- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
CMS COVID-19 Stakeholder Engagement Calls- January 2021
CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.
Call details are below. Conference lines are limited so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. You are welcome to share this invitation with your colleagues and professional networks. These calls are not intended for the press.
Calls recordings and transcripts are posted on the CMS podcast page at: https://www.cms.gov/Outreach-and-Education/Outreach/OpenDoorForums/PodcastAndTranscripts
CMS COVID-19 Office Hours Calls (twice a month on Tuesday at 5:00 – 6:00 PM Eastern)
Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:
- Increase Hospital Capacity – CMS Hospitals Without Walls;
- Rapidly Expand the Healthcare Workforce;
- Put Patients Over Paperwork; and
- Further Promote Telehealth in Medicare
Next Office Hours:
Tuesday, January 12th at 5:00 – 6:00 PM Eastern
Toll Free Attendee Dial In: 833-614-0820; Access Passcode: 4688247
Audio Webcast link: https://edge.media-server.com/mmc/p/p5jw6syi
COVID-19 Care Site-Specific Call
COVID-19 Vaccine Safety: A Fireside Chat with CMS, CDC, and front line staff and providers
Wednesday, January 13, 2021 4pm ET
Register in advance for this webinar (After registering, you will receive a confirmation email containing information about joining the webinar): https://cms.zoomgov.com/webinar/register/WN_VQnfc77zTaOho3-yYrtGUA
Join The Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC) for a fireside chat on vaccine safety. This is the third discussion in a special series, a part of the CMS National Nursing Home Stakeholder Call Series, aimed at addressing staff questions and concerns about the new COVID-19 vaccines. Each session will be moderated by CMS with speakers from CDC and representatives of front line staff and providers.
This chat will continue to address myths surrounding vaccine danger with the following panelist:
- Dr. Lee Fleisher, CMS Chief Medical Officer and Director, Center for Clinical Standards and Quality (CMS)
- Dr. Amanda Cohn, Chief Medical Officer (Acting), Office of Vaccine Policy, Preparedness, and Global Health, Office of the Director (CDC)
- Roberta Jaramillo, Environmental Services District Manager, HealthCare Services Group
Preparing for the call:
- Would you like to submit questions for the panel to discuss? Send questions to COVID-19@cms.hhs.gov . There will not be a Q&A session during the call.
- Resource: Long term Care toolkit: https://www.cdc.gov/vaccines/covid-19/toolkits/long-term-care/index.html
For the most current information including call schedule changes, please click here
To keep up with the important work the White House Task Force is doing in response to COVID-19 click here: https://protect2.fireeye.com/url?k=36fa2226-6aae0b0d-36fa1319-0cc47a6d17cc-2d06c219f858d641&u=http://www.coronavirus.gov/. For information specific to CMS, please visit the Current Emergencies Website.
Long-Term Care Facility Toolkit: Preparing for COVID-19 Vaccination at Your Facility
This toolkit provides long-term care facility (LTCF) administrators and clinical leadership with information and resources to help build vaccine confidence among healthcare personnel (HCP) and residents. You play a critical role in providing trusted information and ensuring high COVID-19 vaccination coverage in your facility.
Based on recommendations from the Advisory Committee on Immunization Practices (ACIP), an independent panel of medical and public health experts, CDC recommends that HCP and LTCF residents be among those offered the first doses of COVID-19 vaccines.
Strategies for Managing a Surge in COVID-19 Cases
In response to a surge in COVID-19 cases in many areas of the country, the federal Healthcare Resilience Working Group has released guidance detailing strategies to help healthcare providers manage patient surge (PDF – 197 KB). State, local, tribal, and territorial governments can use these strategies to enhance their health care capabilities and support a more comprehensive healthcare system response
Vaccine Administration for Those Without Health Care Coverage
Health care providers who have conducted COVID-19 testing, provided treatment for uninsured individuals with a COVID-19 diagnosis, and/or incurred vaccination administration fees on or after February 4, 2020 can request claims reimbursement through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured program.
More than $2.8 billion in claims have been paid for COVID-19 testing and treatment of uninsured individuals. Get started today to receive reimbursement typically within 30 working days.
