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CMS to open Direct Contracting Model to Medicaid managed care organizations
Medicaid managed care organizations with enrollees dually eligible for Medicare can participate in the Direct Contracting Model’s Professional and Global Options beginning in January 2022, the Centers for Medicare & Medicaid Services announced.
Prior authorization bill introduced in Senate
Sens. Sherrod Brown, D-Ohio, and John Thune, R-S.D., introduced the Improving Seniors' Tmely Access to Care Act (S. 5044), bipartisan legislation that would require Medicare Advantage plans to establish an electronic prior authorization system and provide “real-time” decisions for routine services and items.
CMS says it will audit some hospitals in January for compliance with price transparency rule
The Centers for Medicare & Medicaid Services said that will audit a sample of hospitals in January for compliance with the agency’s hospital price transparency rule that takes effect Jan. 1, 2021.
CMS extends deadline for clinicians to apply for COVID-19 MIPS exception
The Centers for Medicare & Medicaid Services has extended to Feb. 1 at 8 p.m. ET the deadline for clinicians participating in the Merit-based Incentive Payment System to apply for an extreme and uncontrollable circumstances exception to reweight the MIPS performance categories.
CMS updates guidance on Medicaid/CHIP coverage for COVID-19 vaccinations
Centers for Medicare & Medicaid Services released updated guidance for states and territories on Medicaid, Children’s Health Insurance Program and Basic Health Program coverage and reimbursement for COVID-19 vaccinations.
CPT codes announced for AstraZeneca COVID-19 vaccine candidate
The American Medical Association announced Current Procedural Terminology immunization and administration codes for reporting on medical claims the COVID-19 vaccine under development by AstraZeneca and University of Oxford.
JAMA article highlights ‘5s framework’ for simplifying policy and operational considerations for COVID-19 surge planning
In an article published in JAMA, Jonathan Perlin M.D., president, clinical operations, and chief medical officer, HCA Healthcare, discusses how with the COVID-19 pandemic, “the less appreciated ravage has been excess morbidity and mortality from patients who have forgone essential care due to patient fears of contracting COVID-19 in health care settings and to policy makers’ restrictions of care activities to ensure capacity” for COVID-19 patients.
NIH launches phase 3 investigational trials for pair of monoclonal antibody therapies for COVID-19
The National Institutes of Health announced enrollment in phase 3 of the clinical trial of two disparate therapies. This trial is specifically looking at the safety and effectiveness of the therapeutics in people hospitalized with moderate COVID-19 symptoms.
FDA panel recommends EUA for Moderna’s COVID-19 vaccine candidate
The Food and Drug Administration’s Vaccines and Related Biological Products Advisory Committee Dec. 17 recommended the approval of Moderna’s mRNA-1273 COVID-19 vaccine candidate.
AHA releases new resources for United Against the Flu, Wear A Mask campaigns
To continue emphasizing the message of protecting against both the flu and COVID-19, AHA’s Wear A Mask and United Against the Flu campaigns released new resources, including new sample social media messages, several graphics and a video that hospitals and health systems can use to reiterate the importance of getting a flu shot, wearing a mask and practicing good hygiene.