The Centers for Disease Control and Prevention (CDC) recently expanded the use of updated (bivalent) COVID-19 vaccines to children ages 5 through 11 years. This followed the Food and Drug Administration’s (FDA) authorization of updated COVID-19 vaccines from Pfizer-BioNTech for children ages 5 through 11 years and from Moderna for children and adolescents ages 6 through 17 years. People with Medicare, Medicaid, Children’s Health Insurance Program (CHIP) coverage, private insurance coverage, or no health coverage can get COVID-19 vaccines, including the updated Moderna and Pfizer-BioNTech COVID-19 vaccines, at no cost, for as long as the federal government continues purchasing and distributing these COVID-19 vaccines.
Medicare Overpaid For Neurostimulator Implantation Surgeries
An Office of Inspector General (OIG) report found that Medicare improperly paid claims for implanted spinal neurostimulators when providers didn’t give sufficient documentation supporting medical necessity. For dates of service on or after July 1, 2021, you must ask your Medicare Administrative Contractor to authorize these services before performing the procedure in the hospital outpatient department.
CMS Releases COVID-19 PHE Unwinding FAQs
The Centers for Medicare & Medicaid Services (CMS) has released numerous guidance documents and tools designed to help states prepare for the eventual end of the COVID-19 public health emergency (PHE), including a State Health Official Letter, Promoting Continuity of Coverage and Distributing Eligibility and Enrollment Workload in Medicaid, the Children’s Health Insurance Program (CHIP), and Basic Health Program (BHP) Upon Conclusion of the COVID-19 Public Health Emergency (SHO #22-001, dated March 3, 2022).
HHS Renews COVID-19 Public Health Emergency For 90 Days
As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19) pandemic, Secretary of Health and Human Services, Xavier Becerra, renewed the COVID-19 public health emergency (PHE), effective October 13, 2022, for another 90 days.
340B Hospital Reimbursement Rate To Increase After Court Ruling
On September 28, 2022, the United States District Court for the District of Columbia vacated the differential payment rates for 340B-acquired drugs in the Calendar Year 2022 Outpatient Prospective Payment System (OPPS) final rule with respect to their prospective application. The Court ruled:
