';
CLOSE
Tags Posts tagged with "CMS"

CMS

0 1056

ODP Announcement 22-085 announces clarification for Supports Coordination Organizations (SCO) on resuming Waiver and Targeted Support Management (TSM) Supports Coordination (SC) in-person monitoring. Many adjustments have been made to the Office of Developmental Programs (ODP) policy and operations during the COVID-19 pandemic. Appendix K allowed for SC services to be provided remotely during the pandemic. ODP planned to replace the Appendix K guidance with new requirements detailed in the Intellectual Disability and Autism (ID/A) Waiver renewals and the Adult Autism Waiver (AAW) amendment effective July 1, 2022, to allow for some SC individual monitoring to continue to be completed remotely.

Both the ID/A Waiver renewals and the AAW amendment are pending approval with the Centers for Medicare and Medicaid (CMS). Therefore, ODP is issuing guidance to clarify the expected requirements of individual monitorings performed by SCs. This announcement outlines the updated requirements for SC in-person and remote monitoring and obsoletes that section of Appendix K.

ODP expects SCOs that were unable to meet the June 30 deadline for completing the in-person monitoring for at-risk individuals to continue to follow their plan and communicate with the ODP regional office to ensure that all the priority individuals are seen in-person.

This announcement outlines requirements for SCOs to implement no later than October 1. For additional questions, please contact your appropriate ODP regional office.

0 1125

The Centers for Medicare & Medicaid Services (CMS) released a State Medicaid Director Letter (SMDL 22-003) providing guidance for the first-ever Home and Community-Based Services (HCBS) Quality Measure Set, the first of two planned guidance documents from CMS.

The HCBS Quality Measure Set is included in the SMDL, starting on page 14. The list of measures includes the NQF number (if applicable), measure steward, and data collection method, as well as information on whether each measure addresses section 1915(c) waiver assurances and/or can be used to assess access, LTSS rebalancing, and/or community integration and HCBS settings requirements.

Most of the measures are derived from consumer surveys; CMS gives states the flexibility to select measures from the consumer survey of their choice from the following validated tools: NCI®-IDD, NCI-AD™, HCBS CAHPS®, and POM®.

Visit here for more information.

0 687

On July 13, 2022, the Centers for Medicare and Medicaid Services’ (CMS) Medicare Administrative Contractors (MACs) distributed notifications to inpatient rehabilitation facilities (IRFs) that were determined to be out of compliance with Quality Reporting Program (QRP) requirements for calendar year (CY) 2021, which will affect their FY 2023 Annual Payment Update (APU). Non-compliance notifications were placed into facilities’ “Certification and Survey Provider Enhance Reports” (CASPER) folders in the Quality Improvement and Evaluation System (QIES) for hospice and skilled nursing facilities (SNFs), and into facilities’ “My Reports” folders in the Internet Quality Improvement and Evaluation System (iQIES) for IRFs and long-term care hospitals (LTCHs). If a facility received a letter of non-compliance, it may submit a request for reconsideration to CMS via email. The submission deadline is 11:59 pm on August 11, 2022. View the full details and instructions for submission here.

0 1161

On July 7, 2022, the Centers for Medicare and Medicaid Services (CMS) released the proposed Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2023. In this proposed rule, CMS is proposing an approximately 4 percent reduction to the base payment factor for all services for 2023. The specific level of adjustment providers may see will depend on changes CMS finalizes to other factors. CMS is also proposing to expand the list of codes that can be provided via telehealth through 2023 to include some therapy codes. Modifications to the Quality Payment Program (QPP), which includes the Merit-Based Incentive Payment System (MIPS), to allow for additional pathways for participation for certain specialties is also being proposed. The proposed rule will appear in the July 29 Federal Register.

0 718

The Centers for Medicare & Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver amendment that transfers oversight of Financial Management Services (FMS) from an OLTL-held contract to an administrative function of the CHC-MCOs and revises waiver performance measure AA-5. The amendment became effective on July 1, 2022.

The current approved CHC 1915(c) Waiver document with the FMS amendment can be viewed here. The link can be found under the heading “Community HealthChoices 1915(b) Managed Care and 1915(c) Home and Community-Based Waivers.”

Questions about the CHC Waiver amendment should be sent via email.

0 712

ODP Announcement 22-076 serves to announce that the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) Waiver renewals, collectively known as the Intellectual Disability/Autism (ID/A) waivers, will not be effective on July 1, 2022, as requested.

This extension does not apply to the Adult Autism Waiver (AAW). The currently-approved AAW was most recently amended on April 1, 2022.

Discussions between the Office of Developmental Programs (ODP) and the Centers for Medicare & Medicaid Services (CMS) have been occurring since the submission of the waiver renewals. During recent discussions, it has become clear that the process to renew the waivers will not be complete by July 1. ODP requested a 90-day extension of the currently-approved waivers on June 27, 2022, since the Consolidated and Person/Family Directed Support waivers expire on June 30, 2022. CMS granted the extension request on June 27, 2022.

