Now Available – IRF and LTCH Provider Preview Reports

December 15, 2023

Now Available – IRF and LTCH Provider Preview Reports

The Long-Term Care Hospital (LTCH) Provider Preview Reports have been updated and are now available. These reports contain provider performance scores for quality measures, which will be published on Care Compare and Provider Data Catalog (PDC) during the March 2024 refresh.

The data contained within the Preview Reports are based on quality assessment data submitted by LTCHs from:

  • Quarter 3, 2022 through Quarter 2, 2023, and
  • LTCH Change in Mobility measure, Quarter 3, 2021 through Quarter 2, 2023.

Additionally, the Centers for Disease Control and Prevention (CDC) measures reflect data from:

  • Quarter 2, 2022 through Quarter 1, 2023 for the Clostridium Difficile Infection (CDI),
  • Catheter-Associated Urinary Tract Infections (CAUTI), and Central Line-Associated Bloodstream Infections (CLABSI) measures, Quarter 4, 2022 through Quarter 1, 2023 for the Healthcare Personnel (HCP) Influenza measure, and
  • Quarter 2, 2023 for the COVID-19 Vaccination Coverage among Healthcare Personnel (HCP) measure.

The data for the claims-based measures will display data from Quarter 4, 2020 through Quarter 3, 2022 for this refresh.

Providers have until January 16, 2024, to review their performance data. Only updates/corrections to the underlying assessment data before the final data submission deadline will be reflected in the publicly reported data on Care Compare.

If a provider updates assessment data after the final data submission deadline, the updated data will only be reflected in the Facility-Level Quality Measure (QM) report and Patient-Level QM report. Updates submitted after the final data submission deadline will not be reflected in the Provider Preview Reports or on the Care Compare website. However, providers can request Centers for Medicare & Medicaid Services (CMS) review of their data during the preview period if they believe the quality measure scores that are displayed within their Preview Reports are inaccurate.

For more information, please visit the CMS LTCH QRP Public Reporting website.

For more information, please visit the CMS IRF QRP Public Reporting website.

Survey Results: Rural Physician and Advanced Practice Provider Compensation

December 6, 2023

Survey Results: Rural Physician and Advanced Practice Provider Compensation

The first-of-its-kind survey provides a path forward for rural healthcare organizations by outlining provider compensation trends, best practices and potential challenges leaders might face when recruiting and retaining top talent in rural healthcare.

Key Takeaways from Survey

  • The majority of provider compensation is not tied to incentives
  • Salary variability continues to increase
  • Salary increase are not necessarily tied to position shortages
  • Independent and affiliated rural hospitals may not know what they are paying providers covered under Professional Service Agreements (PSAs)

See Survey Results

OIG Issues Remote Patient Monitoring (RPM) Alert

December 1, 2023

OIG Issues Remote Patient Monitoring (RPM) Alert

The Office of Inspector General (OIG) is alerting the public about a fraud scheme involving monthly billing for remote patient monitoring. Please educate staff and patients with this important information.

Legitimate RPM involves using medical devices such as scales, glucose monitors, blood pressure cuffs, cardiac rhythm devices, and other equipment to remotely monitor for anomalies in patients with chronic medical conditions. This new treatment is beneficial for those whose condition might deteriorate quickly, where monitoring can reduce complications, hospitalizations or death.

However, the OIG has found unscrupulous companies are signing up Medicare enrollees for this service, regardless of medical necessity. Most often, the monthly monitoring never happens, but the enrollee is billed monthly anyway.

  • Scammers target Medicare enrollees through calls, texts, and Internet ads
  • Scammers steal Medicare numbers and other personal information
  • Scammers then bill Medicare for services that are unnecessary or never provided

Report Fraud

Learn More

American Institute of Healthcare Compliance – Evaluation and Management (E/M) Visits

December 1, 2023

American Institute of Healthcare Compliance – Evaluation and Management (E/M) Visits

Beginning January 1, 2024, the Centers for Medicare and Medicaid (CMS) is finalizing implementation of a separate add-on payment for healthcare common procedure coding system (HCPCS) code G2211.

  • This add-on code will better recognize the resource costs associated with evaluation and management visits for primary care and longitudinal care.
  • Generally, it will be applicable for outpatient and office visits as an additional payment, recognizing the inherent costs involved when clinicians are the continuing focal point for all needed services, or are part of ongoing care related to a patient’s single, serious condition or a complex condition.

Split (or shared) Evaluation and Management (e/M) visits

Split (or shared) E/M visits refer to visits provided in part by physicians and in part by other nonphysician practitioners in hospitals and other institutional settings.

  • For CY 2024, CMS is finalizing a revision to the definition of “substantive portion” of a split (or shared) visit to include the revisions to the Current Procedural Terminology (CPT) guidelines, such that for Medicare billing purposes, the “substantive portion” means more than half of the total time spent by the physician or nonphysician practitioner performing the split (or shared) visit, or a substantive part of the medical decision making.
  • This responds to public comments asking that it be allowed that either time or medical decision making to serve as the substantive portion of a split (or shared) visit.

Click here for more PFS information from CMS

Click here for the November press release which provides a summary of changes

Inflation Reduction Act – Funding and Tax Credits for Rural Health Organizations

November 22, 2023

Inflation Reduction Act – Funding and Tax Credits for Rural Health Organizations

On Friday October 20th, Assistant Secretary for Health, Admiral Rachel Levine announced that OCCHE will be launching a “catalytic program” early in 2024 to support health care providers and especially safety net organizations in taking advantage of the tax credits, grants and other supports made available by the historic Inflation Reduction Act (IRA). This legislation creates unprecedented opportunities for health sector organizations to make investments in clean energy, building efficiency, infrastructure resilience and more.

