About Continuum of Care
Post-acute care — often provided at inpatient rehabilitation facilities, long-term care hospitals, skilled-nursing facilities, and at patients’ homes — is vital to the health care delivery system. These providers deliver essential medical and rehabilitative services following hospital care. Hospital case managers help support, and connect patients, families, and caregivers through communication and coordination with post-acute care providers and home and community-based services. This includes the development of a discharge or transition plan that addresses the patient’s goals, needs and treatment preferences, and prepares patients and caregivers for post-discharge care.
CMS Memos Clarify Policies for Providers, State Survey Agencies
What’s happening: In four new memos, the Centers for Medicare & Medicaid Services (CMS) clarifies survey policies for critical access hospitals (CAHs), long-term care facilities (LTC), and laboratories.
What else you need to know: New and revised guidance addresses time-share and leased space arrangements in CAHs, immediate jeopardy in laboratories, and LTC policies.
CMS Requires Patient Reclassification Notices in February 2025
What’s happening: Beginning Feb. 14, 2025, the Centers for Medicare and Medicaid Services (CMS) will require giving “Observation Change of Status Notices” to patients who are reclassified from inpatient to observation (outpatient) status.
What else to know: CMS has issued updated information on these new requirements for communication to affected patients. Hospitals will be required to provide a Medicare Change of Status Notice (MCSN) to eligible Medicare patients who are reclassified from inpatient to outpatient receiving observation services.
CHA Issues Summaries of CY 2025 OPPS, Physician Fee Schedule Final Rules
What’s happening: Summaries of the calendar year (CY) 2025 outpatient prospective payment system (OPPS) and physician fee schedule final rules are available for CHA members.
What else to know: The rules are effective Jan. 1, 2025.
CHA DataSuite CY 2025 HH Final Rule Impact Analysis Shows How Medicare FFS Payments Will Change
What’s happening: CHA DataSuite has issued a hospital-specific analysis of the calendar year (CY) 2025 Medicare home health (HH) prospective payment system final rule analysis.
What else to know: The analysis is intended to show HH providers how Medicare fee-for-service (FFS) payments will change from CY 2024 to CY 2025 based on the policies set forth in the final rule. A detailed summary of the final rule is available for CHA members.
CHA Symposium Focuses on New Approaches to Behavioral Health Care
What’s happening: More than 250 health care professionals and hospital leaders from across California gathered in Long Beach on Dec. 4-5 for CHA’s annual Behavioral Health Symposium.
What else to know: Attendees discussed innovative ways to connect patients to community-based care and tackle stigma, updates to California’s involuntary treatment and emergency services laws, and more.
Proposed Rule Would Increase Medicare Advantage Plan Oversight
What’s happening: The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for contract year 2026 that would increase oversight of Medicare Advantage (MA) plans.
What else to know: The rule includes additional proposed changes to the prior authorization process and guardrails for artificial intelligence use.
DEA, HHS Extend Telehealth Prescribing Flexibilities
What’s happening: The U.S. Drug Enforcement Administration (DEA) and federal Department of Health and Human Services (HHS) extended existing waiver flexibilities for prescribing controlled substances via telemedicine through Dec. 31, 2025.
What else to know: This is the third extension.
Members-Only Summary on CMS 2025 Home Health PPS Final Rule Now Available
What’s happening: A summary of the Centers for Medicare & Medicaid Services’ calendar year (CY) 2025 home health (HH) prospective payment system (PPS) final rule, prepared by Health Policy Alternatives, Inc., is available solely to CHA members.
What else to know: The regulation is effective Jan. 1, 2025.
CHA Letter Shares Support, Feedback on Annual Data Submission Requirements for MA Plans
What’s happening: In a Nov. 12 letter to the Centers for Medicare & Medicaid Services (CMS), CHA conveyed its strong support for proposed implementation of additional data collection and audit procedures for Medicare Advantage (MA) plans’ utilization management policies and tools — and shared additional comments.
What else to know: CHA has consistently advocated for greater oversight of MA plans by CMS to ensure beneficiary access to medically necessary services.
CMS Initiates Collection of SNF Ownership Information
What’s happening: The Centers for Medicare & Medicaid Services (CMS) has begun notifying skilled-nursing facilities (SNFs) of new requirements to report detailed information about ownership and management.
What else to know: SNFs must disclose this information on the updated Medicare Enrollment Application (CMS-855A) form attachment, for which CMS has provided additional guidance. Over the next few months, CMS will give all SNFs, including hospital-based SNFs, direction on submitting a revalidation application with the information.