Legislation

Provider Requirements Under the No Surprises Act Special ODF — December 8 Wednesday, December 8 from 2 – 3 pm ET CMS will host a Special Open Door Forum (SODF) to explain provider requirements under the No Surprises Act. Starting January 1, 2022,consumers will have new billing protections when getting emergency care, non-emergency care from out-of-network providers at in-network facilities, and air ambulance services from out-of-network providers. These requirements generally apply to items and services provided to people enrolled in group health [...]

CMS Encourages People with Medicare to get COVID-19 Vaccine Booster Shot As part of the Biden-Harris Administration’s ongoing efforts to ensure that Americans are vaccinated against COVID-19 and to reduce stress across the nation’s health care system, the Centers for Medicare & Medicaid Services (CMS) is encouraging those with Medicare who are fully vaccinated to get a booster dose of the COVID-19 vaccine. Data shows that a COVID-19 vaccine booster dose increases immune response, which improves protection against [...]

  AAOS Advocacy in Action In a letter from organizations representing over 1M physicians and non-physician health care providers, AAOS urged Congress to act before the end of the year to extend the 3.75% payment adjustment through at least 2022.       Action Alert: Urge Congress to Avert Pay Cuts Before 2022     Physicians are set to face significant cuts to Medicare reimbursement in 2022 despite the ongoing challenges they already face related to the COVID-19 pandemic. Absent congressional [...]

News Provider Relief Fund Reporting Deadline: November 30, 2021 HIV: Talk to Your Patients About Prevention & Screening Home Health & Hospice: Medicare Provider Resources COVID-19: Pfizer & Modena Booster Shots for 18 Years and Older Compliance DMEPOS Standard Written Order Requirements Claims, Pricers, & Codes IPPS, IRF & LTCH: New Web Pricer Released for FY 2022 MLN Matters® Articles Summary of Policies in the Calendar Year (CY) 2022 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site [...]

  AAOS Advocacy in Action Expressed support with the American Association of Hip and Knee Surgeons for the re-specification of the hospital THA/TKA patient-reported outcome-based performance measure, but stated that it is premature to introduce the measure at this time. Asked Congress, along with 19 other organizations, that the FY 2022 final appropriations bill include $7 million for the Pediatric Device Consortia grant program. Urged the Department of Health and Human Services--with the American Medical Association, state medical associations, [...]

News CMS Repeals MCIT/R&N Rule; Will Consider Other Coverage Pathways to Enhance Access to Innovative Medical Devices Changes to Nursing Home Visitation COVID-19 (Revised) & COVID-19 Survey Activities Annual Medicare Participation Open Enrollment Period It’s Not Too Late to Vaccinate Post-Acute Care QRP: Job Aids & Pocket Guides Quality Payment Program: 2020 Doctors & Clinicians Preview Period Open Until December 14 Lung Cancer Awareness: Help Your Patients Reduce Their Risk Claims, Pricers, & Codes Upcoming Quarterly Update to [...]

News Provider Enrollment Application Fee for CY 2022 LTCH & IRF: CY 2022 QRP Updates Critical Care E/M Services: Comparative Billing Report in November Diabetes Resources for You & Your Patients Compliance DMEPOS: Bill Correctly for Items Provided During Inpatient Stays Claims, Pricers, & Codes HCPCS Application Summaries & Coding Decisions: 510(k)-Cleared Wound Care Products Events HCPCS Public Meeting — December 1 & 2 MLN Matters® Articles Medicare Part B CLFS: Revised Information for Laboratories on Collecting & [...]

News COVID-19 Vaccines for Children COVID-19 Vaccine & Monoclonal Antibody Products: Changes for MA Plan Claims Starting January 1, 2022 Multi-Factor Authentication Requirement for PECOS Events Medicare Clinical Laboratory Fee Schedule Private Payor Data Collection & Reporting Webinar — November 10 COVID-19 Vaccine Webinar for Rural Communities — November 15 MLN Matters® Articles Manual Updates for Clarification on the Election Statement Addendum and Extension of the Hospice Cap Calculation Methodology Fiscal Year (FY) 2022 Inpatient Prospective Payment System [...]

National requirement protects patients at nearly 76,000 providers and covers more than 17 million health care workers The Biden-Harris Administration is requiring COVID-19 vaccination of eligible staff at health care facilities that participate in the Medicare and Medicaid programs. The emergency regulation issued by the Centers for Medicare & Medicaid Services (CMS) today protects those fighting this virus on the front lines while also delivering assurances to individuals and their families that they will be protected when seeking [...]

  AAOS Advocacy in Action In a meeting with regulatory leaders on Oct. 29, highlighted the concern that current surprise billing regulations give primary consideration to the Qualifying Payment Amount during independent dispute resolution in contradiction to statutory intent. Helped garner senatorial support for the bipartisan, bicameral Improving Seniors' Timely Access to Care Act, which was recently introduced as companion legislation to the House bill and would streamline prior authorization for the Medicare Advantage program. Joined the American Podiatric [...]