Month: April 2023

April 17, 2023

The Public Health Service Act, initiating the public health emergency (PHE), was declared on January 31, 2020.  It has been renewed 13 times since then.  The PHE was put into place in response to the COVID-19 pandemic.  Several temporary waivers and flexibilities have been implemented by state and federal governments in response to the challenges faced throughout the nation.  On January 30, 2023, President Joe Biden announced that the PHE will end on May 11, 2023.  The end of the PHE signals the termination of the temporary waivers/flexibilities that were implemented throughout the pandemic (there are a few flexibilities that will extend past May 11, 2023).  Healthcare organizations will need to re-examine their current policies, procedures, processes, workflows, etc. in preparation to transition back to “normal” operations.

April 11, 2023

On April 10, 2023, CMS released a proposed rule that will impact inpatient and long-term care hospitals (LTCH).   The proposed rule recognizes homelessness as a Social Determinant of Health (SDOH), looks to increase equity & safety, and reduce preventable harm.  For FY 2024, acute care hospitals who meet the requirements could see an increase in payments of 2.8% ($3.3B).  LTCHs will also see an increase in the payment rate by 2.9%, however this will be an overall “decrease by 0.9% ($24M), primarily due to a projected decrease in high-cost outlier payments in FY 2024 compared to FY 2023.” (CMS Press release https://www.cms.gov/newsroom/press-releases/cms-proposes-policies-improve-patient-safety-and-promote-health-equity?utm_source=newsletter&utm_medium=email&utm_campaign=name_ocr_cms_updates_auditing_for_compliance&utm_term=2023-04-11)

April 11, 2023

On April 4, 2023 CMS announced that the current Advanced Beneficiary Form (ABN) will expire on June 30, 2023.  The updated ABN will go into effect on June 30, 2023 and expire on January 31, 2026.

The ABN is used by providers who know that a service is not covered or will be denied by the Medicare fee-for-service (FFS) program.  Prior to providing the service, an ABN must be offered to the patient, so that they can decide whether or not to have the service and be financially responsible for the service.  The ABN will list the service, the reason the service is not covered by Medicare, and an estimate of how much the patient can expect to pay.  The patient will choose one of three options listed below and then sign and date the form: