- 2022 is well underway and that’s also the case for the work of Centers for Medicare & Medicaid Services (CMS).
- The CMS updates impacting Hospital Alternate Care Site (ACSs) since January 1 include COVID-19 tests, The No Surprises Act, rulings to decrease prescription drugs costs, and more.
1. COVID-19 Tests
Starting January 15, most people with a health plan can now go online or to a pharmacy or store to purchase at-home over-the-counter COVID-19 diagnostic tests authorized by the U.S. Food and Drug Administration (FDA) at no cost, either through reimbursement or free of charge through their insurance. These tests are available whether you purchased your health plan on your own or have health insurance through your employer.
2. No More Surprises
On January 1, The No Surprises Act (NSA) became federal law requiring ASCs and physician practices to provide cost estimates to self-pay patients. Patients now have more protection in instances where they inadvertently receive medical care from out-of-network providers and practices who played a role in their medical care but who were not chosen directly by the patient.
3. Full Disclosure
Over 300 hospitals were recently issued warnings for violations of rules requiring hospitals to disclose prices. To date, the agency hasn’t issued any penalties of any kind for hospitals demonstrating noncompliance with the Hospital Price Transparency Regulations effective January 1, 2021.
4. Mandate Matters
State attorney generals in 16 states recently asked a federal judge to block the CMS vaccination mandate for healthcare workers. The sixteen states represented are Louisiana, Montana, Arizona, Alabama, Georgia, Idaho, Indiana, Kentucky, Mississippi, Ohio, Oklahoma, South Carolina, Tennessee, Utah, Virginia, and West Virginia. The suit was filed in the U.S. District Court for the Western District of Louisiana.
5. All the Rules
CMS recently proposed rulings to decrease the cost of prescription drugs, increase contract vetting and elevate health equity. The proposed changes primarily target individuals covered by Medicare Advantage and Part D Plans.
6. Pay Cut
CMS will trim 764 hospitals’ Medicare payments in fiscal year 2022 for having the highest rates of patient injuries and infections. The goal of the Hospital-Acquired Conditions Reduction program is to penalize hospitals with high levels of hospital-acquired conditions. There are several ways that a hospital’s score is determined based on performance on key quality measures, including rates of infection, blood clots and other complications that happen inside the hospital that could have potentially been prevented.
Stay tuned for more news as the year unfolds. Keep updated on this and other industry news through our February 2022 newsletter. Subscribe to our monthly newsletter and our Health Prime Blog for ongoing leading industry medical practice guidance and policy updates.