COVID19 - RACmonitor

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Program integrity at the Centers for Medicare & Medicaid Services (CMS) is under pressure to properly conduct Recovery Audit Contractor (RAC) and Medicare Administrative Contractor (MAC) audits during the ongoing public health emergency (PHE). Up high on the “to be audited” list is post-payment reviews of COVID-19 claims to confirm…
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And then there were 12: Medicaid expansion, COVID-19, and the SDoH Elections in Missouri last week moved that state into the expansion fold. Voters approved creating a state constitutional amendment opening Medicaid eligibility to healthy adults, as of July 2021. This win was a big one, given strong opposition from…
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The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities.Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published…
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The new policy is to remain in effect through 2020. The Centers for Medicare & Medicaid Services (CMS) has unveiled a new policy allowing issuers to offer temporary premium reductions for beneficiaries with 2020 coverage in individual and small-group markets, officials announced Tuesday. The “additional flexibility” should allow consumers struggling…
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Federal agencies warn of pre-symptomatic, asymptomatic viral spread. Federal officials announced this week that they are making payments available to physicians and providers for counseling patients receiving COVID-19 tests about the vital importance of self-isolation prior to the onset of symptoms. The Centers for Medicare & Medicaid Services (CMS) and…
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Minorities have been found to be disproportionately affected by adverse outcomes. Federal officials say their first monthly statistical update illustrating the impact of the COVID-19 virus on the Medicare population leaves no doubt: minorities are being disproportionately affected by the continuing pandemic.   The Centers for Medicare & Medicaid Services…
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Against the backdrop of a nation in the grip of a prolonged pandemic caused by the COVID-19 coronavirus and its rising death toll of more than 143,700 Americans, the federal government late Thursday extended the nation’s public health emergency (PHE), which was due to expire July 25. Health and Human…
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Dear hospital administrator/provider who believes you comprehend how terrible the no-visitor policy is: You don’t. Having practiced as a pediatric hospitalist for a decade, I’ve participated in thousands of conversations with patients and family members wherein my goal was to be as straightforward as possible. I try to stick to…
July 23, 2020

SDoH and COVID-19

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New report addresses unemployment and insurance challenges amid COVID-19 Unemployment is a hot topic amid the ongoing COVID-19 pandemic, especially within the context of who has health insurance. A recent report by the Urban Institute and sponsored by the Robert Wood Johnson Foundation yielded concerning trends during what is now…
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Even though the public health emergency (“PHE”) for the COVID pandemic is scheduled to expire July 24, 2020, all evidence indicates that the PHE will be renewed. I cannot imagine a scenario in which the PHE is not extended, especially with the sudden uptick of COVID. Center for Medicare and…