Thursday, November, 18, 2021
- CMS Repeals MCIT/R&N Rule; Will Consider Other Coverage Pathways to Enhance Access to Innovative Medical Devices
- Changes to Nursing Home Visitation COVID-19 (Revised) & COVID-19 Survey Activities
- Annual Medicare Participation Open Enrollment Period
- It’s Not Too Late to Vaccinate
- Post-Acute Care QRP: Job Aids & Pocket Guides
- Quality Payment Program: 2020 Doctors & Clinicians Preview Period Open Until December 14
- Lung Cancer Awareness: Help Your Patients Reduce Their Risk
- 2022 Annual Update of Per-Beneficiary Threshold Amounts
- Low Utilization Payment Adjustment (LUPA) Add-on Amounts for Home Health (HH) Occupational Therapy Visits
Information for Medicare Patients
News
CMS Repeals MCIT/R&N Rule; Will Consider Other Coverage Pathways to Enhance Access to Innovative Medical Devices
On November 12, CMS rescinded the Medicare Coverage of Innovative Technology and Definition of “Reasonable and Necessary” (MCIT/R&N) final rule because of concerns that the provisions in the final rule may not have been sufficient to protect Medicare patients. By rescinding this rule, CMS can take action that will better address those safety concerns in the future… Read the full press release.
Changes to Nursing Home Visitation COVID-19 (Revised) & COVID-19 Survey Activities
CMS is continuing to promote health and safety and address the impacts of the COVID-19 public health emergency on nursing home residents and their families by issuing memos that revise guidance for nursing home visitation and address the backlog of complaint and recertification surveys… Read the full news alert.
More Information:
- Nursing Home Visitation – COVID-19 (PDF) revised memo
- Changes to COVID-19 Survey Activities and Increased Oversight in Nursing Homes (PDF) memo
Annual Medicare Participation Open Enrollment Period
Did you know that 98% of providers participate in Medicare? Between now and December 31, you can decide if you want to participate in Medicare for 2022. Visit the Annual Medicare Participation Announcement webpage for more information.
It’s Not Too Late to Vaccinate
During this busy time of year, your patients may forget to get their flu shot. According to the CDC and the Advisory Committee on Immunization Practices, you should continue offering the flu shot as long as influenza viruses are circulating locally. Help protect your patients from the flu by using every office visit as an opportunity to remind them to get their flu shot.
Medicare Part B covers 1 flu shot per flu season and additional flu shots if medically necessary. Your patients pay nothing if you accept assignment.
More Information:
- CMS Flu Shot webpage
- CDC Seasonal Influenza Vaccination Resources for Health Professionals webpage
- Vaccines.gov
- Flu Shot information for your Medicare patients
Post-Acute Care QRP: Job Aids & Pocket Guides
Companion job aids can help you understand specific guidelines and clinical considerations for coding GG0130. Self-Care items:
- Eating
- Oral Hygiene
- Toileting Hygiene
- Shower/Bathe Self
- Upper Body Dressing
- Lower Body Dressing
- Putting On/Taking Off Footwear
Find the job aids in the Downloads section of the Quality Reporting Program (QRP) Training page for each post-acute care setting:
- Home Health QRP Training
- Inpatient Rehabilitation Facilities QRP Training
- Long-Term Care Hospital QRP Training
- Skilled Nursing Facilities QRP Training
Pocket guides designed to be worn behind your identification badge provide a quick reference for important terms and definitions. They can help you code accurately:
- Coding for Self-Care and Mobility Items (PDF)
- Definitions for Coding Section J Fall Items (PDF)
- Pressure Ulcers/Injuries Stages and Definitions (PDF)
Quality Payment Program: 2020 Doctors & Clinicians Preview Period Open Until December 14
The Doctors and Clinicians Preview Period is open until December 14 at 8 pm ET. Preview your 2020 Quality Payment Program (QPP) performance information before it appears on Medicare Care Compare and in the Provider Data Catalog.
Access the secured preview through the QPP website. Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) and Next Generation Model ACOs can preview their performance information in their 2020 Merit-based Incentive Payment System Performance Feedback Reports. Shared Savings Program ACOs can also review quality performance information on their previously-provided 2020 Quality Performance Reports.
More Information:
- Care Compare: Doctors and Clinicians Initiative webpage
- Preview Period: 2020 Performance Information for Doctors and Clinicians (PDF) presentation
- 2020 Doctors and Clinicians Performance Information: Guide to the Preview Period (PDF) user guide
- ACO Performance Information on Care Compare (PDF) fact sheet
Questions about public reporting? Email QPP@cms.hhs.gov, or call 866-288-8292 weekdays 8 am – 8 pm ET (non-peak hours are before 10 am and after 2 pm ET). If you’re hearing impaired, dial 711 for a TRS Communications Assistant.
Lung Cancer Awareness: Help Your Patients Reduce Their Risk
Medicare covers lung cancer preventive services and screening. Talk to your patients about how they can lower their lung cancer risk during Lung Cancer Awareness Month and the Great American Smokeout®.
Your patients pay nothing for these services, if you accept assignment:
More Information:
- Preventive Services webpage
- CDC Lung Cancer Awareness webpage
- Great American Smokeout webpage
Claims, Pricers, & Codes
Upcoming Quarterly Update to Home Health Grouper
Diagnosis code changes effective April 1, 2022 will affect the Home Health Grouper. Check the Home Health PPS Grouper Software webpage in early February for new software.
Events
Medicare Ground Ambulance Data Collection System: Q&A Session — December 14
Tuesday, December 14 from 2 – 3 pm ET
Do you have questions about the Medicare Ground Ambulance Data Collection System? Join this live Q&A session. You may also send your questions in advance to AmbulanceDataCollection@cms.hhs.gov with “December 14 Q&A” in the subject line. We’ll update documents on our Ambulances Services Center webpage with answers to common questions from this session.
More Information:
- Ambulances Services Center webpage: includes lists of organizations that must collect data starting in 2022
- CY 2022 Physician Fee Schedule (PFS) final rule
- CY 2020 PFS final rule
- Bipartisan Budget Act of 2018
MLN Matters® Articles
2022 Annual Update of Per-Beneficiary Threshold Amounts
Learn about updates to the annual per-beneficiary incurred expenses amounts, now called KX modifier thresholds, and related policy for Calendar Year (CY) 2022 (PDF). The CY 2022 KX modifier threshold is $2,150 for:
- Physical therapy and speech-language pathology services combined
- Occupational therapy services
Low Utilization Payment Adjustment (LUPA) Add-on Amounts for Home Health (HH) Occupational Therapy Visits
- How the changes affect occupational therapists (OTs)
- How CMS computes the OT’s LUPA add-on payment
Information for Medicare Patients
CMS Announces 2022 Medicare Part B Premiums
On November 12, CMS released the 2022 Medicare Parts A and B premiums, deductibles, and coinsurance amounts, and the 2022 Part D income-related monthly adjustment amounts. Most people with Medicare will see a 5.9% cost-of-living adjustment (COLA) in their 2022 Social Security benefits—the largest COLA in 30 years. This significant COLA increase will more than cover the increase in the Medicare Part B monthly premium... Read the full press release.
More Information:
- Fact sheet
- Medicare Savings Programs webpage
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