Medicare regulations

CMS Seeks Help With Reducing Administrative and Regulatory Burdens

Reducing administrative and regulatory burdens is the subject of a new request for information issued last week by the Centers for Medicare & Medicaid Services. In the RFI, CMS explains that it is especially interested in “…innovative ideas that broaden perspectives on potential solutions to relieve burden and ways to improve” reporting and documentation requirements coding and documentation requirements for Medicare or Medicaid payment prior authorization procedures policies and requirements for rural providers, clinicians, and beneficiaries policies and requirements for dually enrolled (Medicare and Medicaid) beneficiaries beneficiary enrollment and eligibility determination CMS processes for issuing regulations and policies Comments are [...]

iqtsupport2019-06-12T06:00:42-04:00June 12, 2019|Centers for Medicare & Medicaid Services, Medicaid regulations, Medicare regulations|

CMS Revamps Medicare ACO Program

The federal government seeks to pursue greater savings and an accelerated approach to value-based care through an overhaul of its programs for Medicare accountable care organizations. The Centers for Medicare & Medicaid Services’ new “Pathways to Success” program seeks to speed up the process of providers assuming risk for costs and outcomes through the following changes from the agency’s current approach. A reduction in how long participating ACOs can remain in the program without assuming some responsibility for their spending. Modifications that CMS hopes will encourage physician groups to remain independent of hospitals and health systems. Greater flexibility to innovate [...]

iqtsupport2018-12-31T06:00:14-05:00December 31, 2018|Accountable Care Organization, ACO, Alternative payment models, Centers for Medicare & Medicaid Services, Medicare regulations, Medicare reimbursement policy|

House Members Protest Site-Neutral Payment Proposal

138 members of the House of Representatives have written to Centers for Medicare & Medicaid Services administrator Seema Verma to protest CMS’s proposal to extend Medicare outpatient site-neutral payment policies to off-campus, provider-based outpatient departments specifically exempted from such policies by Congress under the Bipartisan Budget Act of 2015. In questioning CMS’s rationale for the proposed policy, the House members wrote that It is unclear how CMS has deemed all of the OPD [outpatient department] services at the grandfathered off-campus HOPDs [hospital outpatient departments] as cause of an unnecessary increase in volume of OPD services, and we ask you to [...]

iqtsupport2018-10-25T06:00:25-04:00October 25, 2018|Medicare regulations, Medicare reimbursement policy|

HHS Posts Regulatory Agenda

The U.S. Department of Health and Human Services has posted a list of the regulations it is already working on or intends to work on in the coming months. Included in the list are links to the individual subjects that lead to descriptions of the subject and HHS’s intentions as well as the latest information on the status of the anticipated regulation and its priority within the agency’s overall regulatory work. Among the listed regulations are a number that address Medicare and Medicaid. Go here to see the list.

iqtsupport2018-10-22T06:00:15-04:00October 22, 2018|Medicaid regulations, Medicare regulations|

CMS Proposes Easing Regulatory Requirements

In a newly proposed rule, the Centers for Medicare & Medicaid Services proposes easing the regulatory burden on health care providers. The proposed regulation, which weighs in at 285 pages, covers a broad range of government regulation of health care providers and would, CMS projects, save hospitals more than $1 billion a year while cutting millions of hours of administrative work. Learn more about what CMS proposes by reading its fact sheet on the proposed regulation or going here to see the proposed regulation itself.

iqtsupport2018-09-24T06:00:42-04:00September 24, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare regulations|

Ways and Means Praises CMS for Red Tape Efforts, Seeks More

Leaders of the House Ways and Means Committee have written to Centers for Medicare & Medicaid Services administrator Seema Verma to praise her agency’s work in eliminating Medicare red tape – but also asking her to “…take further steps to improve patient care by alleviating administrative and regulatory burdens for Medicare providers.” In three separate letters, committee chairman Kevin Brady (R-TX) and Health Subcommittee chairman Peter Roskam (R-IL) expressed their pleasure with CMS’s recent efforts but specified areas where they would like to see further action. For hospitals, they wrote that they seek further red-tape cutting in the areas of [...]

iqtsupport2018-09-11T06:00:49-04:00September 11, 2018|Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations|

Proposal Would Equalize Medicare Physician Payments

All physicians would be paid equally for Medicare-covered office visits under a new proposal published recently by the Centers for Medicare & Medicaid Services. Under the proposed regulation, Medicare would collapse four levels of patient evaluation and management office visits, eliminate the extensive documentation required to justify the payments physicians seek, and pay one simple rate for office visits. CMS estimates that reducing the documentation requirements would save every doctor 51 hours a year. Some critics are concerned that specialists and those caring for especially ill or especially complex patients would be shortchanged by the proposed policy while others fear [...]

iqtsupport2018-07-24T06:00:47-04:00July 24, 2018|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations|

HHS Unveils Spring Regulatory Agenda

The U.S. Department of Health and Human Services has published a comprehensive list of the regulatory actions it plans to take in the coming months. Included on the list are regulations that have been proposed, that are being finalized, and that are currently under development. They address Medicare, Medicaid, Food and Drug Administration endeavors, medical devices, the 340B prescription drug discount program, and more. Among the policy changes contemplated through future regulations are measures to reduce regulatory burdens for hospitals, address the opioid problem, facilitate the use of non-Affordable Care Act-compliant health insurance plans, and more. Go here to see [...]

iqtsupport2018-05-14T06:00:28-04:00May 14, 2018|340b, Affordable Care Act, Medicaid, Medicaid regulations, Medicare, Medicare regulations|

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.

iqtsupport2017-09-12T06:00:52-04:00September 12, 2017|Centers for Medicare & Medicaid Services, Medicare, Medicare regulations, MedPAC|

Ways and Means Seeks to Cut Medicare Red Tape

The House Ways and Means Committee’s Health Subcommittee has launched a new initiative to attempt to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery. The subcommittee describes its “Medicare Red Tape Relief Project” as …a new initiative to deliver relief from the regulations and mandates that impede innovation, drive up costs, and ultimately stand in the way of delivering better care for Medicare beneficiaries. In support of this initiative, the committee has announced a three-part approach in which it will seek feedback from stakeholders, host roundtables with stakeholders across the country, [...]

iqtsupport2017-07-27T13:00:59-04:00July 27, 2017|Medicare, Medicare regulations|