On November 1, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after January 1, 2020. The rule includes an 8% cut from Medicare payments for physical and occupational therapy services starting in 2021.
Seema Verma, administrator for the Centers for Medicare & Medicaid Services, sat down for a rare one-on-one interview with Kaiser Health News senior correspondent Sarah Varney.
They discussed her views on President Donald Trump’s plan for sustaining public health insurance programs, how the administration would respond if Obamacare is struck down by the courts in the future and her thoughts on how the latest “Medicare for All” proposals would affect innovation and access to care.
A new study published by yesterday afternoon shows that about 75% of nursing homes in this country are understaffed, and that levels self-reported by nursing home administrators used in the CASPER system were higher than payroll data.
This March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries mThis March, Congress will re-introduce legislation with bipartisan support to allow Medicare beneficiaries that are hospitalized in observation to qualify for SNF coverage following their hospital stay. Currently, under the three-midnight rule, beneficiaries must have been categorized as being an inpatient in a hospital for three midnights in order to qualify for a Medicare Part A SNF stay.
Between 2011 to 2016, Medicare fee-for-service drug spending increased from $17.6 billion to $28 billion under Medicare Part B. Medicare Part D total spending has almost doubled from 2010 to 2016, increasing from $77.5 billion to $146.1 billion, with costs projected to increase further, according to the Centers for Medicare & Medicaid Services (CMS). Drug prices for beneficiaries in the U.S. are also on the rise and can be found in places like Europe for up to 80% cheaper, according to NPR. The cause? A market full of hurdles and barriers to creating biosimilars (drugs with the same or similar active ingredients as the original and often available at a reduced price); current laws that prevent vendors from negotiating drug prices; and outrageous prices for essential drugs that treat ever-more-common chronic conditions, such as cancer, rheumatoid arthritis, and hepatitis C.
Earlier this month CMS announced the release of a new app, “What’s Covered,” that allows people to quickly look up what Original Medicare covers using their mobile device. In addition to the “What’s Covered” app, CMS is enabling beneficiaries to connect their claims data to applications and tools developed by innovative private-sector companies to help them understand, use, and share their health data through Blue Button 2.0.