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Morning Briefing

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Monday, Sep 21 2020

Full Issue

CMS Holds Off On Garnishing Medicare Payments

CMS is evaluating when to begin recoupment as Congress also considers the issue, CMS Administrator Seema Verma told Modern Healthcare.

Modern Healthcare: Verma Confirms Medicare Loan Recoupment Delay Amid Hill Negotiations

CMS Administrator Seema Verma on Friday confirmed the agency is holding off on garnishing providers' Medicare payments amid congressional negotiations on repayment terms for the program's COVID-19 loans. The Coronavirus Aid, Relief, and Economic Security Act expanded the Medicare Accelerated and Advance Payment Program in the spring and required CMS to begin garnishing 100% of loan recipients' Medicare payments starting four months after the loans were issued. The first loans went out in April, and recoupment should have started in August. But Modern Healthcare previously reported that CMS had not started withholding payments. (Cohrs and Livingston, 9/18)

Also —

Modern Healthcare: Medicaid Payments Under Threat As COVID Pummels State Budgets

Like many hospitals struggling to cope with the financial fallout of the COVID-19 pandemic, University Medical Center of Southern Nevada has made tough decisions and reevaluated its business strategy to survive. The Las Vegas hospital has gotten federal relief funding, but “it’s just not enough” to offset increasing care costs and declining revenue, UMC CEO Mason Van Houweling said. The hospital’s fortunes are deeply intertwined with the state’s tourism-heavy economy, which has been hammered for the past six months as casinos shuttered, and conferences were canceled. (Brady, 9/19)

Modern Healthcare: CMS Approves Chronic Kidney Disease Payment Model

CMS on Friday unveiled its alternative payment model for patients with chronic kidney disease. The End-Stage Renal Disease ESRD Treatment Choices—ETC—model encourages increased home dialysis use and kidney transplants. According to the agency, it will affect nearly a third of kidney care providers and save the federal government about $23 million over five and a half years. (Brady, 9/18)

Modern Healthcare: Capitated Payment Models Come With Some Hurdles

At IKP Family Medicine, a 10-provider practice in northwest Houston, the sudden, forced switch to video visits amid the COVID-19 pandemic could have been a disaster, as some patients are in their 80s and 90s and still use flip phones. Fortunately, IKP has been reimbursed in part through capitated models for at least 16 years, so its doctors are used to treating patients however it makes sense for them, without worrying about how they’ll get paid. When a 92-year-old patient recently needed a medication refill but was terrified to come in for fear of getting COVID, for example, Dr. Timothy Irvine simply called her to sort it out. (Bannow, 9/19)

This is part of the Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
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