OCCHE’s planned initiative will occur through collaboration with federal partners including the Environmental Protection Agency and Department of Energy and will feature national webinars as well as breakout sessions by provider type to help organizations’ assess their needs and opportunities.

Sign Up for the November 30 information session in which you will learn more details on this initiative.

When: November 30, 11:00 a.m. CT

Sign Up Now

With Missouri Approval, 40 States Now Offer Full Year of Medicaid Coverage after Pregnancy

November 20, 2023

With Missouri Approval, 40 States Now Offer Full Year of Medicaid Coverage after Pregnancy

On November 14, the U.S. Department of Health and Human Services (HHS) through the Centers for Medicare & Medicaid Services (CMS), announced Missouri’s extension of comprehensive coverage after pregnancy through Medicaid and the Children’s Health Insurance Program (CHIP) for postpartum individuals for a full 12 months.

This announcement marks critical progress in implementing the CMS Maternity Care Action Plan, which supports the Biden-Harris Administration’s Maternal Health Blueprint, a comprehensive strategy aimed at improving maternal health, particularly in underserved communities. Missouri is the 40th state to be approved for the extended coverage, made possible by President Biden’s American Rescue Plan (ARP) and made permanent by the Consolidated Appropriations Act, 2023 (CAA, 2023), which President Biden signed into law earlier this year.

As a result of this announcement, up to an additional 18,000 people in Missouri will be eligible for Medicaid for a full year after pregnancy. Medicaid covers 41% of all births in the nation and more than half of all children in the country. With the approval of Missouri’s plan, an estimated 641,000 Americans across 40 states, the District of Columbia, and the U.S. Virgin Islands now have access to extended postpartum coverage.

If all states adopted this option, as many as 720,000 people across the United States would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

Learn More about the CMS Maternity Care Action Plan

Learn More about the Maternal Health Blueprint

National Health Service Corps Students to Service Loan Repayment Program

November 17, 2023

National Health Service Corps Students to Service Loan Repayment Program

Approaching your final year of school and need help paying off your debt? Consider applying for the National Health Service Corps (NHSC) Students to Service Loan Repayment Program. Medical, physician assistant, nursing and dental students can get money for school loans in exchange for serving in a community of need.

Receive up to $120,000, in addition to a competitive salary and benefits, for three years of full-time service or part-time for six years. This year, there is an additional $40,000 supplement for medical students who commit to providing OB/GYN services in a maternity care target area.

The NHSC is currently accepting applications for the program through Thursday, December 7, 7:30 p.m. ET.

Resources

Apply Now

Participate in NRHA’s Latest Rural Health Advocacy Campaigns

October 26, 2023

Participate in NRHA’s Latest Rural Health Advocacy Campaigns

Are you interested in advocating on behalf of rural health? Your first step should be participating in the National Rural Health Administration’s (NRHA’s) rural health advocacy campaigns – and then registering for NRHA’s 35th Rural Health Policy Institute to take your rural voice to Capitol Hill February 13 – 15 in D.C.

The goal of the NRHA campaigns is to make your advocacy even easier by supplying pre-filled, editable information for you to work with. This means you can reach your members of Congress with one click while customizing content as needed. The current NRHA campaigns call on Congress to invest in a robust rural health workforce, reduce burden in rural health clinics, and invest in rural communities in the 2023 Farm Bill.

Learn More about Rural Health Policy Institute

Read More about NRHA’s Rural Health Advocacy Campaigns

Sign up to amplify your voice today

Improving Access to Rural Healthcare – Vizient Shares Feedback

October 23, 2023

Improving Access to Rural Healthcare – Vizient Shares Feedback

Vizient, a National Rural Health Association (NRHA) Platinum Partner, has responded to the House and Ways Means Committee’s Request for Information (RFI) on enhancing rural healthcare. They highlighted the challenges rural health providers face and suggested policy changes to improve care delivery, financing, reimbursement, and the healthcare workforce. Vizient emphasized the importance of supporting the financial viability of rural healthcare providers, avoiding damaging payment policies, protecting key healthcare programs, and investing in the healthcare workforce. They also suggested using their Vizient Vulnerability Index™ to understand social determinants of health in rural areas.

Read Full Story

Prescribing Controlled Medications via Telehealth

October 17, 2023

Prescribing Controlled Medications via Telehealth

The Drug Enforcement Administration (DEA), jointly with the Department of Health and Human Services (HHS), has extended the full set of telemedicine flexibilities regarding the prescribing of controlled medications as were in place during the COVID-19 public health emergency (PHE), through December 31, 2024.

Authorized providers are able to prescribe controlled substances via telehealth if they meet certain criteria.

Telemedicine flexibilities regarding prescription of controlled medications as were in place during the COVID-19 public health emergency include:

  • A practitioner can prescribe a controlled substance to a patient using telemedicine, even if the patient isn’t at a hospital or clinic registered with the DEA.
  • Qualifying practitioners can prescribe buprenorphine to new and existing patients with opioid use disorder based on a telephone evaluation.

For more information, see:

Prescribing Controlled Substances via Telehealth

Second Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications – from the Federal Register

Interstate licensure resources for health care providers, states, and health care organizations

Telehealth Policy Updates