Billy Wynne

FY 2021 IRF Final Rule Estimates Net Payment Increase of 2.8 Percent; Finalizes Additional Changes to Reduce Provider Burden and Mirror COVID-19 Temporary Flexibilities The Centers for Medicare & Medicaid Services (CMS) released the fiscal year (FY) 2021 inpatient rehabilitation facility (IRF) prospective payment system (PPS) final rule. The rule finalizes important payment and policy…

In CY 2021 Hospital Outpatient and ASC Proposed Payment Rule, CMS would Deepen Cuts to 340B, Expand Site Neutrality The Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2021 hospital outpatient prospective payment system (OPPS) proposed rule (fact sheet) addressing payments to hospital outpatient departments and ambulatory surgery centers (ASCs). Addenda…

CY 2021 MPFS Proposed Rule Includes Provisions to Make Certain COVID-19 Telehealth Flexibilities Permanent; Also Includes Changes to QPP, E/M Code Valuation, and Providers’ Scopes of Practice The Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) proposed rule, which addresses an array of policies under…

President Trump Issues Executive Order on Improving Rural Health and Telehealth Access President Trump signed an Executive Order (EO) (fact sheet) intended to expand and maintain access to telehealth services during the COVID-19 pandemic, with a focus on access in rural areas. The move follows the release of four EOs on drug pricing in July…

Department Extends PRF Application Period for Medicaid and CHIP Providers; Permits Reapplication for Providers with Ownership Changes in 2020 On July 31, the Department of Health and Human Services (HHS) announced it would extend the deadline until August 28 for Medicaid, Children’s Health Insurance Program (CHIP), and dental providers to apply for the $15 billion…

Agency Finalizes FY 2021 Post-Acute Medicare Payment Rules for SNFs, Hospices, IPFs The Centers for Medicare and Medicaid Services (CMS) released final rules for fiscal year (FY) 2021 Medicare payment across three different post-acute care payment systems. What they are. The three final rules pertain to the: Skilled nursing facility (SNF) prospective payment system (PPS):…

Court Sides with CMS on Cuts to 340B Hospitals On July 31, 2020, the U.S. Court of Appeals for the District of Columbia ruled in favor of the Centers for Medicare & Medicaid Services (CMS) cuts to the 340B hospital program. This decision reverses one previously issued by a lower court in 2019, which said…

ASPE Releases Report on Surprise Medical Billing Required by President’s Executive Order on Transparency The Department of Health and Human Services (HHS), through the Assistant Secretary for Planning and Evaluation (ASPE), released a report on surprise medical billing (press release). The report was issued in response to the President’s Executive Order (EO) on transparency that…

Agency Announces 2021 Average Basic Premiums for Part D; Touts Additional Modifications to Part D Program The Centers for Medicare & Medicaid Services (CMS) announced the 2021 average basic premium for Medicare Part D plans. Next year, CMS states the average basic Part D premium will be $30.50, which is reportedly the second lowest average…

ASPE Releases Report on Medicare Telehealth Utilization During the COVID-19 Pandemic The Department of Health and Human Services (HHS), through the Assistant Secretary for Planning and Evaluation (ASPE), released a report on Medicare beneficiary telehealth utilization during the COVID-19 pandemic (press release). The report analyzes Medicare fee-for-service (FFS) claims data from January through May 2020…