CMS recently pitched the physician payment rule for 2023, updated nursing home staffing and participation guidelines and implemented its price transparency rule for payers July 1. Becker's has reported on the following 21 CMS moves in the last month.
Finance:
UNC flagship hospital's Medicare contract in jeopardy
CMS is giving UNC Health's flagship hospital in Chapel Hill, N.C., until July 23 to correct patient safety issues or lose its Medicare funding, The News & Observer reported July 11.
Duke LifePoint hospital at risk of losing Medicare contract
Wilson (N.C.) Medical Center could lose its Medicare contract after state regulators identified immediate jeopardy to patients' health and safety stemming from three events in early 2022, The News & Observer reported July 8.
CMS pitches physician payment rule for 2023: 7 things to know
CMS released its annual proposed changes to the physician fee schedule for 2023 on July 7, which includes a proposed $1.53 conversion factor decrease.
CMS' proposed rule for Rural Emergency Hospital designations: 8 things to know
CMS on June 30 issued proposed conditions of participation for hospitals looking to receive the rural emergency hospital designation.
CMS pitches end-stage renal disease payment rule: 4 things to know
On June 21, CMS issued a proposed rule to update payment rates and policies under the End-Stage Renal Disease Prospective Payment System for renal dialysis services furnished to Medicare beneficiaries on or after Jan. 1, 2023.
Home health firms to lose $810M in Medicare payments: 6 home health CMS updates
Home health agencies would lose $810 million in Medicaid payments in 2023 under a CMS proposal released June 17.
Clinical:
CMS mum on July star ratings release
CMS is slated to release its Overall Hospital Quality Star Ratings update this month, though the agency has been tight-lipped about when this will occur.
CMS adds 4 categories to nursing home staff rating system
CMS updated its nursing home staffing rating system July 7 to include four new measures.
Why CMS wants to conceal hospital safety data
A July 7 Kaiser Health News report sheds more light on CMS' rationale for its proposed plan to obscure hospital safety data from the public — a move that has been met with strong opposition from patient safety groups and other stakeholders.
CMS updates nursing home participation guidance
CMS released updated guidance June 29 on minimum health and safety standards that long-term care facilities must meet to participate in Medicare and Medicaid.
CMS curtailing frequency of vaccination mandate compliance surveys
Oversight of the COVID-19 vaccination mandate covering healthcare facilities participating in Medicare and Medicaid will no longer be part of all CMS surveys.
Oregon State Hospital's proposed safety fixes 'unacceptable,' CMS says
Oregon State Hospital submitted a revised plan of correction last week to remedy numerous safety issues found at the facility after CMS determined its initial correction plan was "generally unacceptable," according to The Lund Report on June 13.
Payer:
Payers must post negotiated prices starting July 1
CMS' Transparency in Coverage final rule took effect July 1, requiring payers nationwide to publish the cost of nearly every healthcare service they've negotiated with providers.
CMS rule limiting 3rd-party Medicare Advantage, Part D marketing now in effect
A CMS rule revising Medicare Advantage and Part D marketing and communication regulations for plan sponsors went into effect June 28 to increase oversight over third-party marketing organizations.
CMS to launch new oncology payment model under Medicare
The Biden administration will launch the next phase of its Cancer Moonshot initiative next July with a new value-based oncology payment model through Medicare that aims to improve cancer care outcomes and lower costs nationwide. Oncology physician group practices, commercial payers, Medicare Advantage plans and state Medicaid programs located anywhere in the U.S. are encouraged to apply through Sept. 30.
CMS response to Roe v. Wade reversal
CMS Administrator Chiquita Brooks-LaSure said she will do everything within her authority "to ensure that people have the choice of when and how to start a family." The federal agency said it will continue to maintain and expand access to IUDs, emergency contraception, oral contraception, other forms of contraception and abortion care within its legal authority.
CMS to cover COVID-19 vaccinations for children 5 and younger
CMS said June 22 it will pay for COVID-19 vaccinations for children aged 6six months to 5five years who are covered under Medicaid and the Children's Health Insurance Program without cost-sharing.
'Time is of the essence' to extend ACA subsidies, CMS administrator says
CMS Administrator Chiquita Brooks-LaSure said "time is of the essence" for Congress to extend ACA subsidies, MarketWatch reported June 22. If the subsidies are not extended, more than 10 million people will see their premium tax credits reduced or lose them entirely, and about 3 million people could lose coverage.
3 more states, Washington, D.C., expand postpartum Medicaid coverage
CMS approved Maine, Minnesota, New Mexico and Washington, D.C.'s, proposals to expand Medicaid and the Children's Health Insurance Program postpartum coverage from 60 days to 12 months. Eleven other states were previously approved, and nine others have submitted extension proposals.
Flawed Medicare data hampering analysis of health disparities, inspector general says
Inaccuracies in Medicare's race and ethnicity data have hurt CMS' ability to assess health disparities, the HHS Office of the Inspector General said in a June 15 report.
CMS may look to require nursing homes to spend a majority of their Medicaid funding on direct care for residents and place a limit on using funds for operations, maintenance, capital improvements or profits, according to Kaiser Health News.