Advanced search Help
Searching for terms: EXACT: "Centers for Medicare & Medicaid Services (U.S.)" in: publisher
Clear all search criteria
Only 2/3! You are seeing results from the Public Collection, not the complete Full Collection. Sign in to search everything (see eligibility).
-
Survey & Certification Group: Emergency Preparedness Rule
"On September 8, 2016 the Federal Register posted the final rule Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers. The regulation goes into effect on November 16, 2016." The purpose of this rule is "To establish national emergency preparedness requirements to ensure adequate planning for both natural and man-made disasters, and coordination with federal, state, tribal, regional and local emergency preparedness systems. This page provides additional information, such as the background and overview of the final rule and related resources.
Centers for Medicare & Medicaid Services (U.S.)
-
Healthcare Payer Strategies to Reduce the Harms of Opioids
"Prescription opioid misuse and opioid use disorder (OUD) are significant and growing public health problems in the United States (U.S.) that impact stakeholders across the healthcare sector, including private, employer-sponsored, and public health plans.(1-4)[1] Healthcare payers (herein, payers), employer organizations, and law enforcement all have strong motivations to combat the inappropriate prescribing of opioids to improve patient health and reduce expenditures for medically unnecessary services and therapies. These are largescale problems for which payers play a critical role in reducing fraud, waste, and abuse while ensuring access to medically necessary therapies. Payers can help to combat the opioid crisis by identifying and sharing strategies, such as reimbursement and coverage policies, conditions for provider plan participation, and dissemination of information to a variety of audiences, to address the large-ranging issues that lead to fraud, waste, and abuse in the healthcare system. Such interventions are particularly suited to payers due to their relationships with providers of healthcare services, pharmacies, insured patients, employers, and law enforcement (in cases where potential fraud is identified). Payers collect and administer a large amount of healthcare information that can be used to identify and intervene on behalf of patients at risk of opioid-related harm, as well as to target fraud, waste, and abuse in opioid prescribing."
Centers for Medicare & Medicaid Services (U.S.)
2017-01
-
Centers for Medicare & Medicaid Services (CMS) Opioid Misuse Strategy 2016
"Many Medicare and Medicaid beneficiaries and their families have experienced opioid use disorder, commonly referred to as addiction. Given the growing body of evidence on the risks of misuse, highlighted by the recently published guidance from the Centers for Disease Control (CDC), and the Administration's commitment to combatting the opioid epidemic, CMS [Centers for Medicare & Medicaid Services] is outlining our agency's strategy and the array of actions underway to address the national opioid misuse epidemic. Strategies outlined in this paper do not include CMS's vision for the treatment of cancer and hospice patients. Treatment of patients in these situations requires careful medical supervision based on therapeutic goals, ethical considerations, and the balance of risks and benefits of opioid therapy. Opioid drugs can treat both acute and chronic pain. While these types of drugs, including fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, and oxymorphone, can have benefits for many patients with serious pain-related conditions, these drugs cause serious and substantial harm when used improperly. Even when used as directed, they contribute to overdose or lead to development of substance use disorder in some individuals. The high potential for misuse of opioids have led to alarming trends across the United States, including record numbers of people developing opioid use disorders, overdosing on opioids, and dying from overdoses. Opioid misuse places Americans at an elevated risk for heroin use, overdose, and death. Use by injection places them at risk for exposure to blood borne diseases, including HIV and Hepatitis C."
Centers for Medicare & Medicaid Services (U.S.)
2017-01-05
-
Disaster Preparedness Toolkit for State Medicaid Agencies
"Medicaid has played a critical role in helping states and Territories respond to public health crises and natural and human-made disasters such as hurricanes (e.g., Hurricanes Katrina, Maria, Harvey and Irma), wildfires (e.g., California wildfires), flooding (e.g., Hurricane Harvey floods in Texas), and public health crises (e.g., Flint, Michigan lead contamination crises). To help Medicaid agencies prepare for such disasters in the future, the Centers for Medicare and Medicaid Services (CMS) Coverage Learning Collaborative developed a set of tools on the strategies available to support Medicaid operations and enrollees in times of crisis. Those tools are: (1) This memorandum which provides a high-level summary of the types of Medicaid and CHIP strategies that can be deployed by states and Territories. It is organized by operational area--eligibility and enrollment, benefits and cost sharing and provider workforce--and provides examples of how the strategies were used by other states and Territories. The memorandum also provides a review of the legal authorities that are available to effectuate various strategies, ranging from changes to State Plan Amendments to obtaining an 1135 Waiver. Finally, Appendix A provides a snapshot summary of the strategies, legal authorities and state examples. (2) A companion inventory of the various strategies available to states and the action needed to effectuate them. Based on interviews with federal officials and a review of federal statute, regulation and approved 1135 and 1115 demonstrations, the CMS Coverage Learning Collaborative team compiled a detailed list of all available strategies, some of which are available without needing approval from CMS. The inventory provides significantly more detail on available options than the memorandum."
