CY 2023 Home Health Prospective Payment System Rate Update Final Rule

The Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2023 Home Health Prospective Payment System (HH PPS) Rate Update final rule (CMS-1766-F), which updates Medicare payment policies and rates for home health agencies (HHAs). This rule includes routine updates to the Medicare Home Health PPS and the home infusion therapy services’ payment rates for CY 2023, in accordance with existing statutory and regulatory requirements.

CMS Announces No Cost Sharing For Bivalent COVID-19 To Children Ages 5 To 11

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.

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