This week in Medicare—10/23/2024
September 2024 Livanta Claims Review Advisor
On October 14, Livanta published the September 2024 edition of the Livanta Claims Review Advisor. This edition focuses on the diagnosis and payment of syncope with the two-midnight rule in mind. Livanta detailed clinical considerations for both orthostatic and non-orthostatic syncope, as well as documentation considerations for each form.
Medicare Preventive Services—Revised
On October 14, CMS updated its Medicare Preventive Services Web Page with new information on a variety of topics. The agency clarified frequency policy for alcohol misuse screening and counseling, listed several coding changes, updated flu season vaccine codes the 2024-2025 season, and more.
OIG Work Plan
On October 15, the OIG updated its Work Plan with the following items:
- Wheelchair Repair Services for Medicare Enrollees
- Audit of Medicare Part D Over-the-Counter Drugs
- Medicare Payments to Suppliers for Oxygen and Oxygen Equipment
CMS Releases Tools and Resources as Annual Medicare Open Enrollment Period Begins
On October 15, CMS updated Medicare.gov with new tools and resources to assist Medicare beneficiaries during the annual Medicare Open Enrollment period. The enrollment period began on October 15 and will end on December 7, with coverage changes taking effect on January 1.
Chapter 3 Revisions (Segment 1) in Publication (Pub.) 100-08 Program Integrity Manual (PIM)
On October 17, CMS published Medicare Program Integrity Transmittal 12897 to update Chapter 3 of the Medicare Program Integrity Manual to reflect current medical review contractors, processes, and regulations.
Effective date: November 19, 2024
Implementation date: November 19, 2024
2024 Top Unimplemented Recommendations
On October 17, the OIG published a List of the top unimplemented recommendations that it believes would most positively affect HHS programs in terms of savings, public health, and performance if implemented. The OIG listed 20 unimplemented recommendations to CMS, including the following:
- Expand the inpatient rehabilitation facility transfer payment policy to apply to early discharges to home health care
- Reassess the risks and benefits of allowing chart reviews that are not linked to service records to be used as sources of diagnoses for risk adjustment
- Update and broaden its lists of hospital-acquired conditions to capture common, preventable, and high-cost harm events
2024 Hurricane Milton Available Waivers for Affected Counties in the State of Florida Health Care Providers
On October 18, CMS updated its Current Emergencies Web Page with information on blanket waivers and other flexibilities available to Florida counties impacted by Hurricane Milton. The waivers are in effect through the end of the Hurricane Milton public health emergency or when no longer needed.