Centers for Medicare & Medicaid Services (U.S.)
2018-08-20
-
Medicaid and CHIP Coverage Learning Collaborative: Inventory of Medicaid and CHIP Flexibilities and Authorities in the Event of a Disaster
"Medicaid has played a critical role in helping states and Territories respond to public health crises and natural and human-made disasters such as hurricanes (e.g., Hurricanes Katrina, Maria, Harvey and Irma), wildfires (e.g., California wildfires), flooding (e.g., Hurricane Harvey floods in Texas), and public health crises (e.g., Flint, Michigan lead contamination crises). To help Medicaid agencies prepare for such disasters in the future, the Centers for Medicare and Medicaid Services (CMS) Coverage Learning Collaborative developed a set of tools to prepare states on the strategies available to support Medicaid operations and enrollees in times of crisis."
Centers for Medicare & Medicaid Services (U.S.)
2018-08-20
-
Role of Medicaid and CHIP in Responding to Public Health Crises and Disasters [presentation]
These presentation slides address the role of Medicaid/CHIP [Children's Health Insurance Program] in responding to emergencies and/or disasters that involve a public health crisis.
Centers for Medicare & Medicaid Services (U.S.)
2018-08-13
-
Center for Clinical Standards and Quality/Quality, Safety & Oversight Group
From the Background: "The Centers for Medicare & Medicaid Services (CMS) is responsible for ensuring the health and safety of nursing home residents by enforcing the standards required to help each resident attain or maintain their highest level of well-being. In light of the recent spread of COVID-19, we are providing additional guidance to nursing homes to help control and prevent the spread of the virus."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-13
-
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes
From the Memorandum Summary: "[1] CMS [Centers for Medicare & Medicaid Services] is 'committed' to taking critical steps to ensure America's health care facilities and clinical laboratories are prepared to respond to the threat of the COVID-19 [Coronavirus Disease 2019]. [2] Guidance for Infection Control and Prevention of COVID-19 - CMS is providing additional guidance to nursing homes to help them improve their infection control and prevention practices to prevent the transmission of COVID-19. [3] Coordination with the Centers for Disease Control (CDC) and local public health departments - We encourage all nursing homes to monitor the CDC website for information and resources and contact their local health department when needed (CDC Resources for Health Care Facilities: [https://www.cdc.gov/coronavirus/2019- ncov/healthcare-facilities/index.html])."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-04
-
Prioritization of Survey Activities
From the Memorandum Summary: "[1] 'The Centers for Medicare & Medicaid Services (CMS) is committed' to taking critical steps to ensure America's health care facilities are prepared to respond to the threat of disease caused by the 2019 Novel Coronavirus (COVID-19). [2] On Friday, March 13, 2020, the President declared a national emergency, which triggers the Secretary's ability to authorize waivers or modifications of certain requirements pursuant to section 1135 of the Social Security Act (the Act). Under section 1135(b)(5) of the Act, CMS is prioritizing surveys by authorizing modification of timetables and deadlines for the performance of certain required activities, delaying revisit surveys, and generally exercising enforcement discretion for three weeks."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-23
-
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes (Revised)
From the Background: "The Centers for Medicare & Medicaid Services (CMS) is responsible for ensuring the health and safety of nursing home residents by enforcing the standards required to help each resident attain or maintain their highest level of well-being. In light of the recent spread of COVID-19, we are providing additional guidance to nursing homes to help control and prevent the spread of the virus."
Centers for Medicare & Medicaid Services (U.S.)
