MACs to Send Direct Mailing to Hospices Regarding MA VBID Hospice Component Model

From the National Association for Home Care and Hospice (NAHC)

In January 2021, the Centers for Medicare & Medicaid Services (CMS) initiated a four-year demonstration model (the MA VBID Hospice Component) under which eligible Medicare Advantage (MA) plans are permitted to offer hospice services as part of the benefit packages. For calendar year (CY) 2022, the MA VBID Hospice Component will expand such that plans in 22 states and territories will participate in the model in some areas of each state. In order to ensure that plans appropriately pay hospices serving patients enrolled in a participating plan and that plans are properly paid by CMS for those patients, special billing rules apply to hospices serving patients in the model.

In an effort to raise general awareness of the MA VBID Hospice Component model and to provide education on participation and billing for MA enrollees that receive hospice services in affected areas, CMS recently issued Change Request 12524/Transmittal 11160 – Direct Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, Value-Based Insurance Design (VBID) Model, Medicare Advantage Organizations (MAOs), directing the Medicare Administrative Contractors (MACs) to conduct a direct mailing to all hospice providers in their jurisdictions affected by the service areas identified for the CY2022 MA VBID Hospice Component [Including Colorado]

According to the transmittal, CMS requires participating MA organizations to communicate with hospice providers in the service area of their participating plans. Hospice providers are also encouraged to communicate with MA plans regarding any questions about the model, billing, coverage, and enrollment. Hospice providers must submit claims and notices to participating MA plans to receive payment when their enrollees elect to receive hospice care. Hospice providers must submit claims and notices to their Medicare contractor, as well, for informational purposes. Enrollees of participating MA plans may seek hospice care with any Medicare-certified hospice provider.

In addition to this specific direct outreach, the MACs have also been directed to conduct education for hospice providers about the CY2022 MA VBID Hospice Benefit Component through relevant outreach events, listserv messages and web postings, which shall include information about CMS and MAC educational products and resources about the model.
 

HHS Announces Critical Investments to Implement Upcoming 988 Dialing Code for National Suicide Prevention Lifeline

Dear all,

Today [December 20, 2021] the Department of Health and Human Services, through its Substance Abuse and Mental Health Services Administration (SAMHSA), will make critical investments in suicide prevention and crisis care services, announcing $282 million to help transition the National Suicide Prevention Lifeline from its current 10-digit number to a three-digit dialing code – 988.
 
In 2020, Congress designated the new 988 dialing code to be operated through the existing National Suicide Prevention Lifeline. Converting to this easy-to-remember, three-digit number will strengthen and expand the existing Lifeline network, providing the public with easier access to life-saving services. The Lifeline currently helps thousands of people overcome crisis situations every day. The 988 dialing code will be available nationally for call, text or chat beginning in July 2022.
 
Standing up the 988 dialing code is a key part of the Biden-Harris Administration’s focus on ensuring that those in crisis have someone to call, someone to respond, and somewhere to go. The 988 code is a first step toward transforming crisis care in this country, creating a universal entry point to needed crisis services in line with access to other emergency medical services.
 
“As we continue to confront the impact of the pandemic, investing in this critical tool is key to protecting the health and wellbeing of countless Americans – and saving lives. Giving the states a tool to prevent suicide and support people in crisis is essential to our HHS mission of protecting the health and wellbeing of everyone in our nation,” said HHS Secretary Xavier Becerra. “We know that remembering a three-digit number beats a ten-digit number any day, particularly in times of crisis, and I encourage every state to rev up planning to implement 988 for the sake of saving lives.”

For more information, please see the materials below:

Lily Griego
Regional Director
U.S. Department of Human Services
 

FDA Authorizes First Oral Antiviral for Treatment of COVID-19

Comagine Health

The Food and Drug Administration  issued an emergency-use authorization Dec. 22 for the first oral antiviral treatment for mild to moderate COVID-19 in adults and children over 12.

Pfizer's Paxlovid will be available by prescription only and should be initiated as soon as possible after the diagnosis of COVID-19 and within five days of symptom onset, according to a press release from the FDA. The pill is designed for those who are high risk for progression to severe COVID-19, including hospitalization or death.

“Today’s authorization introduces the first treatment for COVID-19 that is in the form of a pill that is taken orally — a major step forward in the fight against this global pandemic,” said Patrizia Cavazzoni, M.D., director of the FDA’s Center for Drug Evaluation and Research.  

Paxlovid is not a substitute for vaccination in those for whom COVID-19 vaccination and a booster dose are recommended, the FDA states. 
 

OSHA ETS

From Littler Mendelson P.C.

On Friday evening [December 17,2021], the U.S. Court of Appeals for the Sixth Circuit dissolved the Fifth Circuit’s stay of OSHA’s “vaccine or test” requirement for private employers. Following the Court’s order, OSHA quickly announced that employers will now have until:

  • January 10 to develop compliant policies
  • February 9 to begin testing programs

More detail and analysis of the OSHA ETS litigation can be found in our recently published ASAP.

However, within hours of the Sixth Circuit’s decision, a broad coalition of 26 trade groups filed the first of several emergency appeal applications to the U.S. Supreme Court requesting a stay pending Supreme Court review. The U.S. Supreme Court has asked for responses by December 30, 2021.

In the interim, and if you have 100 or more employees, we recommend that you put plans in place to come into compliance with any OSHA ETS requirements that apply to your business by the newly established deadlines. OSHA intends to begin enforcement efforts unless and until the ETS is enjoined again or ultimately declared unlawful – decisions that we will not get until sometime in 2022.
 

Court Stay on OSHA Emergency Temporary Standard Dissolved

Late Friday evening, it was announced that the U.S. Court of Appeals for the Sixth Circuit dissolved the Fifth Circuit's stay on the OSHA Emergency Temporary Standard (ETS). OSHA can now implement and enforce the COVID-19 Vaccine and Testing ETS for employers with at least 100 employees - at least until another court intervenes.

OSHA has updated its website stating that it will not issue citations for non-compliance with any requirements of the ETS before January 10, 2022, and will not issue citations for non-compliance with the standard’s testing requirements before February 9, as long as an employer is exercising reasonable, good faith efforts to come into compliance with the standard. OSHA further stated that it will work with the regulated community to provide compliance assistance.

 
 
More Articles...
<< first < Prev 251 252 253 254 255 256 257 258 259 260 Next > last >>

Page 260 of 386