@doc_amodeo

Health Policy Wonk | Caffeine & Whisk(e)y Enthusiast | Powerlifting | Video Games | Opinions as strong as my coffee & are my own

 Washington, DC
instagram.com/theboozyprof/?hl=en
Joined August 2009
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Out of X retirement once again to share this Black Clover cosplay I made for @Otakon this year! Manga readers I hope you enjoy my version of the Queen of Briars!
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ICYMI policy wonks - CMS released a marketplace integrity rule (yes the one that is still technically pending at OMB). It didn’t clear OMB or hit the FR yet but was released on the CMS website & via list serv late this afternoon.
CMSGov
@CMSGov10 Mar 2025
CMS proposed a rule to protect ppl from being enrolled in Marketplace coverage without knowledge or consent, promote stable & affordable insurance markets, & ensure taxpayer dollars only fund financial assistance for the ppl the ACA is set to support. cms.gov/newsroom/press-relea…

CMS Takes Aim to Reduce Improper Enrollments and Promote More Affordable Health Insurance Marketp...

Today, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to address the troubling amount of improper enrollments impacting Affordable Care Act (ACA) Health Insurance...

cms.gov
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There’s only a 30-day comment period - tight turn on this one!
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Link to rule - cms.gov/files/document/Marke…
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Coming out of X retirement to say - I got to hang out with THE super cool Dr. @eric_weinhandl this week!
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Replying to @makotoyukimura
@makotoyukimura I loved this unicorn panel so much I had someone make a custom mug. I think they did a great job and I hope you love it! Thank you for all the amazing art ❤️
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The artist is - instagram.com/toadhouse.pott…
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Wow this years MPFS is 2248 pages … thrilling
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The MPFS finally cleared OMB — a fourth of July present indeed for the physician societies 🤪
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Kayla L. Amodeo,PhD retweeted
Joseph@exurbandmv28 Jun 2024
Everyone who actually lives in DC tonight
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QIP— CMS is proposing to add and remove several measures for PY2027 and PY2028. (KT/V changes 😱).
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RFIs on LVPA, ETC, and QIP (health equity and data validation).
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LVPA —proposing to create a two-tiered LVPA. ESRD facilities that furnished fewer than 3k treatments per cost reporting year would receive a 28.4% ⬆️ adjustment to the ESRD PPS base rate, and ESRD facilities that furnished 3k to 3.9k treatments would receive an 18.1% ⬆️ .
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TPEAPA— CMS determined that it would not be appropriate to apply a budget-neutrality factor for the TPEAPA for CY 2025.
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LVPA— CMS is not proposing any other changes to the rural facility adjustment in this rule.
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NEWS🚨: Outlier Payment Pool—For the first time since implementation of the ESRD PPS, the outlier payment pool hit the 1% target in CY23.
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TDAPA—There are no major changes proposed to the existing TDAPA or post-TDAPA payment policies.
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TPNIES—The proposed CY 2025 average per treatment offset amount for the TPNIES for capital-related assets that are home dialysis machines is $10.18. No new TPNIES applications this year.
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🧵:CY25 ESRD PPS proposed rule highlights! Not exhaustive but I’m exhausted 🤣 The proposed base rate is $273.20, an increase from the CY 2024 ESRD PPS base rate of $271.02. (1.8% net update). Same rate for AKI.
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Oral drugs—CMS moving forward with drug shift. CMS is considering whether it may be appropriate to make additional payments to account for operational costs in excess of 100 percent of ASP (ex. Shipping and handling). Asks for feedback.
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BIG NEWS🚨: CMS is proposing to allow payment for AKI renal dialysis services furnished to beneficiaries in their homes. Also proposing for ESRD facilities to bill Medicare for the home and self-dialysis training add-on payment adjustment. (would be budget neutral).
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