(Oct. 4, 2024) – CMS Issues Five PPS Payment and Policy Correction Notices for FY 2025
the Centers for Medicare & Medicaid Systems released five Medicare payment and policy correction notices for the fiscal year 2025. The notices apply to Medicare Inpatient and Long-Term Care Hospitals, Inpatient Rehabilitation Facilities, Skilled Nursing Facilities, Inpatient Psychiatric Facilities and Hospice Programs.
U.S. Households Eligible to Order Free at-Home COVID-19 Tests
U.S. households once again can receive four free at-home COVID-19 tests. Tests may show expired dates on the box, but the FDA has extended those dates. Orders may be placed online or by calling (800) 232-0233. Orders will ship for free beginning the week of Monday, Sept. 30.
The tests available for order are rapid antigen at-home tests, not PCR, and give results within 30 minutes. In addition, these tests can be used even if you do not have COVID-19 symptoms.
Congress Enacts Short-term Continuing Resolution
Congress enacted and the president signed the Continuing Appropriations and Extensions Act, 2025 that will fund the government through Friday, Dec. 20. The legislation will prevent a partial government shutdown Tuesday, Oct. 1.
The continuing resolution will allow Congress to develop a full appropriations package following the election in November. This bill does not include extensions to the Medicare Disproportionate Share Hospital funding reductions, the enhanced Medicare low-volume payment adjustments or the Medicare Dependent Hospital programs that will expire Tuesday, Dec. 31. The package also does not include an increase in Federal Emergency Management Agency funding.
CMS Issues Guidance to States to Encourage EPSDT Utilization, Compliance
The Centers for Medicare & Medicaid Services issued a comprehensive guide for state Medicaid programs to comply with and fully utilize the provisions of the Early and Periodic Screening, Diagnostic and Treatment program. EPSDT is a cornerstone of children's health care under Medicaid. The program requires states to provide Medicaid-eligible children with regular screenings and to provide the medically necessary treatments needed to cure, correct or improve children's physical and mental health conditions.
The guidance provides direction to states for increasing awareness of the EPSDT program, expanding the use of EPSDT screenings and care by health care workers and using EPSDT to enhance care for children with special health care needs.
CMS Issues Notice of Adjustment to CY 2025 Amount in Controversy Thresholds
The Centers for Medicare & Medicaid Services released a notice regarding the annual adjustment in the amount in controversy threshold amounts for administrative law judge hearings and judicial review under the Medicare appeals process. The AIC threshold for ALJ hearings will rise from $180 for the calendar year 2024 to $190 for CY 2025, and the threshold for judicial review will increase from $1,840 for CY 2024 to $1,900 for CY 2025.
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews: