ICYMI, here is recent communication from CMS.
Events
Overview of the Quality Payment Program Policies in the CY 2024 Medicare Physician Fee Schedule (PFS) Final Rule
When: Tuesday, November 14, 2023 2:30pm ET
Register for this event.
Following the release of the 2024 Medicare Physician Fee Schedule (PFS) Final Rule, CMS will host a public webinar to provide an overview of the changes in policies for the Quality Payment Program.
We’re days away from the 2023 CMS Optimizing Healthcare Delivery Conference to Improve Patient Lives. Join us virtually on 11/15 to hear from thought leaders on reducing administrative burden and improving patient lives #CMSoptimizingcare Register now: https://t.co/8nAweYVd2p pic.twitter.com/t8J6XA2W1E
— CMSGov (@CMSGov) November 10, 2023
CMS Innovation Center
How are we doing with incorporating patient perspectives across models? Sign up for the Innovation Center’s upcoming #personcenteredcare listening session on 11/15, 12-1P ET, to learn more from CMS and other experts and provide feedback: https://t.co/GPAgAWgHAx pic.twitter.com/w4Iem4CGWw
— CMS Innovation Ctr (@CMSinnovates) November 3, 2023
MIPS News
Considering virtual group participation for the 2024 #MIPS performance year? Download our #QPP toolkit to learn about the virtual group two-step election process today: https://t.co/c0yXA6CNa0 pic.twitter.com/hHwPRmGYps
— CMSGov (@CMSGov) November 6, 2023
Reminder: 2024 Merit-based Incentive Payment System (MIPS) Performance Year Virtual Group Election Period Open
If you’re interested in forming a virtual group for the 2024 MIPS performance year, the election period is open. To form a virtual group, an election must be submitted to CMS via email at MIPS_VirtualGroups@cms.hhs.gov until December 31, 2023 (11:59 p.m. ET).
News
CMS Finalizes Physician Payment Rule that Advances Health Equity
CMS announced it is finalizing policies to support primary care, advance health equity, assist family caregivers and expand access to behavioral and certain oral health care. These policies are included in the calendar year (CY) 2024 Medicare Physician Fee Schedule (PFS) final rule, which also provides payment for principal illness navigation services to help patients and their families navigate cancer treatment and treatment for other serious illnesses, supporting the Biden-Harris Administration’s Cancer Moonshot mission to accelerate the fight against cancer.
CMS Makes Hospital Prices More Transparent and Expands Access to Behavioral Health Care
CMS announced it is expanding access to behavioral health services for people with Medicare through coverage of intensive outpatient services and that it is making it easier for the public to learn what a hospital charges for items and services through improved hospital price transparency requirements. These policies are included in the calendar year (CY) 2024 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rule with comment period released, which also updates payment rates by 3.1% for hospital outpatient and ASC services for calendar year 2024.
CMS Announces Extension of Medicare Diabetes Prevention Program Enhancements
CMS announced on November 1, 2023 that it will extend the Medicare Diabetes Prevention Program (MDPP) Expanded Model’s Public Health Emergency Flexibilities for four years. Previously, MDPP suppliers were required to resume in-person delivery of the MDPP set of services after December 31, 2023.
Biden-Harris Administration Launches ‘Birthing-Friendly’ Designation on Web-Based Care Compare Tool
CMS will begin displaying the ‘Birthing-Friendly’ designation icon on CMS’s Care Compare online tool. CMS created the new designation to identify hospitals and health systems that participate in a statewide or national perinatal quality improvement collaborative program and that implement evidence-based care to improve maternal health. The public can use the Care Compare tool — along with a complementary interactive map — to find a hospital or health system with the ‘Birthing-Friendly’ designation in their area. This action is one of many key efforts being implemented as part of the White House Blueprint for Addressing the Maternal Health Crisis and is part of Vice President Harris’ nationwide call to action to reduce maternal mortality and morbidity. It also meets a milestone in the CMS Maternity Care Action Plan.
Quality Payment Program
CMS Publishes 2024 Policy Changes for the Quality Payment Program
CMS has released the CY 2024 Medicare Physician Fee Schedule (PFS) Final Rule, which includes policy changes for the Quality Payment Program (QPP) for the 2024 Performance Year (PY) and beyond. This rule will be published on November 16 in the Federal Register.
