…nsion of Hardship Exemption Eligibility (§ 155.605(d)(1)) 18. Amending Exchange Network Adequacy Standards (§ 155.1050) 19. Effective Essential Community Provider Review Program (§ 155.1051) 20. General Program Integrity and Oversight Requirements (§ 155.1200) 21. State Exchange …

…on of Exchange Enrollment or Coverage (§ 155.430) 19. Establishment of Exchange Network Adequacy Standards (§ 155.1050) a. Network Adequacy Standards and Reviews Across Exchanges b. Proposals Related to State Exchange and SBE-FP Network Adequacy Standards and Reviews i. Quantitat…

…on of Exchange Enrollment or Coverage (§ 155.430) 19. Establishment of Exchange Network Adequacy Standards (§ 155.1050) a. Network Adequacy Standards and Reviews Across Exchanges b. Proposals Related to State Exchange and SBE-FP Network Adequacy Standards and Reviews i. Quantitat…

…rticipation Standards (§ 156.200) 10. Standardized Plan Options (§ 156.201) 11. Network Adequacy (§ 156.230) a. Background of Network Adequacy Standards b. FFE Network Adequacy Reviews c. FFE Network Adequacy Standards Beginning With PY 2023 i. Network Adequacy Standards Applicab…

… care-related expenses or lost revenues that are attributable to coronavirus. Nonetheless, we remain concerned that if an excepted PBD that was previously paid the OPPS rate relocates off-campus due to the COVID-19 PHE, some hospitals would have difficulty sustaining operations f…

…nostic Tests a. Monitoring for Noncompliance and Pre-Penalty Actions b. Civil Monetary Penalties c. Appeals Process D. Medicare Inpatient Prospective Payment System (IPPS) New COVID-19 Treatments Add-On Payment (NCTAP) for the Remainder of the Public Health Emergency (PHE) 1. Sec…

…17, and G0518) (13) Iris Procedures (CPT Codes 66680, 66682, and 66683) (14) Magnetic Resonance Examination Safety Procedures (CPT Codes 76014, 76015, 76016, 76017, 76018, and 76019) (15) Screening Virtual Colonoscopy (CPT Code 74263) 7. Procedures Subject to the Multiple Procedu…

…employers, and is seeking comment to help the agency make that determination. Nonetheless, the agency is acting to protect workers now in adopting a standard that will reach two-thirds of all private-sector workers in the nation, including those working in the largest facilities,…

…8.114) P. Request for Information: Histopathology, Cytology, and Clinical Cytogenetics Regulations Under the Clinical Laboratory Improvement Amendments (CLIA) of 1988 1. Background a. Histopathology (1) Slide Preparation and Staining (2) Gross Tissue Examination Review b. Cytolog…

… Participation Standards (§ 156.200) b. Transparency in Coverage (§ 156.220) c. Network Adequacy Standards (§ 156.230) d. Essential Community Providers (§ 156.235) e. Meaningful Access to Qualified Health Plan Information (§ 156.250) f. Enrollment Process for Qualified Individual…

…EMENTARY INFORMATION: Table of Contents Addenda Available Only Through the Internet on the CMS Website CPT (Current Procedural Terminology) Copyright Notice I. Executive Summary A. Purpose 1. Summary of the Major Provisions 2. Summary of Costs and Benefits B. Determination of Pra…

… Participation Standards (§ 156.200) b. Transparency in Coverage (§ 156.220) c. Network Adequacy Standards (§ 156.230) d. Essential Community Providers (§ 156.235) e. Meaningful Access to Qualified Health Plan Information (§ 156.250) f. Enrollment Process for Qualified Individual…

…ION CONTACT: SUPPLEMENTARY INFORMATION: Addenda Available Only Through the Internet on the CMS Website Current Procedural Terminology (CPT) Copyright Notice Table of Contents I. Summary and Background A. Executive Summary of This Document 1. Purpose 2. Summary of the Major Provis…

…ure (MIPS Q377) (c) Quality Measure Set for the ASM Low Back Pain Cohort (i) Magnetic Resonance Imaging (MRI) Lumbar Spine for Low Back Pain, Respecified To Be Relevant to ASM Participants Treating Low Back Pain (ii) Use of High-Risk Medications in Older Adults (MIPS Q238) (iii) …

…ION CONTACT: SUPPLEMENTARY INFORMATION: Addenda Available Only Through the Internet on the CMS Website Current Procedural Terminology (CPT) Copyright Notice Table of Contents I. Summary and Background A. Executive Summary of This Document 1. Purpose 2. Summary of the Major Provis…