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Changes to Medicare Coverage for Substance Use Disorder (SUD) Treatment Services
This NABH Issue Brief highlights changes to coverage for substance use disorder (SUD) treatment services that the Centers for Medicare & Medicaid Services (CMS) included in its 2021 Medicare Physician Fee Schedule (PFS) and other final rules. The PFS rule also contains many changes related to telehealth for substance use disorder (SUD) services. For a review of these modifications, please see NABH Issue Brief CMS Expands Medicare Telehealth Coverage for Mental Health and Addiction Treatment Services. SECTION I: PFS and Other Rules CMS adopted the proposal to expand the PFS…
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HHS Announces Delay in Provider Relief Fund Reporting Deadline and Revisions to ‘Lost Revenue’ Definition
The U.S. Health and Human Services Department (HHS) has announced a new reporting portal for providers to register and submit information about how they have used payments from the Provider Relief Fund (PRF) to cover Covid-19-related costs and lost revenues. HHS also said the deadline for reporting is extended, although it did not specify the deadline. The agency said providers can register and become familiar with the reporting portal in the meantime. Previously HHS said that providers who received payments amounting to more than $10,000 from the PRF were required…
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CMS Expands Medicare Telehealth Coverage for Mental Health and Addiction Treatment Services
The Centers for Medicare & Medicaid Services (CMS) extended some Medicare coverage of telehealth services that the agency authorized during the Covid-19 pandemic. The changes were included in the final 2021 Medicare Physician Fee Schedule rule that was published in the Federal Register on Dec. 28, 2020. Extended Coverage of Certain Services CMS permanently extended Medicare coverage of the following services provided via telehealth: Home Visits, Established Patients (only for treatment of substance use disorders (SUDs) and co-occurring mental health disorder when less complex, lasting typically 25 minutes) (99347 &…
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HHS-OIG Requests Recommendations for New or Updated Safe Harbor Provisions
The U.S. Health and Human Services Department’s Office of Inspector General (OIG) on Wednesday requested proposals and recommendations to develop new, or to modify existing, safe harbor provisions under the Social Security Act’s federal anti-kickback statute. The statute applies criminal penalties for whoever knowingly—and willingly—offers, pays, solicits, or receives money to induce or reward the referral for, or purchase of, items and services that are reimbursed under any federal healthcare program. Because of the statute’s broad reach, there was concern that the statute included relatively harmless business arrangements. This has…