Health System Executive Named Medicare Chief

Modern Healthcare | By Jessie Hellmann
 
President Joe Biden's administration has selected a former not-for-profit health system executive as director of CMS' Center for Medicare, an office that oversees health benefits for tens of millions of seniors, people with disabilities and dialysis patients.
 
Dr. Meena Seshamani, who most recently was vice president of clinical care transformation at MedStar Health, started her new position Tuesday. Seshamani is a medical doctor and holds a PhD in health economics.
 
At MedStar Health, Seshamani "conceptualized, designed and implemented" public health and value-based care initiatives and oversaw efforts around community health, geriatrics and palliative care, according to a CMS news release.
 
Prior to joining Columbia, Maryland-based MedStar Health, Seshamani served as director of HHS' Office of Health Reform, where she helped implement the Affordable Care Act during Barack Obama's presidency.
 
"Dr. Meena Seshamani brings her diverse background as a health care executive, health economist, physician and health policy expert to CMS," agency Administrator Chiquita Brooks-LaSure said in a news release.
 
"Providing quality health care to the people who rely on Medicare and advancing health equity as we do it is a priority for CMS. I am delighted to say Dr. Seshamani will bring her unique perspective on how health policy impacts the real lives of patients to her leadership role as deputy administrator and director of the Center for Medicare," Brooks-LaSure said.

 

 

Vaccination and the Variant 

From The National Institute for Health Care Management (NIHCM)

The COVID-19 news in the United States continues to improve. The New York Times reported on a new study showing that the Pfizer and Moderna shots likely confer lasting immunity, protecting people from the virus for years, rather than months and alleviating the need for booster shots. The new research suggests the immunity should hold as long as the variants do not evolve too much. Here is the latest on the Delta variant and vaccine uptake. 

  • Vaccine Effectiveness: The Pfizer and Moderna vaccines are approximately 90% effective against Delta variant-induced infections and the development of severe COVID-19. The vaccines are holding the line against other current variants as well. 
  • Delta Increasing: The Centers for Disease Control and Prevention (CDC) warn that the Delta variant will soon be the dominant strain of COVID-19 in the U.S. Fortune reports that early data from an Israeli study shows the Delta variant can infect fully vaccinated adults. 
  • Variants Mostly Target Unvaccinated: In a recent CNN report, NIHCM Advisory Board member Scott Gottlieb, MD, says Delta variant induced COVID-19 cases will likely “produce dense outbreaks” in five states, primarily among the unvaccinated.
  • Lagging Vaccination Rate: A Washington Post report shows COVID-19 cases dropping where vaccine rates are high and rising where vaccine rates are low. Young people, ages 18 to 39, are the least likely to get vaccinated, followed by residents of rural areas. Both trends are limiting progress toward the Biden Administration’s national vaccination goal.

 

 

Provider Relief Fund (PRF) Reporting Portal Open for Providers

The Provider Relief Fund (PRF) Reporting Portal is now open for providers who need to report on the use of funds in Reporting Period 1. All recipients of PRF payments must comply with the reporting requirements described in the Terms and Conditions.

Providers who are required to report during Reporting Period 1 have until September 30, 2021 to enter the Portal and submit their information. HRSA is committed to supporting the providers who have received PRF payments in completing their reporting requirements successfully.

Get Started Review the updated 
Reporting Requirements Notice (June 11) and enter the PRF Reporting Portal. Portal registration is the first required step (if not already completed).

  • Reporting resources like user guides, a data entry worksheet, updated Frequently Asked Questions, and more can found on the PRF Reporting web page.

Reminder: Reporting Timelines
Providers who received one or more payments exceeding $10,000, in the aggregate, during a Payment Received Period are required to report in each applicable Reporting Time Period. PRF recipients must only use payments for eligible expenses, including services rendered, and lost revenues attributable to coronavirus before the deadline that corresponds to the relevant Payment Received Period. 

Where can I find more information?Helpful resources can be found on PRF Reporting WebpagePRF Reporting Portal User GuideStakeholder One-pagerStakeholder Toolkit, and Frequently Asked Questions (FAQs). For additional information, please call the Provider Support Line at (866) 569-3522; for TTY dial 711. Hours of operation are 7 a.m. to 10 p.m. Central Time, Monday through Friday. 

 

 

CMS Bans Surprise Billing

Modern Healthcare | By Michael Brady
 
The Biden administration on Thursday unveiled the first in a series of rules aimed at banning surprise billing.
 
The interim final rule bars surprise billing for emergency services and high out-of-network cost-sharing for emergency and non-emergency services. It also prohibits out-of-network charges for ancillary services like those provided by anesthesiologists or assistant surgeons, as well as other out-of-network charges without advance notice.
 
"No patient should forgo care for fear of surprise billing," HHS Secretary Xavier Becerra said in a statement. "Health insurance should offer patients peace of mind that they won't be saddled with unexpected costs. The Biden-Harris Administration remains committed to ensuring transparency and affordable care, and with this rule, Americans will get the assurance of no surprises."
 
While public health insurance programs like Medicare and Medicaid already prohibit balance billing, people with job-based coverage or individual health plans frequently and unknowingly accept care from an out-of-network provider before they are slapped with a surprise medical bill. The new rule aims to put a stop to that.
 
Read Full Article

 

House of Delegates Meet & Greet on Zoom 

Join us to Meet Your Delegates! Your APTA Delegates will be discussing this year's APTA motions that decide what direction the APTA will go moving forward.
Key motions this year include:
  • Productivity standards
  • Anti-discrimination
  • Future of specialization
  • Involvement of Ethics
  • APTA governance
A new President will also be elected. Join us to learn more about the House of Delegates and to make sure your voice is heard!
When: Wednesday, July 14, 2021 | 7:00pm MT
This event is open for all APTA Colorado members and non-members. Please click here register for free! 
 
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