DentaQuest Partnership Releases New Oral Health Report
The DentaQuest Partnership released a report, “Public Health Dental Providers Embrace COVID-19-Related Changes.” This new report outlines how dental public health providers are taking strategic action in response to COVID-19. The report also discusses how some dental providers are preparing for long-term changes expected beyond the pandemic.
Analyzing Changes in Employment During the COVID-19 Recession by Education, Race, Ethnicity, and Gender
The current recession has had a disproportionate impact on lower-wage jobs and the workers who hold them. Because workers of color and women are overrepresented in the nation’s lower-wage economy, this recession has the potential to impact some groups of workers more severely than others.
Focusing on Pennsylvania, New Jersey, and Delaware, this new research explores recent changes in employment by residents’ education, race, ethnicity, and gender. Overall, the employment rate — or the share of working-age residents employed — fell by roughly 8 percentage points between May 2019–October 2019 and the same period in 2020, from 76.5 percent to 68.4 percent. Employment rate declines approached or exceeded 20 percentage points for three groups of workers with no more than a high school diploma: Black men, Black women, and Hispanic women. White men, regardless of their educational attainment, experienced much more modest declines, as did both Hispanic men and White women with at least some college education. The underlying drivers of these uneven outcomes, including the potential roles played by occupational segregation, labor market discrimination, and access to affordable, high-quality childcare, should be explored in order to ensure the economic recovery is not only full but also equitable.
This report is the latest in our Equity in Recovery series, which looks at the workers, small businesses, and places most affected by economic disruption caused by the COVID-19 pandemic. For additional resources on COVID-19 and the economy, visit our website.
Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Suspended Through March
The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31. The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021.
Pennsylvania Health Secretary Signs Order Directing Vaccine Access for Health Care Personnel
Pennsylvania Secretary of Health Dr. Rachel Levine today signed an order directing that a percentage of all vaccine distributions to hospitals, health systems, federally qualified health centers (FQHCs) and pharmacies be designated for health care personnel within Phase 1A, including those health care personnel working in Emergency Medical Services, that are not affiliated with a hospital or health system. This order goes into effect January 6, 2021.
“Getting Pennsylvanians immunized with a safe and effective COVID-19 vaccine is an essential step in reducing the number of virus-related cases, hospitalizations and deaths, including all those who continue to take care of us,” Dr. Levine said. “There are nearly one million health care personnel across the commonwealth who work directly or indirectly with patients and are eligible for vaccine initially. The department will continue to follow and update our COVID-19 interim vaccination plan to address how and when all Pennsylvanians can receive their vaccine.”
Health care personnel are defined by the Advisory Committee on Immunization Practices as paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials. This may include, but is not limited to, emergency medical service personnel, nurses, nursing assistants, physicians, technicians, therapists, phlebotomists, pharmacists, students and trainees, direct support professionals, clinical personnel in school settings or correctional facilities, contractual staff not employed by the health care facility, and persons (e.g., clerical, dietary, environmental services, laundry, security, maintenance, engineering and facilities management, administrative, billing, and volunteer personnel) not directly involved in patient care but potentially exposed to infectious agents that can be transmitted among from health care personnel and patients.
Interested health care personnel not affiliated with a hospital or health system should take the following steps to ensure they can receive the vaccine:
- Review the COVID-19 interim vaccination plan, including Phase 1A sub-prioritization guidance;
- Talk with their employer to identify which type of enrolled COVID-19 vaccine provider is most appropriate;
- Find a participating location if their employer does not assign one;
- Be patient with providers;
- Schedule full vaccine regimen; and
- Provide necessary documentation when being vaccinated.
This order requires providers to designate at least 10 percent of each vaccine shipment received for vaccination of Phase 1A non-hospital affiliated health care personnel.
The Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine will be distributed as outlined in Pennsylvania’s COVID-19 Interim Vaccination Plan.There are three phases to vaccinate residents across the commonwealth. The first phase is broken out into three parts starting with 1A for all health care personnel and those working and living in long-term care facilities.
