CMS, HHS Further Provider Relief Funds, Surprise Billing, Insurance Access
CMS issued a slew of notices and funding for improving rural healthcare and reprocessing outpatient claims while HHS focuses on provider relief fund, surprise billing, and insurance access.
Source: Getty Images
By - After a relatively quiet summer, HHS and CMS dove back into rulemaking, guideline issuing, and funding awards. Following vaccine mandates for all federal employees and healthcare settings, CMS issued funding to Texas, Washington, Alabama, and South Dakota organizations to bolster rural healthcare. The agency also advised it would begin reprocessing site-neutral outpatient claims from 2019 in accordance with the Physician Fee Schedule.
Meanwhile, HHS issued awards to improve patient access to state-based insurance marketplaces and bolster provider relief funds while cracking down on penalties for providers and facilities that are not in compliance with the No Surprises Act.
Biden Administration Requires Vaccines for Federal Employees, Healthcare Settings
The Biden Administration recently announced it will require COVID-19 vaccinations for federal employees and staff in Medicare and Medicaid-certified facilities. The order goes beyond the administration’s previous regulation for nursing homes to include hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies. Each agency is responsible for developing an independent plan for COVID-19 vaccinations at their facility under guidance from the Safer Federal Workforce Task Force. READ MORE
TX, WA, AL, SD Awarded CMS Funding to Transform Rural Healthcare, Telehealth
CMS announced $2 million in funding to Texas, Washington, Alabama, and South Dakota organizations to improve healthcare access and health equity in rural areas.
The Texas Health and Human Services Commission will use the funding to decrease unplanned hospital readmissions and increase access to primary and specialty care while the Washington State Healthcare Authority will put the funds toward testing evidence-informed community standards and addiction treatment.
Meanwhile, the University of Alabama at Birmingham and the South Dakota Department of Social Services will focus on improving telehealth services and access to transportation. All organizations will use the funding to address underlying disparities that exist in each of their respective areas and improve access to care in rural communities. READ MORE
CMS Will Reimburse Patients for Site-Neutral Outpatient Claims
On November 1, CMS will begin reprocessing outpatient clinic visit claims after a reinstated site-neutral payment policy. Claims with dates of service between January 1 and December 31, 2019, will be adjusted so the services are paid at the same rate as services at non-excepted off-campus provider-based departments according to the Physician Fee Schedule. No action is required on the provider side as CMS will independently process the necessary claims. READ MORE
HHS Awards $20 Million Toward Improving Access to Health Insurance
Through the American Rescue Plan, HHS Awarded $20 million to state-based marketplaces in an effort to increase member access to affordable health insurance coverage. Twenty-one state-based marketplaces will use the funding to modernize IT systems for targeted consumer outreach activities that make the enrollment process easier. The goal of the funding is for consumers to increase accessibility of these exchanges to members and increase the number of members covered by health insurance. READ MORE
HRSA to Distribute Further Provider Funding
The Health Resources and Services Administration (HRSA) will distribute further COVID-19 provider funding beginning September 29. The additional funding includes $8.5 billion from the American Rescue Plan to support rural providers and the fourth round of Provider Relief Fund distribution totaling $17 billion. This round of funding is set aside for smaller provider organizations, according to HHS, and includes bonus payments for providers who care for Medicare, CHIP, and Medicare patients. READ MORE
HHS Pitches More Surprise Billing Compliance Rules
HHS recently released a notice of proposed rulemaking to further enforce the No Surprises Act. The proposal would impose penalties of up to $10,000 on providers and facilities that are not in compliance with surprise billing rules. The amount of the penalty would be based on “the nature of claims of noncompliance and the circumstances under which such claims were presented.” READ MORE
