New year brings some changes to quality reporting criteria
The 2021 Medicare Hospital Outpatient Prospective Payment System (OPPS)/ASC Final Payment Rule was released on December 1, 2020, and became effective as of January 1, 2021. Gina Throneberry, MBA, RN, CASC, CNOR, director of education and clinical affairs, Ambulatory Surgery Center Association (ASCA), summarized the status of Medicare regulations and…
Pfizer/BioNTech vaccine reaches 141 of 145 first-day locations
Editor's Note The first batch of the Pfizer/BioNTech's newly authorized COVID-19 vaccine for emergency use reached 141 of 145 targeted locations on the first day of its national rollout, a Department of Health and Human Services spokeswoman told Reuters. Four island territories—American Samoa, Guam, North Mariana Islands, and the US…
HHS purchases 100 million additional doses of Moderna’s COVID-19 vaccine
Editor's Note The Department of Health and Human Services (HHS) announced on December 11 that it would purchase 100 million additional doses of Moderna’s COVID-19 vaccine. The vaccine, which was developed by Moderna with scientists from the National Institute of Allergy and Infectious Diseases (NIAID), is scheduled for a December…
CMS releases final 2021 Medicare payment rule for ASCs, HOPDs
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on December 2 released its 2021 final payment rule for ASCs and hospital outpatient departments (HOPDs). CMS has finalized the addition of 11 procedures to the ASC covered procedures list, including total hip arthroplasty, autochondrocyte knee implant, and open complex…
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…
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