“The vaccination process will take time. We need Pennsylvanians, including health care personnel to be patient as we continue to get the vaccine into the hands of the right people at the right time so we can protect against COVID-19,” Dr. Levine said. “We appreciate the work of our health systems, hospitals, FQHCs and pharmacies for their partnership on this effort to ensure all health care personnel can receive the vaccine. We are hopeful as we move forward, additional vaccines trials will be completed and receive an Emergency Use Authorization, enhancing the number of vaccines we receive.”
You can find more information regarding the COVID-19 vaccine, guidance and fact sheets for health care personnel and enrolled providers related to this order and the COVID-19 Interim Vaccination Plan at the Department of Health’s website here.
Fraud Alert: COVID-19 Scams
As the number of people and communities affected by the COVID-19 pandemic grows, so do the scams associated with it. Scammers use public health emergencies as opportunities for new fraud schemes, and because older adults and people with disabilities are at greater risk for serious illness from COVID-19, they may target these populations.
It’s important to remember that although the Centers for Disease Control and Prevention (CDC) and other public health officials may contact you if they believe you may have been exposed to the virus, they will not need to ask you for insurance or financial information.
Scammers rapidly alter their tactics and adapt their schemes to the changing landscape, and we anticipate that they will leverage the COVID-19 vaccine to prey on unsuspecting people. Be vigilant and protect yourself from potential fraud concerning COVID-19 vaccines and treatments.
Here are things you need to know about the COVID-19 vaccine:
- You likely will not need to pay anything out-of-pocket to get the vaccine during this public health emergency.
- You cannot pay to put your name on a list to get the vaccine.
- You cannot pay to get early access to the vaccine.
- You will not be solicited door to door to receive the vaccine.
- No one from Medicare or the Health Department with contact you.
- No one from a vaccine distribution site or health care payer, like a private insurance company, will call you asking for your Medicare number, Social Security number, or your credit card or bank account information to sign you up to get the vaccine.
The Senior Medicare Patrol (SMP) recommends that Medicare beneficiaries:
- Contact your own doctor if you are experiencing potential symptoms of COVID-19.
- Do not give out your Medicare number, Social Security number, or personal information in response to unsolicited calls, texts, emails, home visits, or booths at health fairs and other public venues. If your personal information is compromised, it may be used in other fraud schemes as well.
- Be suspicious of anyone going door-to-door to offer free coronavirus or COVID-19 testing, supplies, treatments, or vaccines.
- Beware of providers offering other products, treatments, or medicines to prevent the virus. Check with your health care provider before paying for or receiving any COVID-19-related treatment.
- If you get a call, text, email — or even someone knocking on your door — claiming they can get you early access to the vaccine, STOP. That’s a scam.
- Carefully review your Medicare Summary Notice (MSN) or Explanation of Benefits (EOB), looking for errors or claims for products or services that weren’t received.
- Follow the instructions of your state or local government for other actions you should be taking in response to COVID-19.
- Contact your local SMP for help. SMPs empower and assist Medicare beneficiaries, their families, and caregivers to prevent, detect, and report health care fraud, errors, and abuse.
The Senior Medicare Patrol (SMP) is ready to provide you with the information you need to PROTECT yourself from Medicare fraud, errors, and abuse; DETECT potential fraud, errors, and abuse; and REPORT your concerns. SMPs help educate and empower Medicare beneficiaries in the fight against health care fraud. Your SMP can help you with your questions, concerns, or complaints about potential fraud and abuse issues. It also provides information and educational presentations. To locate your local Senior Medicare Patrol, call 1-877-808-2468 or visit www.smpresource.org.
More Information
COVID-19 Vaccine Codes: Updated Effective Date for Moderna
On December 18, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Moderna COVID‑19 Vaccine for the prevention of COVID-19 for individuals 18 years of age and older. Review Moderna’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use.
During the COVID-19 Public Health Emergency (PHE), Medicare will cover and pay for the administration of the vaccine (when furnished consistent with the EUA). Review our updated payment and HCPCS Level I CPT code structure for specific COVID-19 vaccine information. Only bill for the vaccine administration codes when you submit claims to Medicare; don’t include the vaccine product codes when the vaccines are free.
Related links:
- CMS COVID-19 Provider Toolkit
- CMS COVID-19 FAQs
- CDC COVID-19 Vaccination Communication Toolkit for medical centers, clinics, and clinicians
- FDA COVID-19 Vaccines webpage