Tag: Centers for Medicare & Medicaid Services (CMS)

CMS Announces New Office (“Aubrey”) To Streamline Interoperability and Informatics

Aubrey Edwards — Photo Credit: James Musselwhite

 

Healthcare has a new acronym – OBRHI. Quite a mouthful. Perhaps “Aubrey” is a little easier to say.

The Centers for Medicare & Medicaid Services (CMS) announced the creation of a new office, the Office of Burden Reduction and Health Informatics. It is designed to reduce friction and regulatory and administrative burden between itself and caregivers – “to further the goal of putting patients first, the organization said in a statement.

PER CMS, this office is an “outgrowth” of its Patients over Paperwork (PoP) Initiative, meant to cut administrative red tape across the health system. Additionally, the agency said it seeks reform through the office to eliminate “duplicative, unnecessary and excessively costly requirements and regulations.”

As part of the PoP Initiative — focused on reducing the unnecessary regulatory burden to allow providers to concentrate on their primary mission – these efforts and the office’s creation hope to save clinicians $6.6 billion and 42 million burden hours through 2021.

“As part of our efforts to date, CMS has heard from over 2,500 providers, clinicians, administrative staff, health care leaders, beneficiaries and their support teams through 158 site visits and listening sessions,” the agency said. “Through more than 10 Requests for Information (RFI) combined with stakeholder interviews, CMS also has over 15,000 comments to assist us in our burden reduction efforts.”

CMS Administrator Seema Verma said in the agency’s statement: “Specifically, the work of this new office will be targeted to help reduce unnecessary burden, increase efficiencies, continue administrative simplification, increase the use of health informatics, and improve the beneficiary experience.”

In its effort to streamline, CMS says it’s seeing “significant results,” including removing unnecessary, obsolete or excessively burdensome conditions of participation for hospitals and other healthcare providers previously spent on paperwork and faster processing of state requests to make program or benefit changes to their respective Medicaid programs through the state plan amendment and section 1915 waiver review process. 

“The new office will strengthen CMS’s efforts across Medicare, Medicaid, the Children’s Health Insurance Program and the Health Insurance Marketplace to decrease the hours and costs clinicians and providers incur for CMS-mandated compliance,” the agency said.

OBRHI (or “Aubrey”) may also increase the number of clinicians, providers, and health plans CMS engages, it says, to ensure it gains a better understanding of how various regulatory burdens impact healthcare delivery.

Aubrey also will focus on health informatics development, the use and application of health data and clinical information to healthcare, as well as furthering interoperability innovation.

Time will tell if OBRHI is just another red-tape agency or if it reaches its intended goal of improving communication with caregivers and driving healthcare innovation. Lovers of big government, applaud, Those who feel the government-run programs like the DMV are the pinnacle of customer service, furrow your brow.

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CMS Approves Approximately $34 Billion for Providers with the Accelerated/Advance Payment Program for Medicare Providers In One Week

CMS Logo | American Ambulance AssociationThe Centers for Medicare & Medicaid Services (CMS) has delivered near $34 billion in the past week to the healthcare providers on the frontlines battling the 2019 Novel Coronavirus (COVID-19). The funds have been provided through the expansion of the Accelerated and Advance Payment Program to ensure providers and suppliers have the resources needed to combat the pandemic.

“Healthcare providers are making massive financial sacrifices to care for the influx of coronavirus patients,” said CMS Administrator Seema Verma. “Many are rightly complying with federal recommendations to delay non-essential elective surgeries to preserve capacity and personal protective equipment. They shouldn’t be penalized for doing the right thing. Amid a public health storm of unprecedented fury, these payments are helping providers and suppliers – so critical to defeating this terrible virus – stay afloat.”

The streamlined process implemented by CMS for COVID-19 has reduced processing times for a request of an accelerated or advance payment to between four to six days, down from the previous timeframe of three to four weeks.  In a little over a week, CMS has received over 25,000 requests from health care providers and suppliers for accelerated and advance payments and have already approved over 17,000 of those requests in the last week.  Prior to COVID-19, CMS had approved just over 100 total requests in the past five years, with most being tied to natural disasters such as hurricanes.

The payments are available to Part A providers, including hospitals, and Part B suppliers, including doctors, non-physician practitioners and durable medical equipment (DME) suppliers. While most of these providers and suppliers can receive three months of their Medicare reimbursements, certain providers can receive up to six months.

The CMS Accelerated and Advance Payment Program is funded from the Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B) trust funds, which are the same fund used to pay out Medicare claims each day. The advance and accelerated payments are a loan that providers must pay back. CMS will begin to apply claims payments to offset the accelerated/advance payments 120 days after disbursement.

The majority of hospitals including inpatient acute care hospitals, children’s hospitals, certain cancer hospitals, and critical access hospitals will have up to one year from the date the accelerated payment was made to repay the balance. All other Part A providers and Part B suppliers will have up to 210 days to complete repayment of accelerated and advance payments, respectively.

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CMS: Telehealth Benefits In Medicare Are A Lifeline for Patients During Coronavirus Outbreak

See the source imageThe Centers for Medicare & Medicaid Services (CMS) issued a fact sheet with additional guidance for healthcare providers and patients about the telehealth benefits in the agency’s Medicare program. The fact sheet is part of a broader effort by CMS and the White House Task Force to ensure that all Americans – particularly those at high-risk of complications from the COVID-19 virus – are aware of easy-to-use, accessible benefits that can help keep them healthy while helping to contain the community spread of this disease.

“As we continue to learn about the COVID-19 virus, it’s important for all Americans, and particularly vulnerable populations who are at heightened risk, to be able to access their providers when they feel sick or have questions” said CMS Administrator Seema Verma. “Over the last three years, President Trump’s leadership and historic efforts have made it possible for doctors to bill for their time on the phone or video chat with patients to help triage medical issues. Today, a patient who is not feeling well can call their doctor to decide whether or not they need to go in for a visit, offering solutions and peace of mind immediately.”

CMS’ historic effort made virtual check-ins and other services that use telecommunications possible with new policies implemented in 2019 and 2020. These services are available right now to patients and their physicians, providing a great deal of flexibility and an easy way for patients who are concerned about illness to remain in their home avoiding exposure to others.

With the COVID-19 virus, there is an urgency to expand the use of virtual care to keep the beneficiaries with mild symptoms in their homes while increasing access to their provider’s office.

For the beneficiary, these benefits can be very helpful. For example, a Medicare beneficiary who is looking for advice about symptoms they are experiencing, can call their doctor and receive medical advice about whether he or she needs to see their doctor in person for a physical exam.

If they start to feel more ill, a virtual check-in allows a healthcare provider to offer recommendations about next steps and even take precautions for someone they are concerned may have the COVID-19 virus or flu before they step in the office or hospital putting others at risk. These check-ins are billable services and the Medicare coinsurance and deductible would apply to these services.

Medicare Advantage plans may also provide enrollees access to Medicare Part B services via telehealth in any geographic area and from a variety of places, including beneficiaries’ homes, as part of their benefit packages for a plan year.

Therefore, enrollees in Medicare Advantage plans that include coverage of such services may be available to receive clinically appropriate services for treatment of COVID-19 via telehealth from many sites, including their home.

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