- Hospital Price Transparency: Progress & Commitment to Achieving Its Potential
- Home Infusion Therapy Services Monitoring Report
- Immunosuppressive Drugs: Comparative Billing Report in February
- Expanded Home Health Value-Based Purchasing Model Resources: Submit Feedback through March 31
- HCPCS Level II Coding: FAQs for Single Source Drugs & Biologicals
- National Correct Coding Initiative: No April Update
News
Hospital Price Transparency: Progress and Commitment to Achieving Its Potential
Excerpt: Pricing information has long been opaque in the health care marketplace. Lack of transparent information on prices makes it challenging for consumers to shop for services and limits competition. Over the past several years, CMS has implemented or is in the process of implementing complementary groundbreaking policies to promote transparency across the health care system.
In a blog post in Health Affairs, CMS authors focus on the Hospital Price Transparency regulations, which became effective January 1, 2021, and require each hospital operating in the United States to make public its standard charges for the items and services it provides. Recent CMS analyses of how hospitals are putting the hospital price transparency requirements into practice demonstrate a substantial increase in hospitals meeting website assessment criteria from 27% to 70% between 2021 and 2022. This improvement results from an increase in penalties for noncompliance, and significant education, monitoring, and enforcement activities.
Despite the improvement, all hospitals must fully comply with the law, and CMS is exploring additional policies to accomplish this as well as examining ways to make healthcare pricing information more usable for consumers.
Read the full blog at Health Affairs.
Home Infusion Therapy Services Monitoring Report
Read the February 2023 Home Infusion Therapy Monitoring Report about benefit use from the first quarter 2020 – second quarter 2022, including:
- Visits
- Patients
- Supplier organizations
More Information:
- Home Infusion Therapy Services
- Email questions to HomeInfusionPolicy@cms.hhs.gov
Immunosuppressive Drugs: Comparative Billing Report in February
This month, CMS will issue a Comparative Billing Report (CBR) on Medicare Part B claims for immunosuppressive drugs. Use the data-driven report to compare your billing practices with those of your peers in your state and across the nation.
Look for an email from cbrpepper.noreply@religroupinc.com to access your report.
More Information:
- View a webinar recording
- Visit the CBR website
- Register for a live webinar March 8 from 3–4 pm ET
Expanded Home Health Value-Based Purchasing Model Resources: Submit Feedback through March 31
CMS wants to give you the information you need to successfully participate in the Home Health Value-Based Purchasing Model. Provide your feedback:
- Do current resources meet your needs?
- What other topics should we cover?
Responses are anonymous, unless you choose to share your name and email.
Claims, Pricers, & Codes
HCPCS Level II Coding: FAQs for Single Source Drugs & Biologicals
CMS published FAQs (PDF) for coding single source drugs and biologicals. For more information, see HCPCS Coding Questions.
National Correct Coding Initiative: No April Update
CMS isn’t updating any National Correct Coding Initiative edit files this April. Continue using the January edit files until we post the July files.
Publications
DMEPOS Quality Standards — Revised
Learn what’s changed:
- Discontinued Certificates of Medical Necessity and Durable Medical Equipment Information Forms
- Added items that support medical necessity in a patient’s medical record
- Replaced the National Supplier Clearinghouse with 2 National Provider Enrollment contractors
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