Wright, David
2020-03-13
-
Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage, Placement and Hospital Discharge
From the Background: "The Centers for Medicare & Medicaid Services (CMS) is committed to the protection of patients and residents of healthcare facilities from the spread of infectious disease. This memorandum responds to questions we have received and provides important guidance for hospitals and critical access hospitals (CAH's) in addressing the COVID-19 [coronavirus disease 2019] outbreak and minimizing transmission to other individuals. Specifically, we address FAQs [frequently asked questions] related to optimizing patient placement, with the goal of addressing the needs of the individual patient while protecting other patients and healthcare workers."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-04
-
General Provider Telehealth and Telemedicine Tool Kit
From the Intent of the Toolkit: "Under President Trump's leadership to respond to the need to limit the spread of community COVID-19 [coronavirus disease 2019], the Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. These policy changes build on the regulatory flexibilities granted under the President's emergency declaration. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. The benefits are part of the broader effort by CMS and the White House Task Force to ensure that all Americans - particularly those at high-risk of complications from the virus that causes the disease COVID-19, are aware of easy-to-use, accessible benefits that can help keep them healthy while helping to contain the community spread of this virus."
Centers for Medicare & Medicaid Services (U.S.)
2020?
-
Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies (HHAs)
From the Background: "The Centers for Medicare & Medicaid Services (CMS) is committed to the protection of patients in the home care setting from the spread of infectious disease. This memorandum responds to questions we have received and provides important guidance for all Medicare and Medicaid participating Home Health Agencies (HHAs) in addressing the COVID-19 [coronavirus disease 2019] outbreak and minimizing transmission to other individuals."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-10
-
Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit
From the Intent: "Under President Trump's leadership to respond to the need to limit the spread of community COVID-19 [coronavirus disease 2019], the Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility. These policy changes build on the regulatory flexibilities granted under the President's emergency declaration. CMS is expanding this benefit on a temporary and emergency basis under the 1135 waiver authority and Coronavirus Preparedness and Response Supplemental Appropriations Act. The benefits are part of the broader effort by CMS and the White House Task Force to ensure that all Americans - particularly those at high-risk of complications from the virus that causes the disease COVID-19, are aware of easy-to-use, accessible benefits that can help keep them healthy while helping to contain the community spread of this virus."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-27
-
COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers
From the Document: "The Trump Administration is taking aggressive actions and exercising regulatory flexibilities to help healthcare providers contain the spread of 2019 Novel Coronavirus Disease (COVID-19). CMS [Centers for Medicare & Medicaid Services] is empowered to take proactive steps through 1135 waivers as well as, where applicable, authority granted under section 1812(f) of the Social Security Act (the Act) and rapidly expand the Administration's aggressive efforts against COVID-19. As a result, the following blanket waivers are in effect, with a retroactive effective date of March 1, 2020 through the end of the emergency declaration."
Centers for Medicare & Medicaid Services (U.S.)
2020-04-29
-
COVID-19 Emergency Declaration Health Care Providers Fact Sheet
From the Document: "The Trump Administration is taking aggressive actions and exercising regulatory flexibilities to help healthcare providers combat and contain the spread of 2019 Novel Coronavirus Disease (COVID-19). In response to COVID-19, CMS [Centers for Medicare & Medicaid Services] is empowered to take proactive steps through 1135 waivers and rapidly expand the Administration's aggressive efforts against COVID-19. As a result, the following blanket waivers are available."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-13
-
Information for PACE Organizations Regarding Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19)
From the Document: "The Centers for Medicare & Medicaid Services is committed to the protection of individuals from the spread of infectious disease. In light of the recent spread of COVID-19, we are providing information to PACE [Program of All-inclusive Care for the Elderly] Organizations (POs) to help control and prevent the spread of the virus that causes COVID-19. [...] Per current CDC [Centers for Disease Control and Prevention] guidelines, health care providers should put into practice strategies for preventing the spread of COVID-19, such as reviewing infection control practices with all personnel, implementing proper hand and respiratory hygiene; monitoring participants, personnel, and visitors for fever and respiratory symptoms; using alcohol-based hand sanitizers; and keeping all individuals including visitors, staff, and residents at home when they are ill. POs should implement sick leave policies for personnel that are non-punitive, flexible, and consistent with public health guidance."
Centers for Medicare & Medicaid Services (U.S.)
2020-03-17
-
COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and Children's Health Insurance Program (CHIP) Agencies
This document from the Centers for Medicare & Medicaid Services provides answers to frequently asked questions regarding how to deal with the coronavirus disease 2019 (COVID-19) outbreak.
Centers for Medicare & Medicaid Services (U.S.)
