers for Medicare & Medicaid Services CMS has updated its payment and HCPCS Level I CPT code structure with specific COVID-19 vaccine information. Among other things, it notes that providers should only bill the vaccine administration codes when they submit claims to Medicare and should not include vaccine product codes when the vaccines are free. CMS has updated its data on Medicare Accelerated and Advance Payments Program payments to providers. The data is both general, about different provider types, and specific for [...]

iqtsupport2020-12-15T10:29:33-05:00December 15, 2020|Coronavirus, COVID-19|

GAO: CMS Should Pay More Attention to States’ Financing of Medicaid

The federal government does not adequately monitor how states finance their Medicaid programs. It also lacks a sufficiently clear understanding of how they pay providers of Medicaid-covered services. These are among the conclusions in a new study on Medicaid financing and payments by the U.S. Government Accountability Office. According to the GAO report, GAO estimated that states’ reliance on provider taxes and local government funds decreased states’ share of net Medicaid payments (total state and federal payments) and effectively increased the federal share of net Medicaid payments by 5 percentage points in state fiscal year 2018. It also resulted in [...]

iqtsupport2020-12-14T06:00:57-05:00December 14, 2020|Medicaid|

Coronavirus Update for Thursday, December 10

The following is the latest COVID-19 information from the federal government as 3:00 p.m. on Thursday, December 10. Centers for Medicare & Medicaid Services CMS has updated its FAQs for Medicare fee-for-service billing with 20 new or updated questions, all marked “12/8/2020,” that address payments for monoclonal antibody treatments and vaccines, including billing and payments for skilled nursing facilities and non-excepted off-campus provider-based departments; requirements for providing antibodies through infusion therapy; and “hospital without walls” flexibilities. Find the new and updated questions between pages 122 and 135. CMS has posted an infographic on coverage of monoclonal antibody products to treat [...]

iqtsupport2020-12-11T06:00:14-05:00December 11, 2020|Coronavirus, COVID-19|

MedPAC Meets

Last week the Medicare Payment Advisory Commission met in Washington, D.C. to discuss a number of Medicare payment issues. MedPAC’s proposed Medicare 2021 payment recommendations dominated the December agenda, including: hospital inpatient and outpatient payments ambulatory surgical center payments physician and health professional payments hospice payments home health care payments inpatient rehabilitation facility payments long-term care hospital payments In addition, MedPAC discussed Medicare’s policy for transfers between post-acute-care facilities and hospice and received a staff update on the Medicare Advantage program. MedPAC is an independent congressional agency that advises Congress on issues involving Medicare. While its recommendations are not binding [...]

iqtsupport2020-12-10T06:00:36-05:00December 10, 2020|Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Coronavirus Update for Tuesday, December 8

The following is the latest COVID-19 information from the federal government as 2:30 p.m. on Tuesday, December 8. Provider Relief Fund HHS announced that the Provider Relief Fund will distribute $523 million in second-round performance payments to 9248 nursing homes as rewards for successfully reducing COVID-19-related infections and deaths between September and October. HHS concluded that between September and October, 69 percent of 13,251 eligible nursing homes met the incentive program's infection control criteria. See HHS’s announcement of the nursing home distribution and a list of how much of this money HHS distributed to nursing homes in individual states. HHS [...]

iqtsupport2020-12-09T11:09:24-05:00December 9, 2020|Coronavirus, COVID-19|

Coronavirus Update for Friday, December 4

The following is the latest COVID-19 information from the federal governments as of 2:45 p.m. on Friday, December 4. Centers for Medicare & Medicaid Services CMS has updated its FAQs on Medicare fee-for-service billing with 14 new questions that address administration and billing for monoclonal antibody therapy. The new questions can be found on pages 33-34, p. 34, pp. 120-121, p. 121, pp. 121-124, pp. 124-125, p. 125 (four questions), p. 126, pp. 126-127, p. 127, and pp. 127-128. CMS covers much the same ground in an updated version of its document “Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction.” CMS [...]

iqtsupport2020-12-07T09:07:46-05:00December 7, 2020|Coronavirus, COVID-19|

Coronavirus Update for Wednesday, December 2

The following is the latest COVID-19 information from the federal government as of 2:45 p.m. on Wednesday, December 2. Centers for Medicare & Medicaid Services CMS has announced the introduction of two new Medicare condition codes that will take effect for claims received on or after February 1, 2021: one to enable providers to report when a service is provided as part of Expanded Access approval and another to enable providers to report when the service is provided as part of an Emergency Use Authorization. Find an article about the new codes here in MLN Matters, CMS’s online publication. CMS [...]

iqtsupport2020-12-03T06:00:46-05:00December 3, 2020|Coronavirus, COVID-19|

Coronavirus Update for Monday, November 30

The following is the latest COVID-19 information from the federal government as of 2:30 p.m. on Monday, November 30. Centers for Medicare & Medicaid Services CMS has expanded its March program “Hospitals Without Walls,” which provided broad regulatory flexibility that permitted hospitals to provide services in locations beyond their existing walls, by establishing a new “Acute Hospital Care At Home program” that expands those regulatory flexibilities so hospitals may treat eligible patients in their homes. The CMS news release announcing the program expansion explains that the agency believes that … treatment for more than 60 different acute conditions, such as [...]

iqtsupport2020-12-01T06:00:47-05:00December 1, 2020|Coronavirus, COVID-19|

Insurers Owe Customers Billions

Low medical loss ratios will compel insurers to return nearly $2.5 billion to their customers for the 2019 reporting year. Under federal law, individual and small group insurers must spend 80 percent of their premium revenue on health care services and large group insures must spend 85 percent. If they fail to do so they must return the difference to their enrollees, whether individuals, employers, or a combination of the two. In all, insurers owe nearly $2.5 billion – the most ever in a single year – to more than 11 million customers. Rebates can be paid as premium credit [...]

iqtsupport2020-11-30T06:00:49-05:00November 30, 2020|Uncategorized|

New Treatments Haven’t Yet Reduced COVID-19 Death Rate

The development of new therapeutics in recent months has not yet translated into a reduced death rate for patients with COVID-19. In the spring the death rate was five to six percent, a rate attributed to limited testing. Since testing became more widely available during the summer, however, the death rate has fallen to approximately 1.7 percent but has remained at that level despite the introduction of new ways to treat COVID-19. Learn more about the new treatments, their impact on care, and the prospects for their eventual impact on COVID-19 death rates in the Washington Post article “Coronavirus survival [...]

iqtsupport2020-11-30T06:00:27-05:00November 30, 2020|Coronavirus, COVID-19|

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