Until CMS approves the ID/A waiver renewals, the waiver amendments approved with an effective date of June 1, 2022, remain in effect. They can be found on the Department of Human Services website at the following links:

The ID/A waiver renewals submitted to CMS on April 1, 2022, are also available.

Additional changes will be made to the waiver renewals as a result of ongoing discussions with CMS. ODP will inform all stakeholders when the waiver renewals have been approved. The final approved versions of the waivers will be made available online at that time.

0 1216

The Centers for Medicare and Medicaid Services (CMS) recently issued updates associated with the inpatient rehabilitation facility (IRF) provider preview reports and the IRF Patient Assessment Instrument (PAI).

CMS has released the updated IRF Provider Preview Reports, which contain provider performance scores for quality measures and contain IRF-PAI data submitted by IRFs from Quarter 1 (Q1) 2021 through Quarter 4 (Q4) 2021, as well as CDC Clostridium Difficile (CDI) and Catheter-Associated Urinary Tract Infections (CAUTI) measures from Quarter 4 (Q4) 2020 through Quarter 3 (Q3) 2021, and Q4 2018 through Q1 2019 of the Healthcare Personnel (HCP) Influenza measure. The new HCP COVID-19 Vaccination Coverage measure will also be publicly reported on Care Compare in the September 2022 release and will reflect Q4 2021 data. Unlike prior September Care Compare refreshes, CMS will not be preforming the annual update to IRF claims-based measures, due to CMS only resuming the reporting of claims-based measures during the June 2022 refresh.

Providers have until July 15, 2022, to review their performance data. Providers can request CMS review their data during the preview period if they believe the scores are inaccurate. The final reports will be published on Care Compare and Provider Data Catalog during the September 2022 refresh of the website. Additional information is on the CMS IRF Quality Reporting Program (QRP) public reporting website.

CMS also published the IRF-PAI Quarterly Questions & Answers (Q&A) document that provides clarification to existing guidelines.

0 1029
Medicare binary sign concept illustration design over black

The Centers for Medicare and Medicaid Services (CMS) is conducting interactive training webinars that cover Medicare basics today, June 14, 2022, and tomorrow, June 15, 2022, from 1:00 pm – 3:00 pm. The topics and registration links for both days are provided below:

Day 1 (June 14) — Topics will include Medicare enrollment and eligibility; SSA and CMS roles and responsibilities; cost and coverage under Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance); why enrolling on time is important; and an overview of Medicare Supplement Insurance (Medigap) policies.

Register for the Day 1 webinar here.

Day 2 (June 15) — Topics will include Medicare drug coverage (Part D); Medicare Advantage Plans; coordination of benefits; how to detect and report suspected Medicare fraud, waste, and abuse; and different resources to help you find answers to Medicare policy and coverage questions.

Register for the Day 2 webinar here.

These webinars will be recorded and posted to the National Training Program (NTP) website. You can view the recordings here.

0 1834

ODP Announcement 22-061 is to announce that the amendments to the Consolidated, Community Living, and P/FDS waivers (hereafter referred to as the Intellectual Disability and Autism (ID/A) waivers) were approved by the Centers for Medicare & Medicaid Services (CMS) effective June 1, 2022.

The ID/A waiver amendments were submitted to CMS on January 3, 2022. Since that time, the Office of Developmental Programs (ODP) has been engaged in ongoing discussions with CMS. Substantive changes were approved as follows:

  • Eligibility was expanded to include children with a developmental disability due to a medically complex condition. The Family Medical Support Assistance service was added to support the complex medical needs of these children. Provider qualification criteria were enhanced to ensure providers have the needed structure to support these children.
  • Delivery of services while the participant is hospitalized is currently allowed through Appendix K flexibilities. Guidance regarding delivery of services while the participant is hospitalized is contained in the Operational Guide. This guidance should continue to be followed until otherwise notified.
  • Homemaker services include infection control measures and intensive cleaning, such as cleaning medical equipment and disinfecting the home.
  • Home accessibility adaptations support individuals to transition from an institutional setting to a private home (including a Life Sharing home) and clarify covered home accessibility adaptations due to changes in Medical Assistance.
  • Transition to Independent Living payments were added to the Consolidated Waiver to support participants to transition from residential habilitation homes to Life Sharing or Support Living.
  • Changes were made to residential qualification requirements to ensure that all residential providers are adequately prepared prior to delivering a service and prior to the provider going through ODP’s qualification process.

The following rates, as communicated in ODP Announcement 22-051, are also effective June 1, 2022, when authorized on an Individual Support Plan:

  • Family Medical Support Assistance services;
  • Medically Complex Life Sharing services in the Consolidated Waiver; and
  • Transition to Independent Living payments in the Consolidated Waiver. Each full waiver application approved by CMS and the record of change document are available here.

ODP will be scheduling webinars soon to discuss the changes made in these approved amendments, as well as changes made to the July 2022 waiver renewals once they are approved by CMS. ODP will release a communication announcing the webinars when the waiver renewals are approved. Questions about this communication should be directed to the appropriate Office of Developmental Programs Regional Office.

Prev1...121314...25Next Page 13 of 25
© 2021 - Rehabilitation & Community Providers Association