Rural Health
News by Topic: Reimbursement and payment models
Jul 1, 2024 - Pre-publication notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) proposing policies for assessing performance year (PY) 2023 financial performance of Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) in light of significant, anomalous, and highly suspect (SAHS) billing activity for selected intermittent urinary catheters on Medicare Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) claims. Among other things, rule proposes benchmarks for ACOs starting agreement periods in 2024, 2025, and 2026; and financial calculations used in the application cycle for ACOs applying to enter a new agreement period beginning on January 1, 2025, and the change request cycle for ACOs continuing their participation in the program for PY 2025. Comments are due by July 29, 2024.
Source: Federal Register
Jun 28, 2024 - Pre-publication notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) making changes related to End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for calendar year 2025 and proposing updates to the payment rate for renal dialysis services furnished by an ESRD facility to individuals with acute kidney injury (AKI). Among other things, this rule also proposes updated requirements for the Conditions for Coverage for ESRD facilities, the ESRD Quality Incentive Program, and the ESRD Treatment Choices Model. Comments are due by August 26, 2024.
Source: Federal Register
Jun 27, 2024 - Pre-publication notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) updating the home health payment rates for calendar year (CY) 2025. This rule also proposes changes to the Home Health Quality Reporting Program (HH QRP) requirements; provides an update on potential approaches for integrating health equity in the Expanded Health Value-Based Purchasing (HHVBP) Model; proposes a new standard for acceptance to service policy in the home health conditions of participation (CoPs); proposes rebasing and revising the home health market basket; and proposes updates to provider and supplier enrollment requirements and changes to the long-term care reporting requirements for acute respiratory illnesses, among other things. Also includes requests for information seeking input on permitting rehabilitative therapists to conduct the initial and comprehensive assessment and the factors that may influence the patient referral and intake processes. Comments are due by August 26, 2024.
Source: Federal Register
Jun 26, 2024 - Discusses Pennsylvania legislation which will require public and private insurers to cover telehealth services. Notes the importance of telehealth for ensuring access to healthcare services in rural Pennsylvania, where 15 hospitals have closed in the last 5 years.
Source: The Center Square
Jun 26, 2024 - Highlights efforts by the Morehouse School of Medicine in Atlanta to expand access to doula services for Black women in rural Georgia. Describes doula services including education, health system navigation, emotional support, and resource referrals. Discusses funding challenges and efforts to make doula services reimbursable by Medicaid in Georgia.
Source: WABE
HHS: Improving Child Care Access, Affordability, and Stability in the Child Care and Development Fund (CCDF); Corrections
Federal Register
Jun 24, 2024 - Notice from the U.S. Department of Health and Human Services (HHS) making technical corrections to the March 1, 2024, final rule regarding childcare access, affordability, and stability in the Child Care and Development Fund (CCDF). These correcting amendments are effective June 24, 2024.
Source: Federal Register
Jun 20, 2024 - Highlights proposed legislation in Virginia and nationally to recruit obstetric and gynecology physicians and increase Medicaid reimbursement rates for labor and delivery services.
Source: Virginia Mercury
Jun 17, 2024 - Announces the conclusion of the Center for Medicare & Medicaid Services (CMS) Accelerated and Advance Payment (AAP) Program, which launched in March to address payment disruptions resulting from the Change Healthcare cyberattack. Notes that over $2.55 billion has been distributed to Part A providers as a result of the program, which will conclude on July 12.
Source: Center for Medicare & Medicaid Services
GAO: Request for Nominations for the Physician-Focused Payment Model Technical Advisory Committee (PTAC)
Federal Register
Jun 12, 2024 - The Government Accountability Office (GAO) is accepting nominations for appointment to the Physician-Focused Payment Model Technical Advisory Committee (PTAC), which provides comments and recommendations to the Secretary of Health and Human Services on physician payment models. Nominations are due by July 10, 2024.
Source: Federal Register
Jun 6, 2024 - Features the perspective of the leadership of Mississippi hospitals who participate in the Rural Emergency Hospital (REH) Program, which launched in January 2023. Notes that REH conversion has led to pushback from some communities due to the loss of maternal care and other inpatient services. Explores additional considerations for hospital leadership, including loss of eligibility for the 340B Drug Pricing Program.
Source: Stateline