Resource Federal Register Final Rule Publications

Medicare Program:​

End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, and End-Stage Renal Disease Quality Incentive Program​

An unpublished Rule by the Centers for Medicare & Medicaid Services (​

This document is unpublished.​

It is scheduled to be published on 11/09/2020).​

Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals With Acute Kidney Injury, and End-Stage Renal Disease Quality Incentive Program

This final rule updates and makes revisions to the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year (CY) 2021. This rule also updates the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). In...

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Medicare Program; End-Stage Renal Disease Prospective Payment System, Payment for Renal Dialysis Services Furnished to Individuals with Acute Kidney Injury, and End-Stage Renal Disease Quality Incentive Program (CMS-1732-F) | CMS

OVERVIEW:

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Medicare and Medicaid Programs;​

CY 2021 Home Health Prospective Payment System Rate Update, Home Health Quality Reporting Program Requirements, and Home Infusion Therapy Services and Supplier Enrollment Requirements; and Home Health Value-Based Purchasing Model Data Submission Requirements​

On October 29, CMS issued a final rule that finalizes routine updates to the home health payment rates for Calendar Year (CY) 2021 in accordance with existing statutory and regulatory requirements. This rule also finalizes the regulatory changes related to the use of telecommunications technology in providing care under the Medicare home health benefit.

CMS estimates that Medicare payments to Home Health Agencies (HHAs) in CY 2021 will increase in the aggregate by 1.9 percent, or $390 million, based on the finalized policies. This increase reflects the effects of the 2.0 percent home health payment update percentage ($410 million increase) and a 0.1 percent decrease in payments due to reductions in the rural add-on percentages mandated by the Bipartisan Budget Act of 2018 for CY 2021 ($20 million decrease). This rule also updates the home health wage index including the adoption of revised Office of Management and Budget statistical area delineations and limiting any decreases in a geographic area’s wage index value to no more than 5 percent in CY 2021.

This final rule also:

• Finalizes Medicare enrollment policies for qualified home infusion therapy suppliers
• Updates the home infusion therapy services payment rates for CY 2021
• Finalizes a policy excluding home infusion therapy services from home health services as required by law
• Finalizes policies under the Home Health Value Based Purchasing Model published in the interim final rule with comment period, as required by law

Medicare and Medicaid Programs; CY 2021 Home Health Prospective Payment System Rate Update, Home Health Quality Reporting Program Requirements, and Home Infusion Therapy Services and Supplier Enrollment Requirements; and Home Health Value-Based Purch

This final rule updates the home health prospective payment system (HH PPS) payment rates and wage index for calendar year (CY) 2021. This final rule also implements the changes to the home health regulations regarding the use of telecommunications technology in providing services under the...

www.federalregister.gov

 

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Outpatient Prospective Payment System rule
1. CMS is increasing outpatient payment rates by 2 percent in 2022 for hospitals that meet applicable quality reporting requirements.
2. CMS is modifying the hospital price transparency regulation beginning Jan. 1. Hospitals with 30 or fewer beds that aren't in compliance with the regulation will face a minimum penalty of $300 per day. Hospitals with more than 30 beds will face a minimum penalty of $10 per bed per day. The maximum penalty will be capped at $5,500 per day. A full year of noncompliance with the price transparency regulation would result in a maximum penalty of about $2 million per hospital.
3. CMS is requiring that the machine-readable file that includes hospital prices be accessible to automated searches and direct downloads.
4. The final rule halts elimination of the inpatient only list and adds back most of the services that were removed from the list in 2021.
5. CMS will continue paying hospitals 22.5 percent less than the average sales price for certain drugs and biologics purchased through the 340B program
Check out the full Outpatient Prospective Payment System Final Rule at:

https://public-inspection.federalregister.gov/2021-24011.pdf?fbclid=IwAR3QjnnuzC8ghZh6ZZYqKJuOewke42r4wfVDzxN8fDCoplpzH7acl5Y_CDs

 

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From the AAO/HNS:
CMS Releases 2022 Physician Fee Schedule/Quality Payment Program Final Rule
On November 2, the Centers for Medicare & Medicaid Services (CMS) released a final rule implementing changes to the Physician Fee Schedule and Quality Payment Program for 2022. The regulation includes new values for hypoglossal nerve stimulation and drug-induced sleep endoscopy, procedures commonly performed by otolaryngologist-head and neck surgeons. The agency heeded the Academy’s concerns regarding proposed updates to clinical labor pricing. In the final rule, CMS opted to phase in the changes over a four-year period. CMS also revised its proposals on critical care services. The agency will not bundle the services with other unrelated procedures next year. As expected, the 2022 fee schedule does not address the scheduled 9.75% cut to all physician services effective January 1, 2022. The AAO-HNS will continue to urge Congress to seek immediate action to reverse these cuts before the end of the year as well as to address long-term solutions for physician payment reform.
Read more of the Physician Fee Schedule Final Rule for 2022:

https://public-inspection.federalregister.gov/2021-23972.pdf?fbclid=IwAR39y-huXuYT5RTkC3tJEmIWobYJ5H4yDJAMysIsaCqpNeTSeDyCGv_W5-U

 

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CMS Releases 2022 Physician Fee Schedule Final Rule​

The 2022 MPFS final rule promotes greater telehealth utilization and boosts payment rates for vaccine administration.​

Plus all these topics.

Rate setting Revamped, Conversion Factor Reduced​

Final Rule Extends and Expands Telehealth​

Encouraging Proven Vaccines to Protect Against Preventable Illness​

Other Major Actions in the 2022 MPFS Final Rule​

Updating E/M Visit Payment Policies​

Promoting Growth in Medicare Diabetes Prevention Program​

Increasing Access to Medical Nutrition Therapy Services​

Expanding Pulmonary Rehabilitation Coverage​

Modifying Billing for Physician Assistant Services​

Postponing AUC Payment Penalty Phase​

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CMS Releases 2022 Physician Fee Schedule Final Rule

The 2022 MPFS final rule promotes greater telehealth utilization and boosts payment rates for vaccine administration. The Centers for Medicare &

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