CEO Update 112
CMS Announces 2.2% Increase in Base Payment Rate for IPFs and Scope-of-Practice Changes for 2021
The Centers for Medicare & Medicaid Services (CMS) will update the Medicare base payment rate for the Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) by 2.2% in Fiscal Year (FY) 2021, the agency announced in a final rule.
In its April proposed rule, CMS had estimated a 2.4% payment rate update for IPFs next year. The agency included its updated estimates and calculations in a fact sheet accompanying the final rule.
The agency said in the final rule that it estimates the 2021 update will increase total IPF payments to providers by 2.3%, or about $95 million. The agency included its calculations in a fact sheet accompanying the final rule.
CMS said in the final rule that it will allow advanced practice providers, including physician assistants, nurse practitioners, psychologists, and clinical nurse specialists, to operate within the scope of practice allowed by state law by documenting progress notes in the medical record of patients for whom they are responsible, receiving services in psychiatric hospitals. NABH has advocated for this policy change and is pleased the agency made this update.
CMS also finalized its proposal to adopt revised Office of Management and Budget statistical area delineations resulting in wage index values that the agency said are “more representative of the actual costs of labor in a given area.”
CMS is finalizing its proposed policy that any decline in a provider’s wage index value from its FY 2020 wage index, regardless of the circumstance causing the decline, will be capped at a 5 percent decrease for FY 2021.
CMS Proposes Expanding Medicare Telehealth Benefits and Scope of Practice Beyond Pandemic
CMS is proposing to maintain—either permanently or temporarily— many of the Medicare telehealth benefits and workforce flexibilities authorized during the Covid-19 pandemic, according to the fiscal year 2021 Medicare physician fee schedule proposed rule the agency released Monday.
In issuing these proposed changes, CMS referred to President Trump’s Aug. 3 Executive Order on improving rural health and telehealth access that directs the Health and Human Services (HHS) secretary to propose regulations to extend flexibilities provided during the Covid-19 public health emergency (PHE) as appropriate. Please click here to read the full NABH Analysis about this rule.
Also this week, NABH was one of 20 organizations that sent a letter to federal lawmakers supporting the Telehealth Response for E-prescribing Addiction Therapy Services (TREATS) Act. Please click here to read the full letter.
HHS Extends Deadline for Provider Relief Fund Until Aug. 28
HHS has extended the deadline to Friday, Aug. 28 from Monday, Aug. 3 for healthcare providers who participate in Medicaid and CHIP to apply to the Provider Relief Fund established in the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
HHS had previously extended this deadline to Aug. 3 from July 20. HHS said it plans to issue a simplified application form soon.
In addition, HHS said it is re-opening the portal for Medicare-participating providers to apply for funding set aside from the Provider Relief Fund. The previous deadline to apply for this distribution was June 3.
Providers will now have until Aug. 28 to apply for the balance of funding up to 2% of their annual patient revenue. HHS is re-opening this application process after learning that many providers, including many Medicaid and CHIP providers, did not apply to the prior Medicare-based distribution because they had relatively low Medicare revenues.
HHS also announced it is working on another funding distribution from the Provider Relief Fund focused on providers who have not received any of this funding including those who only bill commercially or do not directly bill for the services they provide to Medicare and Medicaid beneficiaries.
Information about how to apply for the various Provider Relief Fund distributions is on the HHS website.
CMS and SAMHSA Add Kentucky and Michigan to CCBHC Demonstration
CMS and SAMHSA have chosen Kentucky and Michigan as additional participants in the Certified Community Behavioral Health Clinic (CCBHC) demonstration that the CARES Act requires, CMS announced this week.
The demonstration is part of a broader effort to integrate behavioral healthcare with physical healthcare, increase evidence-based practices on a consistent basis, and improve access to high quality care for people with mental health and substance use disorders.
Although the Protecting Access to Medicare of 2014 created this demonstration for a two-year period, the program has been extended several times. Kentucky and Michigan join the original participants selected in 2016.
Wit v. UnitedHealthcare Hearing Delayed to Wednesday, Sept. 2
The remedies hearing in the Wit v. UnitedHealthcare case that had been scheduled for this week has been delayed to Wednesday, Sept. 2.
NABH has learned that U.S. Chief Magistrate Judge Joseph Spero has re-scheduled the hearing due to meetings related to Covid-19.
Members of the public and press are welcome to join the webinar, and NABH will send an updated Zoom link when it becomes available.
Fact of the Week
A new study shows 55% of patients who have survived Covid-19 were diagnosed with at least one psychiatric disorder.
For questions or comments about this CEO Update, please contact Jessica Zigmond.