CMS Proposes ESRD Value-Based Payment, Surprise Billing Final Rule

July 07, 2021 - CMS proposed a value-based payment model for the treatment of end-stage renal disease and released a final ruling to combat surprise billing. Meanwhile, Congress introduced a bill to expand broadband access and promote telehealth adoption while the DoD is requiring additional cybersecurity certificates for some employees.

Proposed BRIDGE Act of 2021 Would Expand Broadband Access, Telehealth

The Broadband Reform and Investment to Drive Growth in the Economy (BRIDGE) Act of 2021 was re-introduced with bipartisan support to expand broadband access across the country. The bill would provide $40 billion to areas of the country with limited broadband access to close the digital divide and give these communities better access to high-speed internet. In turn, this would also allow for greater telehealth adoption and use. READ MORE

DoD Requires Additional Cybersecurity, Privacy Certificates

The US Department of Defense (DoD) recently announced it will require certain cybersecurity staff to complete additional privacy and cloud security certifications. Under the DoD’s Cyber Workforce Management Program, employees are required to complete baseline certifications. The two additional (ISC)2 certificates—the Certified Cloud Security Professional and the HealthCare Information Security and Privacy Practitioner—emphasize DoD’s focus on protecting health information and cloud data. READ MORE

CMS Proposed Rule Supports Value-Based Payment for End-Stage Renal Disease

CMS announced several proposed changes to end-stage renal disease payment and quality reporting measures for calendar year 2022. Under the proposed rule, funding for end-stage renal disease facilities would increase to $8.9 billion. The proposed rule also includes updates to acute kidney injury dialysis payment rates for dialysis done in end-stage renal facilities and a delay in the use of some quality measures, like standardized hospitalization ratio, until 2022 because of the pandemic’s impact. READ MORE

Comment Period Open for Surprise Billing Interim Final Rule

Last year, the No Surprises Act passed as an effort to protect patients from unexpected and excessive out-of-network bills. Recently, HHS, the Department of Labor, Department of the Treasury, and the Office of Personnel Management released an interim final rule to begin meaningful steps toward fulfilling this goal. The rule is titled “Requirements Related to Surprise Billing; Part 1” and provisions of include:

• Ban on surprise billing for emergency services
• Ban on out-of-network services if they exceed patient cost-sharing for in-network services
• Ban on out-of-network charges for ancillary care performed at in-network facilities
• Ban on out-of-network charges without prior notice in plain-language

Health plans are slated to meet these requirements beginning January 1, 2022. Meanwhile, the interim final rule is open for public comment. READ MORE