(Sept. 27, 2024) – CMS Releases Medicare Shared Savings Program Final Rule
The Centers for Medicare & Medicaid Services released a final rule regarding the impact of significant, anomalous and highly suspect billing activity on Medicare Shared Savings Program financial calculations in calendar year 2023. CMS determined that two specific HCPCS codes -- A4352 and A4353 -- displayed significant, anomalous and highly suspect billing activity. Because of the findings, CMS will adjust selected shared savings program calculations to exclude all Medicare Parts A and B payment amounts on DMEPOS claims associated with A4352 and A4353 in CY 2023.
CDC Issues Health Update on Mpox Clade I Outbreak
The Centers for Disease Control and Prevention recently issued a health update that provides additional information about the ongoing outbreak of the clade I monkeypox virus that causes mpox, in central and eastern Africa, particularly in the Democratic Republic of the Congo. This alert offers updated situational awareness, vaccination and travel guidance.
Transmission in endemic regions typically occurs through contact with infected wildlife, but person-to-person spread via close or sexual contact also has been reported.
While clade I mpox has not been detected outside central Africa, travelers to affected regions should be aware of the risks and consider vaccination if they anticipate certain sexual exposures. Monitoring continues in the U.S., where the ongoing clade II mpox outbreak remains a concern.
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews:
Before You Go ...
- A National Institutes of Health study shows that fewer than half of U.S. jails provide any form of medication to individuals with opioid use disorder. Findings from the study highlight critical gaps in treatment access in correctional facilities, where almost two-thirds of people have a substance use disorder.
- For the first time in decades, public health data shows a sudden decline in drug overdose deaths across the U.S. National surveys compiled by the Centers for Disease Control and Prevention already show an unprecedented decline in drug deaths of roughly 10.6 percent.
- Many individuals using medications to combat addiction, like methadone and buprenorphine, are losing their Medicaid coverage due to the expiration of federal pandemic protections. Researchers at the nonprofit think tank KFF estimate that more than 1 million low-income Americans depend on the federal-state program for life-saving addiction care.