November 8, 2024

Medicare Finalizes New Standards for Hospital Obstetric Care

The Centers for Medicare & Medicaid Services (CMS) released the Medicare Outpatient Hospital Prospective Payment System (OPPS) Final Rule for Calendar Year 2025.

In addition to annual updates in outpatient hospital Medicare payment rates, this rule finalizes new standards for hospitals and Critical Access Hospitals (CAHs) with obstetric (OB) units regarding maternal quality assessment and performance improvement, the organization, staffing, and delivery of OB care, and staff training on evidence-based maternal health practices.

For hospitals and CAHs with emergency services, it adds standards on facility readiness in caring for emergency services’ patients, including pregnant, birthing, and postpartum women.

The rule also finalizes new transfer policies for hospitals that mirror the current CAH and Rural Emergency Hospital standards. These Conditions of Participation (CoPs) will be phased in over two years.

Click Here to Read Final Rule

November 8, 2024

Policy Update: Medicare Finalizes Changes to Medicare Home Health Program, Effective January 1, 2025

On November 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2025 Home Health Prospective Payment System (HH PPS) Rate Update final rule, which updates the Medicare payment policies and rates for home health agencies (HHAs).

CMS projects an increase in aggregate payments by 0.5 percent, and finalizes a permanent prospective adjustment of 1.975% to the CY 2025 home health payment rate.

CMS finalized a new standard for acceptance to service policy in the Home Health Conditions of Participation (HH CoPs) and their proposal with modification to require ongoing respiratory illness reporting for Long-Term Care (LTC) facilities. The rule is effective January 1, 2025.

Click Here to see 2025 Home Health Prospective Payment System Rate Update final rule

October 17, 2024

OSHA Request for Information: Extending COVID-19 Recordkeeping and Reporting for Employees in Healthcare Settings – respond by December 9

The federal Occupational Safety and Health Administration (OSHA) seeks comments on their request to extend requirements for collecting information specified in OSHA’s COVID-19 Recordkeeping and Reporting in Healthcare Standard, which applies to settings where any employee provides healthcare services.

The requirements include:

• Establishing and maintaining a log of each instance identified by the employer that an employee is COVID-19 positive;
• Make the individual log entry available upon request for examination and copying, and
• Reporting to OSHA each work-related COVID-19 fatality and each work-related COVID-19 in-patient hospitalization within specific timeframes of the employer learning of them.

OSHA would like to hear from the public:

• Whether the information collection requirements are necessary for the proper performance of the agency’s function to protect workers;
• If OSHA’s estimate of the burden (time and costs) of collecting the information is accurate; and
• What are some ways to minimize the burden on employers who much comply.

OSHA will summarize responses when they submit their request to the Office of Management and Budget to extend the requirements.

Click Here to Comment

October 17, 2024

Request for Information: Medicare $2 Drug List Model – Respond by December 9

In response to an Executive Order to lower prescription drug costs, the Centers for Medicare & Medicaid Services (CMS) developed a model to test whether a simpler approach to offering low-cost, clinically important generic drugs can improve medication adherence, lead to better health outcomes, and improve satisfaction with the Part D prescription drug benefit for people with Medicare and for prescribers.

This RFI aims to obtain input from a broad range of interested parties to support continued development of the model. CMS’ primary areas of interest include:

• Drug List Development Process;
• Maximizing Plan Participation;
• CMS Outreach Efforts;
• Part D Sponsor Outreach and Education Efforts for Beneficiaries;
• Assessment of Model Impact;
• Drug List Modifications.

CMS is interested in hearing from all stakeholders, including, but not limited to:

• Medicare beneficiaries
• Advocates
• Medicare Part D plan sponsors
• Pharmacy benefit managers
• Prescribers
• Pharmacists
• Pharmacies
• Policy experts
• Researchers
• Drug manufacturers
• Wholesalers
• Distributors
• All other interested parties

Click Here to Read More

Click Here to Read Executive Order

Process for Submitting Response:

• Deadline to respond: December 9, 2024, 11:59 p.m. PST
• Comments can be submitted here

October 17, 2024

Policy Update: Final Rule on Medicare Beneficiaries’ Appeal Rights for Certain Changes in Patient Status

In response to a court order, the Centers for Medicare & Medicaid Services (CMS) has finalized appeals processes for certain Medicare beneficiaries who are initially admitted as hospital inpatients but are subsequently reclassified as outpatients receiving observation services during their hospital stay, along with other eligibility criteria.

This final rule establishes processes for

• Standardized appeals,
• Expedited appeals,
• and retrospective appeals for beneficiaries.

It also extends the timeframe for providers to submit a claim following a favorable decision and to submit records as requested by a contractor.

While CMS estimates a relatively low number of appeals that meet these criteria, they acknowledge that there will be administrative costs for hospitals to accommodate the new appeals process.

This final rule is effective October 11, 2024.

Click Here to Read Full Details

August 19, 2024

Annual Time Burden on CAHs for New Medicare Data Collection – Comment by October 7

The Centers for Medicare & Medicaid Services (CMS) requests public input on the annual hourly burden for Critical Access Hospitals to collect and report data on obstetrical services, as proposed in the Outpatient Prospective Payment System Rule, and on acute respiratory illnesses, as finalized in the Inpatient Prospective Payment System Rule.

The new Conditions of Participation (CoPs) in these rules include multiple information collection requirements that are one-time burdens for developing new policies, protocols and ongoing reporting requirements, such as daily or biweekly reporting of respiratory illnesses as well as maternal deaths.

More information can be found HERE in the rules and in the information collection supporting documentation.

Comments must be made by October 7, 2024

See Outpatient Prospective Payment System Rule

See Inpatient Prospective Payment System Rule

Click Here to submit a formal comment