Bulletin Board
Bulletin Board
GAO: Improvement Needed in MLTSS Oversight
The Centers for Medicare & Medicaid Services needs to improve the job it does overseeing state Medicaid programs of managed long-term services and supports. According to a new report by the U.S. Government Accountability Office, 22 states use MLTSS programs to help qualified seniors continue living independently in the community and to save money on nursing home costs. CMS’s oversight of these efforts, and of the use of federal funds, is inconsistent and often falls short when monitoring key considerations such as provider network adequacy, critical incidents, and appeals and [...]
MACPAC Meets
The Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. Among the issues MACPAC commissioners discussed during their two-day meeting were: delivery system reform incentive payment programs Medicaid enrollment and renewal processes managed care oversight monitoring and evaluating section 11115 demonstration waivers Medicaid coverage of telemedicine services MACPAC advises the administration, Congress, and the states on Medicaid and CHIP issues. It is a non-partisan agency of the legislative branch of government. Go here to find background information on these and other subjects as well as links to [...]
What is a Hospital?
The Centers for Medicare & Medicaid Services has taken a step toward answering that question in a new, 12-page guidance document that seeks to define whether a facility qualifies as a hospital under section 1861(e) of the Social Security Act. At the heart of the question is that law’s definition of a hospital, which includes that it is “primarily engaged” in caring for inpatients. CMS’s guidance outlines parameters for determining whether a hospital meets this standard. Find that CMS document here.
MedPAC Meets
Members of the Medicare Payment Advisory Commission met last week in Washington, D.C. Among the issues they discussed during their two days of meetings were Medicare coverage policy, Medicare coverage of telehealth services, pharmacy benefit managers and specialty pharmacies, and physician supervision requirements in critical access and small rural hospitals. Go here to see the issue briefs and presentations that were discussed during the meeting.
MedPAC Comments on Proposed Physician Fee Schedule
The Medicare Payment Advisory Commission has written to the Centers for Medicare & Medicaid Services to convey its views on CMS’s proposed revisions to Medicare physician payment policies for 2018. Among the issues MedPAC addresses in its comment letter are proposed payments to physicians for nonexcepted items and services provided in nonexcepted off-campus provider-based hospital departments, the Medicare shared savings program, and the Medicare diabetes prevention program. See CMS’s comment letter here.