It is new year and as with every new year, there is new information from CMS for the year ahead. Below is a summary of a few things to take note of.
Notice of Medicare Non-Coverage
Starting January 1st, providers had to start using the revised Notice of Medicare Non-Coverage (NOMNC). This form is to be used for both Traditional Medicare and Medicare Advantage (MA).
The NOMNC has been updated considering the new regulations for Medicare Advantage (MA)Members. As with Traditional Medicare, MA Members now have the same right to appeal the end of coverage of services before or after the end date of services. Members may appeal to the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO).
To learn more and to get copies of the revised forms, go to FFS & MA NOMNC/DENC | CMS
Telehealth
The American Relief Act, 2025 was signed into law on December 21st. This bill was passed to keep the government funded through March 14th, 2025. It also offered disaster relief and aid to farmers. Interestingly, it also had provisions to extend several waivers granted during the pandemic. Telehealth waivers were included in this bill. As such, occupational, physical, and speech therapists can continue to provide telehealth through March 31st, 2025.
To view the test of the bill, click on the following link: Text - H.R.10545 - 118th Congress (2023-2024): American Relief Act, 2025 | Congress.gov | Library of Congress
State Survey
As a reminder, the new long term-care guidance issued by CMS will go into effect on February 24, 2025. The goal of the guidance revisions is to consolidate the process and prevent overlapping citations. MDS accuracy, Admission Agreements, Enhanced Barrier Precautions, Psychotropic Medications, and QAPI are some of the areas addressed in the revised guidance.
To review CMS’ Memo regarding the revised survey guidance, go to the following link - Revised Long-Term Care (LTC) Surveyor Guidance: Significant revisions to enhance quality and oversight of the LTC survey process | CMS
Training is offered for Providers and Surveyors, through the Quality, Safety, and Education Portal (QSEP).
CMS has also indicated State Surveyors will be incorporating the new reporting requirements for respiratory illness into the survey process. Providers are required to report respiratory illness, such as flu, COVID-19, and Respiratory Syncytial Virus (RSV) to NHSN as of January 1st,2025. View the memo sent to State Survey Agency Directors on December 31st at Long-Term Care (LTC) Facility Acute Respiratory Illness Reporting Requirements | CMS
HIPAA Security Proposed Rule
Friday, December 27th, HHS’ Office for Civil Rights (OCR) released a Notice of Proposed Rulemaking to revise the Health Insurance Portability and Accountability Act (HIPAA) of1996. The main goal is to strengthen cybersecurity protections for protected health information (PHI) through strengthened policies, procedures, and guidance.
To review the proposed rule and provide feedback go to Federal Register :: HIPAA Security Rule To Strengthen the Cybersecurity of Electronic Protected Health Information Comments are due by March 7th,2025.