- CMS Announces Resources & Flexibilities to Assist with Public Health Emergency in Texas
- CMS Oral Health Cross-Cutting Initiative Fact Sheet
- Doctors & Clinicians: Utilization Data on Medicare.gov Compare Tool
- Help Improve the Program for Evaluating Payment Patterns Electronic Reports & Comparative Billing Reports
- Viral Hepatitis: Talk with Your Patients About Shots & Screenings
- Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: October Update
- Lymphedema Compression Treatment Items: Implementation — Revised
News
CMS Announces Resources & Flexibilities to Assist with Public Health Emergency in Texas
CMS announced additional resources and flexibilities available in response to Hurricane Beryl in Texas. CMS is working closely with the state of Texas 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 July 12, 2024, HHS Secretary Xavier Becerra determined that a public health emergency exists in Texas and has existed since July 5, 2024.
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 hurricane.
More Information:
CMS Oral Health Cross-Cutting Initiative Fact Sheet
CMS released the Oral Health Cross-Cutting Initiative (PDF) fact sheet. Overall health and well-being are impacted by oral health, affecting individuals, families, and communities. CMS is committed to eliminating barriers to oral health care as part of our broader goal of improving quality, equity, and outcomes in the health care system. The CMS Oral Health Cross-Cutting Initiative aligns our programs and policies to better address oral health needs, and the fact sheet highlights this important work and accomplishments to date.
Doctors & Clinicians: Utilization Data on Medicare.gov Compare Tool
In July, CMS added utilization data for 6 new procedures to the Medicare.gov compare tool profile pages for doctors and clinicians:
- Upper endoscopy
- Arthroscopy – upper extremity
- Arthroscopy – lower extremity
- Varicose vein ablation
- Laminectomy/laminotomy (lumbar)
- Lower limb revascularization
Visit Care Compare: Doctors and Clinicians Initiative for more information, including the first 12 procedures released in January 2024.
Help Improve the Program for Evaluating Payment Patterns Electronic Reports & Comparative Billing Reports
CMS is taking steps to improve the effectiveness, accessibility, and design of the Program for Evaluating Payment Patterns Electronic Reports (PEPPERs) and Comparative Billing Reports (CBRs). You can help by responding to questions in the Request for Information (PDF) by August 19, 2024.
See Medicare Fee-for-Service Compliance Programs for more information.
Viral Hepatitis: Talk with Your Patients About Shots & Screenings
Viral hepatitis is a serious public health threat. It’s a leading cause of liver cancer and kills thousands of Americans each year.
Hepatitis B is vaccine-preventable, and hepatitis C is curable (see CDC). World Hepatitis Day is an opportunity to learn about disparities in your Medicare Fee-for-Service patient population (PDF), and encourage them to get shots and screenings.
Medicare covers viral hepatitis screening and immunization services, including:
- Hepatitis B screening
- Hepatitis B shot & administration
- Hepatitis C screening
- Sexually transmitted infection (STI) screening & high-intensity behavioral counseling to prevent STIs
Your patients pay nothing if they meet coverage criteria, and you accept assignment.
Get information for your patients:
- CDC Viral Hepatitis Basics
- Hepatitis B virus infection screenings, hepatitis B shots, hepatitis C screening tests, and STI screenings & counseling
Compliance
Opioid Treatment Program: Bill Correctly for Opioid Use Disorder Treatment Services
In a report, the Office of the Inspector General found that Opioid Treatment Program (OTP) providers didn’t always comply with federal requirements when they bill for opioid use disorder (OUD) treatment services, including intake activities. Review OTP Billing & Payment, and learn how to:
- Bill for OUD services
- Use the correct G-codes for treatment
MLN Matters® Articles
Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: October Update
Learn about updates for laboratory billing (PDF):
- Next private payor data reporting period of January 1 – March 31, 2025
- New and deleted HCPCS codes
Lymphedema Compression Treatment Items: Implementation — Revised
Learn how to prevent claim denials due to duplicate payments (PDF) for compression bandaging systems.
Publications
Ground Ambulance Industry Trends 2017–2022
CMS posted 2 reports on ground ambulance industry trends from 2017–2022:
- Analysis of Medicare Fee-for-Service Claims (PDF)
- Analysis of Ground Ambulance Organization Entrance and Exit (PDF)
Visit Medicare Ground Ambulance Data Collection System for more information.
Multimedia
Post-Acute Care Quality Reporting Programs: FY & CY 2025 Program Updates Web-Based Training
Find out what you need to know about the Post-Acute Care (PAC) Quality Reporting Programs. Take this cross-setting web-based training course for an overview of key updates for FY and CY 2025, including:
- New, removed, and revised quality measures
- Timelines for public reporting
- Measure specifications
- Assessment guidelines and coding instructions for 2 new data elements:
- O0350 – Patient and resident COVID-19 vaccination is up to date
- A1400 – Payer information (inpatient rehabilitation facilities only)
If you have questions or feedback about this training, contact the PAC Training mailbox.
From Our Federal Partners
Disruptions in Availability of Becton Dickinson BACTEC Blood Culture Bottles
The CDC issued this Health Alert Network (HAN) Health Advisory to inform health care providers, laboratory professionals, health care facility administrators, and state, tribal, local, and territorial health departments of a critical shortage of Becton Dickinson BACTEC™ blood culture media bottles. This shortage has the potential to disrupt patient care by leading to delays in diagnosis, misdiagnosis, or other challenges in the clinical management of patients with certain infectious diseases. Health care providers, laboratory professionals, health care facility administrators, and state, tribal, local, and territorial health departments affected by this shortage should immediately begin to assess their situations and develop plans and options to mitigate the potential impact of the shortage on patient care.
Recommendations:
- Implement practices to optimize the use of blood cultures at your facility
- Take steps to prevent blood culture contamination
- Ensure that the appropriate volume is collected when collecting blood for culture
- Determine the type of blood culture bottles your laboratory or facility uses and whether this shortage will impact you
- If your laboratory or facility will be impacted by the bottle shortage, determine whether you have alternative options for blood cultures
- Monitor current and future supplies of blood culture bottles at your laboratory or facility and report any potential shortages or interruptions to the FDA at deviceshortages@fda.hhs.gov
- If your facility will be impacted by the bottle shortage, convene a group of local laboratory and clinical experts to determine how a limited supply of blood culture bottles will be prioritized for use in your facility
See the full Health Advisory for more information.
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