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21st Century CURES Act and Post- Acute Care: Are You Aware?

21st Century CURES Act signed into law.


December, 2016 saw the 994 page 21st Century CURES Act signed into law. The primary function was to identify new funding initiatives for the National Institute of Health and to expedite the Food and Drug Administration Drug and Device approval process. However, many other provisions were included; many of which impact post- acute care. There is over $6.3 Billion available in funding.

Over $1Billion in grants were made available to fight the opioid epidemic, especially those directed toward improving drug monitoring programs.

The Act addresses treatment of mental health and substance abuse, strengthening prior MH regulations such as the Mental Health and Safe Communities Act of 2015. Fortune Magazine stated that families will be helped with this Act through an “increase in availability of psych beds, establishing a new assistant Secretary for Mental Health and Substance Abuse in HHS, and boosting treatment for young MH patients among the other provisions.” This Act is considered by many as the “most significant attempt at MH reform in decades.”

Section 4013 of the Act requires CMS to give an annual report to Congress regarding Medicare beneficiaries, “such as those with chronic conditions whose care may be improved most in terms of quality and efficiency through the expansion of telehealth services.” Telehealth is gaining attention.

Section 12006 requires an electronic visit verification system for personal care services as well as home health services under Medicaid. States are required to have adopted a system(s) (not required to have a single state system) for personal care services by January 1, 2019 and for home health services by January 1, 2023 or they will face a reduction in payment.

Of the other several provisions, two include making Medicare Advantage plan choice available for end-stage renal disease individuals and a provision updating the Medicare Advantage Risk Adjustment Model to account more accurately persons with multiple chronic conditions.

Also, under section 17004, CMS is tightening a specific regulation under the “No Payment for Items and Services Furnished by Newly Enrolled Providers or Suppliers Within a Temporary Moratorium Area.”  This provision is meant to address new home health agencies that skirt regulation by establishing an office outside a moratoria radius but provide services within that area. This regulation covers Medicare, Medicaid, and CHIP services.

This overall Act is far reaching and multi- dimensional. For more information on this topic or on our USA based Document review and Coding Services or Revenue Cycle Management, please call Select Data at 1.800.332.0555.

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