2020-03-18
-
Upcoming Requirements for Notification of Confirmed COVID-19 (Or COVID-19 Persons Under Investigation) Among Residents and Staff in Nursing Homes
From the Document: "The Centers for Medicare & Medicaid Services (CMS) is responsible for ensuring the health and safety of nursing home residents by enforcing the standards required to help each resident attain or maintain their highest level of well-being. In light of the recent spread of COVID-19 [coronavirus disease 2019], we are providing additional direction to nursing homes to help control and prevent the spread of the disease. [...] Nursing homes are currently required to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections. This includes a system of surveillance designed to identify possible communicable diseases or infections before they can spread to other persons in the facility. Further, nursing homes are required to know when and to whom possible incidents of communicable disease or infections should be reported."
Centers for Medicare & Medicaid Services (U.S.)
2020-04-19
-
Opening Up America Again: Centers for Medicare & Medicaid Services (CMS) Recommendations: Re-Opening Facilities to Provide Non-Emergent Non-COVID-19 Healthcare: Phase 1
From the Document: "The United States is experiencing an unprecedented public health emergency from the COVID-19 [coronavirus 2019] pandemic. Healthcare facilities in some areas are stretched to their limits of capacity, and surge areas have been needed to augment care for patients with COVID-19. To expand capacity to care for these patients and to conserve adequate staff and supplies, especially personal protective equipment (PPE), on March 18 the Centers for Medicare & Medicaid Services (CMS) recommended limiting non-essential care and expanding surge capacity into ambulatory surgical centers and other areas. However, CMS recognizes that at this time many areas have a low, or relatively low and stable incidence of COVID-19, and that it is important to be flexible and allow facilities to provide care for patients needing non-emergent, non-COVID-19 healthcare. In addition, as states and localities begin to stabilize, it is important to restart care that is currently being postponed, such as certain procedural care (surgeries and procedures), chronic disease care, and, ultimately, preventive care. Patients continue to have ongoing healthcare needs that are currently being deferred. Therefore, if states or regions have passed the Gating Criteria (symptoms, cases, and hospitals) announced on April 16, 2020, then they may proceed to Phase I."
Centers for Medicare & Medicaid Services (U.S.)
2020-04-19
-
Information to Assist Providers and Suppliers in Meeting the New Training and Testing Requirements of the Emergency Preparedness Requirements for Medicare & Medicaid Participating Providers and Suppliers Final Rule
"The Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers Final Rule became effective on November 15, 2016 with an implementation date of November 15, 2017 (a correction notice was published on November 15, 2016 (81 FR 80594) correcting technical, typographical errors and did not alter the effective date). This means that as of November 15, 2017, all affected providers and suppliers must meet all of the applicable requirements of the rule. For additional background information, providers and suppliers may reference policy memorandum SC-17-05 'Information on the Implementation Plans for the Emergency Preparedness Regulation' published, on October 28, 2016."
Centers for Medicare & Medicaid Services (U.S.); United States. Department of Health and Human Services
2017-03-24
-
Provider Survey and Certification Frequently Asked Questions: Declared Public Health Emergencies -- All Hazards Health Standards and Quality Issues
From the Document: "The waivers and modifications apply only to providers located in the declared 'emergency area' (as defined in section 1135(g)(1) of the SSA) in which the Secretary has declared a public health emergency, and only to the extent that the provider in question has been affected by the disaster, or is treating evacuees. The CMS [Centers for Medicare & Medicaid Services] Regional Office(s) will review the provider's request and make decisions on a case-by-case basis. The waivers do not apply to care that is delivered to an evacuee by a provider that is not located in one of the designated areas. Providers outside of the affected areas should operate under normal rules and regulations unless specifically notified otherwise."
United States. Department of Health and Human Services; Centers for Medicare & Medicaid Services (U.S.)
2013-05-21
-
Emergency Preparedness- Updates to Appendix Z of the State Operations Manual (SOM)
"The Emergency Preparedness Final Rule (81 Fed. Reg. 63860, September 16, 2016) sets out requirements for all providers and suppliers in regards to planning, preparing and training for emergency situations. The rule includes requirements for emergency plans, policies and procedures, communications and staff training. While there are minor variations based on the specific provider type, the rule is applicable to all providers and suppliers. The emergency preparedness requirement is a Condition of Participation/Condition for Coverage which covers the requirement for facilities to have an emergency preparedness program."
United States. Department of Health and Human Services; Centers for Medicare & Medicaid Services (U.S.)
