Regulatory Updates

State: All

Program: Renal Dialysis

Under Article Text added Documentation Requirements section and corresponding verbiage and revised verbiage in #4 to read “The medical record documentation must support the medical necessity of the services as stated in the related policy”

State: All

Date Proposed : 10/5/2020

Program: Hospice

Extraordinary Circumstances as Related to Hospice Staffing Requirements: A hospice may use contracted staff, if necessary, to supplement hospice employees in order to meet the needs of patients under extraordinary or other non-routine circumstances. The regulation allows the hospice to utilize these services temporarily without a waiver or exemption from the State Survey Agency (SA) or the CMS Location.

State: All

Date Proposed : 11/6/2020

Date Effective : 10/1/2020

Program: Hospice

The Centers for Medicare & Medicaid Services (CMS) is making changes to the Medicare Benefit Policy Manual to include the modifications to the election statement and the requirements for the hospice election statement addendum, effective for hospice elections beginning on or after October 1, 2020.

State: All

Date Proposed : 10/1/2020

Program: Pharmacy

We are pleased to have reached this important milestone and continue our collaborative efforts with states and other stakeholders to protect patients from the potential risks associated with poor quality compounded drugs, while ensuring appropriate access to compounded drugs for patients that have a medical need for them. The availability of our standard memorandum of understanding (MOU) for signature by the states will help enhance communication and maximize our federal and state resources for oversight of compounded drugs produced by traditional compounding pharmacies.

State: All

Date Proposed : 09/19/2021

Program: Hospice

Hospice is an increasingly important benefit for the Medicare population. The goals of hospice care are to make terminally ill patients, with a life expectancy of 6 months or less, be as physically and emotionally comfortable as possible and to support their families and other caregivers throughout the process. Medicare patients who elect hospice care are an especially vulnerable population. They have the right to be free from abuse, neglect, mistreatment, and misappropriation of patient property. When hospices cause harm or fail to prevent or mitigate harm caused by others, patients are deprived of these basic rights.

State: Maryland

Date Proposed : 10/14/2019

Date Effective : 01/1/2020

Program: Home Health

CR 11330 will enable all Medicare-enrolled nurse practitioners in Maryland to certify home health services for Medicare beneficiaries as part of the Maryland Total Cost of Care (TCOC) Model. This will apply to services that the nurse practitioners provide on and after January 1, 2020. Medicare systems will be operational to process claims with dates of service on or after January 1, 2020, at the beginning of the second year of the Maryland TCOC Model. Make sure your billing staffs are aware of these changes.