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23 Nov, 6 tweets, 3 min read
Modernizing and Clarifying the Physician Self-Referral Regulations Final Rule (CMS-1720-F) cms.gov/newsroom/fact-…
HHS conceded laws, are “potentially inhibiting beneficial arrangements ➡️advance transition to value-based care/ improve coordination of patient care among providers➡️ across care settings in Federal health care programs ➡️ commercial sector.” seyfarth.com/news-insights/…
84 FR 55694 - Medicare and State Healthcare Programs: Fraud and Abuse; Revisions To Safe Harbors Under the Anti-Kickback Statute, and Civil Monetary Penalty Rules Regarding Beneficiary Inducements govinfo.gov/app/details/FR…
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Code of Federal Regulations ⤵️ govinfo.gov/app/details/FR…
CMS revisions to Physician Self-Referral Law regulations include: providing exceptions/definitions for value-based arrangements
• a new exception for donations of cybersecurity technology/ related services
•amending existing exception for electronic health records (EHR) items

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More from @BlessingBox4u

BlessingBox Profile picture
22 Nov
Public Hearing on Notice of Proposed Rulemaking 11/23/20
Agenda/ Public Hearing: Securing Updated and Necessary Statutory Evaluations Timely Notice of Proposed Rulemaking
November 23, 2020
10a.m. – 2 p.m. Eastern Time) Dial-in: +1-415-527-5035 (access code): 199 934 0311
Password: jB4kisMJt47 hhs.gov/sites/default/…
SUMMARY: This document announces a public hearing to receive information and views on the Notice of Proposed Rulemaking (NPRM) entitled “Securing Updated and Necessary Statutory Evaluations Timely.” public-inspection.federalregister.gov/2020-25246.pdf
Read 6 tweets
BlessingBox Profile picture
16 Sep
CMS releases the Federal Meta-Evaluation Design for Section 1115 Substance Use Disorder (SUD) Demonstrations medicaid.gov/medicaid/downl…
(CMS) released an evaluation design that explains how the Agency will conduct a meta-analysis on Medicaid section 1115 Substance Use Disorder (SUD) demonstrations, which will be complete in the spring of 2023.
Section 1115 SUD demonstrations require states to increase access to SUD treatment services; increase capacity to provide services; implement widely recognized patient placement criteria and provider standards, care coordination policies, other prevention/treatment strategies.
Read 6 tweets
BlessingBox Profile picture
11 Sep
Texas HHS Vendor Drug Vendor Reminder: "Quantity Prescribed" Required for Schedule II Drugs Beginning Sept. 21
September 2, 2020

Beginning Sept. 21, 2020, VDP will require the "Quantity Prescribed" field (460–ET) on all pharmacy claims for Schedule II drugs.

CMS published a final rule on Jan. 24, 2020
‘‘Administrative Simplification: Modification of the Requirements for the Use of Health Insurance Portability and Accountability Act of 1996 National Council for Prescription Drug Programs D.0 Standard’’
Read 11 tweets
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1 Sep
Texas HHS Vendor Drug Program (VDP) will implement a uniform opioid policy for Medicaid (both fee-for-service and managed care) and CHIP to encourage appropriate use and reduce opioid over-prescribing effective 9/1/20. #DPPRtx txvendordrug.com/about/news/202…
1) Recently, HHS Federal Register “more or less” in very “ambiguous language” advised that the Feds were passing the buck to the States, and that States were only “liable” to adhere to “minimum Federal standards” for participation in Medicaid (qualify
2) for eligibility for Federal funding for each State Medicaid program) in reference to opioid policy, and the States were more or less “free to create” more “stringent standards” at their pleasure, hence there were “Medicaid Drug Utilization Review” meetings held in Texas
Read 19 tweets
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20 Jun
CMS wants to introduce “..new Medicaid Drug Utilization Review (DUR) provisions designed to reduce opioid related fraud, misuse and abuse..” Docket Number: CMS-2482-P federalregister.gov/documents/2020…
H. Changes Related to the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
Pg 17-18
s3.amazonaws.com/public-inspect…
“These proposals include standards that would enhance a states’ ability to identify or limit inappropriate prescribing of opioids if a beneficiary is already receiving medication assisted treatment for substance use disorder (SUD).” cms.gov/newsroom/press…
Read 4 tweets

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