The Association for Clinical Oncology (ASCO) recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the FY 2021 Hospital Inpatient Prospective Payment System proposed rule.
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The Centers for Medicare & Medicaid Services (CMS) published the Open Payments Program Year 2019 data, along with newly submitted and updated payment records from previous program years.
The Association for Clinical Oncology (ASCO) submitted comments to the Centers for Medicare & Medicaid Services (CMS) regarding the Medicare and Medicaid Programs, Basic Health Program, and Exchanges; Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency and Delay of Certain Reporting Requirements for the Skilled Nursing Facility Quality Reporting Program (CMS-5531-IFC) interim final rule. The rule clarifies earlier changes to Medicare reimbursement that promote the use of telehealth services during the COVID-19 pandemic and establishes reimbursement for audio-only evaluation and management (E&M) services at the same rate as telehealth and in-person E&M services.
The Centers for Medicare & Medicaid Services (CMS) announced flexibilities for clinicians participating in the 2020 Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) who have been impacted by the COVID-19 Public Health Emergency (PHE). Affected clinicians may submit an Extreme & Uncontrollable Circumstances Application to reweight any MIPS performance categories or may apply for the MIPS Promoting Interoperability Performance Category Hardship Exception.
The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Children's Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs.
The Centers for Medicare & Medicaid Services (CMS) released Part 1 of its final rule outlining changes to the Medicare Advantage (MA) and Medicare Prescription Drug Benefit (Part D) programs for contract year 2021. Due to June 1 bid deadlines for both the MA and Part D 2021 plan years, CMS finalized only a subset of the agency’s proposed policies at this time, which the Association for Clinical Oncology (ASCO) submitted comments regarding six provisions in the proposed rule.
The Association for Clinical Oncology (ASCO) submitted a letter to the Centers for Medicare & Medicaid Services (CMS) regarding the Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency (CMS-1744-IFC) interim final rule. In the letter, ASCO applauds the temporary flexibilities CMS has established to promote efficiency and streamline processes for healthcare providers during the COVID-19 pandemic and the public health emergency (PHE).
The Centers for Medicare & Medicaid Services Innovation Center (CMMI) announced new flexibilities and adjustments to its current and future alternative payment models in response to the COVID-19 Public Health Emergency (PHE). Of note for the cancer community, CMMI made changes to the Oncology Care Model, such as payment methodology, quality reporting, and the timeline.
On May 7, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Patient Protection and Affordable Care Act 2021 Notice of Benefit and Payment Parameters final rule, which updates the regulatory and financial standards for Affordable Care Act (ACA) Exchanges. The rule finalized a policy that gives insurers the discretion to not count any form of direct support from drug manufacturers to enrollees for specific prescription drugs toward the annual limit on patient cost sharing amounts.
On May 11, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Hospital Inpatient Prospective Payment System (IPPS) proposed rule for 2021. Of particular note, CMS is proposing a new Medicare Severity-Diagnosis Related Group (MS-DRG) for chimeric antigen receptor T-cell therapy (CAR T-cell therapy).
The Centers for Medicare & Medicaid Services (CMS) has confirmed ASCO’s Survey on COVID-19 in Oncology Registry (ASCO Registry) is an acceptable clinical trial registry for the attestation of the high-weighted practice Improvement Activity (IA), “COVID-19 Clinical Trials related to the Emergency Response & Preparedness,” under the Merit-based Incentive Payment System (MIPS).
On April 30, the Centers for Medicare & Medicaid Services (CMS) released a second Interim Final Rule establishing new regulatory waivers and rule changes to increase flexibility for health care providers during the COVID-19 public health emergency (PHE). These waivers and rule changes further aim to expand telehealth, make it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19, increase hospital capacity, augment the health care workforce, and decrease administrative burden.
On April 26, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it is reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance.
The pre-publication review and dispute process for the Open Payments 2019 program year has begun. Physicians and teaching hospitals may review and dispute any updated records attributed to them until May 15. The Centers for Medicare & Medicaid Services (CMS) will publish its Open Payments program year 2019 data and any updates to previous program years’ data in June 2020.
How to Review Data
To help ensure that health care providers have the resources necessary to care for patients during the COVID-19 pandemic, Congress and the Centers for Medicare & Medicaid Services (CMS) took action to provide direct financial support to providers who have been impacted by the emergency. The Coronavirus Aid, Relief, and Economic Security (CARES) Act and new guidance from CMS both contain provisions to provide financial support to qualified providers.