Clinical Care

About Clinical Care

Taking care of patients and their communities is at the heart of what hospitals do, and that wouldn’t be possible without the clinical services that hospitals provide. These services touch all aspects of a hospital’s operations, ranging from the emergency department to behavioral health. Through its numerous area-specific groups, CHA provides advocacy and representation on all aspects of operations — guiding hospitals in meeting regulatory, legal, and licensing requirements.

CMS to Host Webinar on Medicare Clinical Laboratory Fee Schedule Private Payer Data Collection and Reporting Policies 

The Centers for Medicare & Medicaid Services will host a webinar on Nov. 10 at 12:30 p.m. (PT) to provide updates and key information on the Medicare clinical laboratory fee schedule (CLFS) private payer data collection and reporting policies. Registration is required.  The next CLFS data reporting period for clinical diagnostic laboratory tests is Jan. 1 through March 31, 2022, and is based on the original data collection period of Jan. 1 through June 30, 2019.  

CMS, OSHA Issue Regulations on COVID-19 Vaccination Requirements

The Centers for Medicare & Medicaid Services (CMS) has issued an interim final rule with comment period, requiring COVID-19 vaccinations for workers in most health care settings that receive Medicare or Medicaid reimbursement, including but not limited to hospitals, dialysis facilities, ambulatory surgical settings, home health agencies, and long-term care facilities.  

New E-Prescribing Laws Take Effect Jan. 1, 2022

The Centers for Medicare & Medicaid Services (CMS) implemented in 2009 the Electronic Prescribing (eRx) Incentive Program, which uses incentive payments and payment adjustments to encourage the use of qualified electronic prescribing systems. For questions regarding the eRx Incentive Program or eRx payment adjustments, or for assistance submitting a hardship exemption request, contact the QualityNet Help Desk at (866) 288-8912 (TTY 1-877-715-6222) or via [email protected] For additional information and resources, visit www.CMS.gov/ERxIncentive

CMS Releases Billing Codes for Johnson & Johnson, Moderna Booster Shots 

On Oct. 20, the Food and Drug Administration amended the emergency use authorization for COVID-19 vaccines to allow booster doses for the Moderna and Johnson & Johnson vaccines.   The Centers for Medicare & Medicaid Services has released new billing coding for the Johnson & Johnson and Moderna COVID-19 vaccine booster shots. Current billing codes, payment allowances, and effective dates are available online.  

FDA Revises Draft Guidance on Hospital and Health System Drug Compounding

The Food and Drug Administration (FDA) has issued revised draft guidance on hospital and health system compounding under section 503A, updating draft guidance released in 2016. As advocated for by CHA, the FDA has revised the 2016 guidance to remove a requirement that would have limited the distribution of compounded drugs to health care facilities located within a one-mile radius of the compounding pharmacy. 

CMS to Pay for COVID-19 Booster Shots

The Centers for Medicare & Medicaid Services has announced will pay the full cost of the Pfizer-BioNTech COVID-19 booster shots to providers without cost-sharing for Medicare, Medicaid, and the Children’s Health Insurance Program beneficiaries.