CMS has finalized new #QPP policies in the 2024 Physician Fee Schedule Final Rule to promote more meaningful participation for clinicians. Our new resources provide an overview of the #MIPS and #APM policy changes: https://t.co/cG4hV4ymlH pic.twitter.com/H7hYJ5f7GX
— CMSGov (@CMSGov) November 7, 2023
Considering participating in #QPP via traditional #MIPS, #MIPS Value Pathways (MVPs), or APM Performance Pathway (APP) for the 2024 performance year? Learn about finalized #QPP program updates in the 2024 Physician Fee Schedule Final Rule: https://t.co/r4DftxH4wO pic.twitter.com/kbDm94EEua
— CMSGov (@CMSGov) November 6, 2023
ATTN #QPP participants: CMS is still accepting exception applications for the 2023 #MIPS performance year. Find out if you qualify: https://t.co/IwzcdGdrcX pic.twitter.com/vY3Bys9lbb
— CMSGov (@CMSGov) November 3, 2023
Administrative Simplification
#DYK you can file a complaint against a #HIPAA covered entity that isn’t complying with Administration Simplification requirements for electronic health care transactions? If you think an entity is in violation, follow these steps: https://t.co/lJjkVSShD5 #AdminSimp pic.twitter.com/Xxtbp6rWXc
— CMSGov (@CMSGov) November 6, 2023
.@HHSgov-adopted code sets help reduce confusion about which codes should be used in electronic health care transactions. Learn more here: https://t.co/7B0ShHKK8d #AdminSimp pic.twitter.com/fzRQYHnKks
— CMSGov (@CMSGov) November 2, 2023
MLN Matters Articles
- Medicare Deductible, Coinsurance, & Premium Rates: CY 2024 Update
- Processing Claims Affected by Retroactive Entitlement
- Update for Blood Clotting Factor Add-on Payments
- ICD-10 & Other Coding Revisions to National Coverage Determinations: October 2023 Update
- Limitation on Recoupment of Overpayments
- Inpatient & Long-Term Care Hospital Prospective Payment System: FY 2024 Changes
- Ambulatory Surgical Center Payment System: October 2023 Update
- DMEPOS Fee Schedule: October 2023 Quarterly Update
- Hospital Outpatient Prospective Payment System: October 2023 Update
- Changes to the Laboratory National Coverage Determination Edit Software: January 2024 Update
- Inpatient Psychiatric Facilities Prospective Payment System: FY 2024 Updates
Claims, Pricers, & Codes
- Vagus Nerve Stimulators: Transitional Pass-through Status for HCPCS Code C1827
- Conditional Payment Claims: Continue to Submit to Your Medicare Administrative Contractor
- Home Health Consolidated Billing Enforcement: CY 2024 HCPCS Code
- HCPCS Application Summaries & Coding Decisions: Drugs & Biologicals
- RARCs, CARCs, Medicare Remit Easy Print, & PC Print: October Update
- ICD-10 Coordination & Maintenance Committee: Meeting Materials & Deadlines
- National Correct Coding Initiative: October Update
- Integrated Outpatient Code Editor: Version 24.3
CMS Innovation Center
Attention Medicare Diabetes Prevention Program (MDPP) Expanded Model suppliers – you can now continue to offer distance learning through 12/31/2027. For more info visit the proposed rule: https://t.co/vW1zQIf9BD pic.twitter.com/2Ts9Wze8gJ
— CMS Innovation Ctr (@CMSinnovates) November 2, 2023
#ICYMI the States Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model’s goals are collaborating w/states to curb #healthcarecosts, improving #populationhealth & advancing #healthequity. Visit the model infographic to learn more: https://t.co/oaMt227018 pic.twitter.com/7Doa7BS6tJ
— CMS Innovation Ctr (@CMSinnovates) October 27, 2023
New Making Care Primary (MCP) Applicant Resources
The CMS Innovation Center’s Making Care Primary (MCP) Model team has made available a step-by-step Application User Manual to support new user registration, portal navigation, and application submission. The manual includes all application questions, instructions for completion, as well as screenshots of the application portal for ease of use. Materials from the October 24 Office Hours event are forthcoming.