2019-02-01
-
Tribal Nursing Home Best Practices: Emergency Preparedness
From the Document: "Across Indian Country, tribal nursing homes provide culturally sensitive long-term care environments where American Indian and Alaska Native elders can age with dignity and remain connected to their communities. Emergency planning is a crucial aspect of ensuring elders' comfort and safety. Many tribal nursing homes developed emergency preparedness plans to protect their residents in case of a natural disaster or other emergency. [...] A comprehensive, well-rehearsed emergency plan helps ensure that nursing home staff conduct evacuations and other emergency protocols efficiently to protect the safety of everyone involved. Having a plan in place reassures nursing home residents and their loved ones that they will remain safe in the event of an emergency. Many tribal nursing home emergency plans provide examples of culturally sensitive planning measures that other tribal facilities can emulate. This report describes the emergency preparedness approaches of five tribal nursing homes. It compiles emergency preparedness recommendations from nursing homes that have successfully created emergency plans and shares what has worked for these facilities, including leveraging partnerships, securing funding, and implementing staff training."
Centers for Medicare & Medicaid Services (U.S.); United States. Department of Health and Human Services
2017-12-01
-
Emergency Preparedness Final Rule Interpretive Guidelines and Survey Procedures, Appendix Z
From the Document: "On September 16, 2016, the final rule on Emergency Preparedness Requirements for Medicare and Medicaid Participating Providers and Suppliers was published (Federal Register Vol. 81, No. 180). This rule affects all 17 provider and supplier types eligible for participation in Medicare. The rule became effective on November 15, 2016 and will be implemented on November 15, 2017. [...] An advanced copy of the interpretive guidelines and survey procedures is available and will be incorporated into the SOM [State Operations Manual] under Appendix Z and applies to all 17 provider and supplier types. Since the Conditions of Participation (CoPs), Conditions for Coverage (CfCs) and requirements apply across providers and suppliers and only vary slightly, CMS [Centers for Medicare & Medicaid Services] has compiled the requirements under one appendix."
United States. Department of Health and Human Services; Centers for Medicare & Medicaid Services (U.S.)
2017-06-02
-
Suspension of Survey Activities
From the Background: "CMS [Centers for Medicare & Medicaid Services] is committed to taking critical steps to ensure America's health care facilities and clinical laboratories are prepared to respond to the threat of the COVID-19 and other respiratory illness. Specifically, CMS is suspending non-emergency inspections across the country, allowing inspectors to turn their focus on the most serious health and safety threats like infectious diseases and abuse. This shift in approach will also allow inspectors to focus on addressing the spread of the coronavirus disease 2019 (COVID-19). CMS is issuing this memorandum to State Survey Agencies to provide important guidelines for the inspection process in situations in which a COVID-19 is suspected."
Centers for Medicare & Medicaid Services (U.S.); United States. Department of Health and Human Services
2020-03-04
-
Emergency Medical Treatment and Labor Act (EMTALA) Requirements and Implications Related to Coronavirus Disease 2019 (COVID-19)
From the Memorandum Summary: "This Memorandum conveys information in response to inquiries from hospitals and critical access hospitals (CAHs) concerning implications of COVID-19 [coronavirus disease 2019] for their compliance with EMTALA [Emergency Medical Treatment and Labor Act]. This guidance applies to both Medicare and Medicaid providers. [...] Every hospital or CAH with a dedicated emergency department (ED) is required to conduct an appropriate medical screening examination (MSE) of all individuals who come to the ED, including individuals who are suspected of having COVID-19, and regardless of whether they arrive by ambulance or are walk-ins. Every ED is expected to have the capability to apply appropriate COVID-19 screening criteria when applicable, to immediately identify and isolate individuals who meet the screening criteria to be a potential COVID-19, to contact their state or local public health officials to determine next steps. [...] In the case of individuals with suspected or confirmed COVID-19, hospitals and CAHs are expected to consider current guidance of CDC and public health officials in determining whether they have the capability to provide appropriate isolation required for stabilizing treatment and/or to accept appropriate transfers. In the event of any EMTALA complaints alleging inappropriate transfers or refusal to accept appropriate transfers, CMS [Centers for Medicare & Medicaid Services] will take into consideration the public health guidance in effect at the time."
Centers for Medicare & Medicaid Services (U.S.); United States. Department of Health and Human Services
2020-03-09
1
