Thursday, September 21, 2023
- CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Georgia
- Organ Transplantation Affinity Group: Strengthening Accountability, Equity, And Performance
- Psychotherapy for Crisis: Medicare Pays for Services
- Flu Shot: Encourage Preferred Vaccines for Patients 65+
- Help Reduce Health Gaps for Hispanic or Latino Patients
- Limitation on Recoupment of Overpayments
- Inpatient & Long-Term Care Hospital Prospective Payment System: FY 2024 Changes
News
CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Georgia
On September 14, CMS announced additional resources and flexibilities available in response to Hurricane Idalia in the state of Georgia. CMS is working closely with the state of Georgia to put these flexibilities in place to ensure those affected by this natural disaster have access to the care they need – when they need it most.
On September 7, President Biden determined that an emergency exists in the state of Georgia due to the emergency conditions resulting from Hurricane Idalia beginning August 30 and continuing.
CMS stands ready to assist with resources and waivers to ensure hospitals and other facilities can continue to operate and provide access to care to those impacted by the consequences of the hurricane.
More Information:
- Full News Alert
- Current Emergencies webpage
- Medicare Claims During Public Health Emergencies webpage
Organ Transplantation Affinity Group: Strengthening Accountability, Equity, And Performance
In 2021, HHS Secretary Becerra established a coordinated effort to improve organ donation, procurement, and transplantation. Led by CMS and the Health Resources and Services Administration, this collaborative seeks to drive improvements in donations, clinical outcomes, system improvement, quality measurement, transparency, and regulatory oversight.
This federal collaborative, called the Organ Transplantation Affinity Group, is a coordinated group working together to strengthen accountability, equity, and performance to improve access to organ donation, procurement, and transplantation for patients, donors, families and caregivers, and providers.
This joint work leverages recent actions by both agencies to strengthen accountability and transparency.
See the full blog.
Psychotherapy for Crisis: Medicare Pays for Services
Medicare pays for psychotherapy for crisis under the Physician Fee Schedule. Psychotherapy for crisis services are appropriate for patients in high distress with life-threatening, complex problems that require immediate attention. Bill using CPT codes 90839 and 90840.
Services include:
- Providing an urgent assessment and history of a crisis state
- Performing a mental status exam and psychotherapy
- Mobilizing resources to defuse the crisis and restore safety
- Using interventions to minimize the potential for psychological trauma
Visit Psychotherapy for Crisis for coverage and coding specifics, and new proposals for CY 2024. Bookmark this webpage for the latest information and updates.
Flu Shot: Encourage Preferred Vaccines for Patients 65+
It’s time to talk with your patients about flu shots. The CDC recommends annual flu shots for everyone 6 months and older. September and October are the best times for most people to get vaccinated.
Consider giving a preferred vaccine to your patients 65 years and older. Preferred vaccines are potentially more effective than standard dose flu vaccines. There are 3 recommended vaccines:
- Fluzone High-Dose Quadrivalent vaccine
- Flublok Quadrivalent recombinant flu vaccine
- Fluad Quadrivalent adjuvanted flu vaccine
If one of these recommended vaccines isn’t available, give your patients a standard-dose flu vaccine instead.
Medicare Part B covers the seasonal flu shot and additional flu shots if medically necessary. Your patients pay nothing if you accept assignment.
Find out when your patients are eligible for the flu shot. We give information from claims billed in the last 18 months:
- CPT or HCPCS codes
- Dates of service
- NPIs who administered the shots
If you need help, contact your eligibility service provider.
More Information:
- CDC Flu webpage
- CDC Seasonal Influenza Resources for Health Professionals webpage
- Vaccines.gov website
- Flu shots: Get information for your Medicare patients
Help Reduce Health Gaps for Hispanic or Latino Patients
More than 50% of Medicare Fee-for-Service Hispanic or Latino patients report fair or poor health (see data highlight). During National Hispanic Heritage Month, help increase awareness of health disparities, reduce gaps in health care, and increase access to culturally and linguistically competent health care and coverage.
More Information:
- Introduction to Language Access Plans web-based training
- Coverage to Care webpage
- Roadmap to Better Care (Spanish)
- Roadmap to Behavioral Health (Spanish)
MLN Matters® Articles
Limitation on Recoupment of Overpayments
Learn how appeals and reconsiderations affect how Medicare recoups overpayments.
Inpatient & Long-Term Care Hospital Prospective Payment System: FY 2024 Changes
Learn about FY 2024 updates for:
- Inpatient Prospective Payment System (IPPS)
- Long-Term Care Hospital Prospective Payment System
- Certain hospitals CMS excludes from the IPPS
Information for Patients
HHS Takes the Most Significant Action in a Decade to Make Care for Older Adults & People with Disabilities More Affordable and Accessible
On September 18, HHS, through CMS finalized a rule to streamline enrollment in the Medicare Savings Programs (MSPs), making coverage more affordable for an estimated 860,000 people.
The MSPs, run by state Medicaid programs, currently cover Medicare premiums and, in most cases, cost-sharing for more than 10 million older adults and people with disabilities who also have limited incomes. The final rule makes it easier for millions of people to enroll in, retain, and afford health coverage and care through Medicare.
See the full press release.
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