CMS Releases Fact Sheet for Hospital Alternate Care Sites
On May 26th, the Centers for Medicare and Medicaid Services (CMS) released a fact sheet that provides state and local governments with information on how to seek payments through CMS programs for acute inpatient and outpatient care provided at alternate care sites (ACS). The easiest way for already-enrolled hospitals or health systems to obtain reimbursement is to treat an ACS as a temporary expansion of their existing ‘brick-and-mortar’ locations. Governments that wish to establish a hospital ACS have three options:
- Turn over operational and billing responsibilities to an enrolled hospital or health system;
- Enroll the ACS as a new hospital in CMS programs; or,
- If the first two options are not available, CMS would not make facility payments, but qualified and enrolled physicians or other non-physician practitioners could bill for covered services that they furnish at the ACS.
The fact sheet encourages state and local governments to contact their CMS Regional Offices to discuss the process. The fact sheet is available here.
HHS OIG Releases Strategic Plan for Oversight of COVID-19 Response and Recovery
On May 26th, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a document highlighting the agency’s goals and strategies for providing protective oversight related to the COVID-19 emergency. HHS OIG’s stated objectives are to:
- Assist in and support ongoing COVID-19 response efforts, including rapid-cycle reviews;
- Investigate COVID-related fraud, such as testing and identity-theft scams;
- Assess the impacts of HHS programs on health and safety;
- Prevent, detect, and remedy waste or misspending of COVID-19 response and recovery funds;
- Investigate diversions of COVID-19 funding from intended purposes and misuse of emergency flexibilities granted to providers;
- Protect the security and integrity of IT systems and health technology, including audits of incidents and mitigation efforts;
- Audit Federal, State, and local COVID-19 response and recovery efforts to assess effectiveness; and,
- Leverage successful practices and lessons learned to strengthen HHS programs for the future.
The strategic plan is available here.
HHS Extends Compliance Deadline for CARES Act Provider Relief Fund by 45 Days
On May 22nd, HHS announced a further extension of 45 days to the deadline for providers to accept or reject the terms and conditions of the CARES Act Provider Relief Fund. All providers who billed Medicare fee-for-service in 2019 should have received some funding from the first $30 billion tranche of the general distribution from this fund in April. Such providers now have 90 days from the date of receipt of funds to reject the payment, after which they will be deemed to have accepted automatically. HHS has provided an opportunity for these providers to submit their latest year revenue information and estimated losses from COVID-19 to be eligible for another payment from the second $20 billion tranche, which is intended to make each provider’s funding equal to 2 percent of annual net patient revenue. Such information must be submitted by June 3rd.
The full announcement is available here.
CMS Releases CY 2021 MA and Part D Final Rule
On May 22nd, CMS issued the Contract Year (CY) 2021 Policy and Technical Changes to the Medicare Advantage (MA) Program, Medicare Prescription Drug Benefit Program, and Medicare Cost Plan Program final rule. A longer summary will be distributed by SPG on Friday, though in light of the COVID-19 response it is worth noting here that CMS is codifying existing network adequacy methodology and finalizing policies that address maximum time and distance standards in rural areas and the use of telehealth. These policies include a direct incentive for plans to contract for telehealth services. Specifically, CMS is allowing MA plans to be eligible to receive a bonus credit of 10 points towards the measured percentage of beneficiaries residing within published time and distance standards when they contract with telehealth providers in the following provider specialty types:
- Dermatology;
- Psychiatry;
- Cardiology;
- Otolaryngology;
- Neurology;
- Ophthalmology;
- Allergy and Immunology;
- Nephrology;
- Primary Care;
- Gynecology/ OB/GYN;
- Endocrinology; and,
- Infectious Diseases.
The final rule is available here.