Home and Community-Based Settings Regulation – Implementation Timeline Extension and Revised Frequently Asked Questions State Medicaid Director Letter

Today, the Centers for Medicare & Medicaid Services (CMS) issued guidance to state Medicaid agencies informing them that the agency will be extending the deadline for ensuring compliance with the Home and Community-Based Settings Regulation, in response to the COVID-19 pandemic. CMS recognizes that states have faced significant challenges and delays in their implementation activities, and that service provision and community integration approaches have been disrupted.

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CMS Directs Additional Resources to Nursing Homes in COVID-19 Hotspot Areas

The Centers for Medicare & Medicaid Services (CMS) announced the agency’s targeted approach to provide additional resources to nursing homes in coronavirus disease 2019 (COVID-19) hotspot areas.  Specifically, CMS plans to deploy Quality Improvement Organizations (QIOs) across the country to provide immediate assistance to nursing homes in the hotspot areas as identified by the White House Coronavirus Task Force.

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CMS Issues Clarifications on How to Obtain Additional Coverage during the Pandemic

The Centers for Medicare & Medicaid Services (CMS) continues to clarify instructions on authorized Medicare coverage waivers and modifications due to the COVID-19 public health emergency (PHE) through a Medicare Learning Network (MLN) publication.[1] In a CMA Alert last month, the Center for Medicare Advocacy presented a case study that described the circumstances under which a beneficiary may qualify for an additional 100 days of coverage in a skilled nursing facility (SNF) due to the PHE.[2] CMS has recently confirmed that “beneficiaries who do not themselves have a COVID-19 diagnosis may nevertheless be affected by the PHE.”[3] CMS clarified that if “the beneficiary is receiving the very same course of treatment as if the emergency had never occurred”, the beneficiary would not qualify for additional SNF days.[4] However, the qualification states that a “determination basically involves comparing the course of treatment that the beneficiary has actually received to what would have been furnished absent the emergency.

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CMS Proposes Medicare Payment Changes to Support Innovation and Increased Access for Dialysis in the Home Setting

Rule proposes improved process to pay for innovative dialysis equipment and support home dialysis for Medicare’s most vulnerable population Today, the Trump Administration took dramatic steps to support access to home dialysis through the Centers for Medicare & Medicaid Services (CMS) proposed changes to the Medicare End-Stage Renal Disease (ESRD) Prospective Payment System (PPS). Building on President Trump’s Executive Order on Advancing American Kidney Health, CMS is proposing that certain new and innovative equipment and supplies used for dialysis treatment of patients with ESRD in the home would qualify for an additional Medicare payment.

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CMS publishes 2020-2021 Medicaid Managed Care Rate Development Guide

Today, the Centers for Medicare & Medicaid Services (CMS) released the 2020-2021 Medicaid Managed Care Rate Development Guide for use by states in setting their capitation rates between July 1, 2020 and June 30, 2021 for managed care programs subject to the actuarial soundness requirements. This guide includes information that states must include in their rate certifications to ensure that CMS can determine compliance with the applicable provisions in federal statute.

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Additional Medicaid & CHIP COVID-19 FAQs for State Medicaid and CHIP Agencies

Today, the Centers for Medicare & Medicaid Services (CMS) posted additional Frequently Asked Questions (FAQs) to Medicaid.gov, to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the coronavirus disease 2019 (COVID-19) pandemic. The new FAQs cover a variety of Medicaid and CHIP topics, including: Eligibility and Enrollment;Notice and Fair Hearings;Optional COVID-Testing Group FAQs;Premiums and Cost Sharing;Benefits;Non-Emergency Medical Transportation (NEMT);Information Technology; andFinancing These new FAQs have been integrated into the previously released COVID-19 FAQ document, as we have done with prior updates.

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CMS Announces Plans to End the Medicare Blanket Waiver Requiring Nursing Homes to Submit Staffing Data

Today, the Centers for Medicare & Medicaid Services (CMS) announced plans to end the Medicare emergency blanket waiver requiring all nursing homes to resume submitting staffing data through the Payroll-Based Journal (PBJ) system by August 14, 2020. The PBJ system allows CMS to collect nursing home staffing information which impacts the quality of care residents receive.

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Trump Administration Issues Call to Action Based on New Data Detailing COVID-19 Impacts on Medicare Beneficiaries

Data Underscores Need for Payment Models that Produce Better Health Outcomes  On June 22nd the Centers for Medicare & Medicaid Services (CMS) is calling for a renewed national commitment to value-based care based on Medicare claims data that provides an early snapshot of the impact of the coronavirus disease 2019 (COVID-19) pandemic on the Medicare population.  The data released today includes the total number of reported COVID-19 cases and hospitalizations among Medicare beneficiaries between January 1 and May 16, 2020.

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CMS Unveils Major Organizational Change to Reduce Provider and Clinician Burden and Improve Patient Outcomes

FOR IMMEDIATE RELEASE June 23, 2020 Contact: CMS Media Relations (202) 690-6145 | CMS Media Inquiries CMS Unveils Major Organizational Change to Reduce Provider and Clinician Burden and Improve Patient Outcomes New office to continue agency’s work of reducing regulatory burden to allow providers to focus on patients instead of paperwork and reducing health care costs Today, the Centers for Medicare & Medicaid Services (CMS) is announcing the creation of the Office of Burden Reduction and Health Informatics to unify the agency’s efforts to reduce regulatory and administrative burden and to further the goal of putting patients first.

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Trump Administration Issues Call to Action Based on New Data Detailing COVID-19 Impacts on Medicare Beneficiaries

Today the Centers for Medicare & Medicaid Services (CMS) is calling for a renewed national commitment to value-based care based on Medicare claims data that provides an early snapshot of the impact of the coronavirus disease 2019 (COVID-19) pandemic on the Medicare population.  The data shows that older Americans and those with chronic health conditions are at the highest risk for COVID-19 and confirms long-understood disparities in health outcomes for racial and ethnic minority groups and among low-income populations.

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