CMS releases final PFS for 2021, surgeons say rule jeopardizes care
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on December 1 released its 2021 final rule for the Medicare physician fee schedule (PFS), which expands telehealth services and increases payments for primary care and chronic disease management. The rule also reduces payments for surgeons, emergency physicians, and other…
Editorial
Most respondents to a July 2020 American Organization for Nursing Leadership survey said they felt prepared for a future surge of COVID-19. That future is now, with nearly 150,000 new cases being reported daily across the country and multiple hospitals at capacity. Survey respondents said their biggest challenges early in…
Shifts in case mix bode well for future of outpatient surgery
Before COVID-19 emerged as the biggest disruptor of 2020, many ambulatory surgery centers (ASCs) had been growing volume and receiving Medicare reimbursements for an increasing number of procedures. Stopping elective procedures in the spring was a significant setback, especially for smaller, independent facilities, notes a Global Healthcare Advisors (GHA) brief,…
Medicare to cover monoclonal antibody COVID-19 treatments
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on November 10 announced that Medicare will cover out-of-pocket costs for monoclonal antibody drugs for COVID-19 during the public health emergency. The agency’s coverage includes Eli Lilly’s bamlanivimab, which recently received an emergency use authorization from the Food and Drug…
CMS: How to prepare for COVID-19 vaccine
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on November 5 released a set of toolkits and enrollment actions to take to administer the COVID-19 vaccine when it’s available. Many Medicare-enrolled providers don’t have to take any actions until the vaccine is available. Some Medicare-enrolled providers must also…
CMS penalizes 2,545 hospitals for high readmissions
Editor's Note The Centers for Medicare and Medicaid Services (CMS) will penalize and reduce a year’s worth of payments to nearly half of the nation’s hospitals because of 30-day readmission rates, the November 2 Kaiser Health News reports. The penalties are part of the ninth year of the Hospital Readmissions…
CMS issues coverage plan for COVID-19 vaccines, treatments
Editor's Note The Centers for Medicare and Medicaid Services (CMS) on October 28 issued an interim final rule that requires CMS to cover any COVID-19 vaccines that receive Food and Drug Administration (FDA) authorization at no cost to beneficiaries. The rule also will increase what Medicare pays hospitals for COVID-19…
Joint Commission deletes EP on flu vaccination goal
Editor's Note The Joint Commission on October 28 announced that beginning January 1, 2021, it is eliminating the element of performance (EP) for Infection Control Standard IC.02.04.01, which sets incremental influenza vaccination goals to try and achieve the 90% rate set by national initiatives. The US Department of Health and…
Impact of COVID-19 on HAIs
Editor's Note To provide flexibility to healthcare workers responding to the COVID-19 crisis, the Centers for Medicare & Medicaid Services (CMS) waived reporting requirements for healthcare associated infections (HAIs) through June 2020. Using the experience of hospitals in New York City and St Louis, Missouri, the authors provide commentary on…
Joint Commission: Lab surveyors to evaluate CMS reporting requirements for COVID-19 testing results
Editor's Note The Joint Commission announced October 14 that, effective October 15, surveyors will evaluate the Centers for Medicare and Medicaid Services (CMS) reporting requirements for COVID-19 testing results in the Laboratory Accreditation Program. Surveyors will review documentation of COVID-19 test result reporting during the Regulatory Review session of an…
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