Use the myCGS Eligibility Tab to Avoid Claim Errors

CGS

It’s a new year and the perfect time to add one more resolution to your list! Before you submit a claim, use the myCGS eligibility tab to avoid these simple errors:

• Eligibility – Is your patient eligible to receive services covered under the Part A, Part B or Part B Immunosuppressive Drug benefit?
• Deductibles/Caps – Has your patient met the annual Part B deductible, therapy cap or rehabilitation services limitation?
• Preventive Services – Is your patient eligible to receive a service that Medicare covers to prevent certain illnesses and chronic conditions?
• Plan Coverage – Did your patient enroll in a Medicare Advantage (MA) managed care plan that replaces traditional Medicare?
• MSP – Is your patient entitled to other insurance coverage that makes Medicare a secondary payer (MSP)?
• Hospice/Home Health, Inpatient – Did you provide services to your patient that overlap a hospice or home health period of care, or an inpatient hospital or Skilled Nursing Facility stay covered under Part A?

Stop the guesswork and eliminate the need to submit multiple claims. myCGS is a FREE, online web portal available to ALL CGS J15 providers. Register and use myCGS today to save your organization time and money!

Colorado (Again) Changes Rules on How Employers Must Compensate Employees Using Paid Leave

Littler Publications | Dec 20, 2022

Effective January 1, 2023, regulations under Colorado’s Healthy Families and Workplaces Act (HFWA) will again change how employers calculate the rate of pay when employees use paid sick and safe leave and/or public health emergency leave. Although employers might welcome certain changes to the pay rate calculation rules, the fact is that these new regulations amount to the third time that Colorado’s Department of Labor & Employment (CDLE) has revised the pay rate calculation rules since the HFWA first took effect in mid-2020. Thus, pay rate calculations under the HFWA are a moving target, making compliance a challenge. Learn More

Biden Administration Renews Public Health Emergency Again

Full text of the declaration reads:

As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)  pandemic, on this date and after consultation with public health officials as necessary, I, Xavier Becerra, Secretary of Health and Human Services, pursuant to the authority vested in me under section 319 of the Public Health Service Act, do hereby renew, effective January 11, 2023, the January 31, 2020, determination by former Secretary Alex M. Azar II, that he previously renewed on April 21, 2020, July 23, 2020, October 2, 2020, and January 7, 2021, and that I renewed on April 15, 2021, July 19, 2021, October 15, 2021, January 14, 2022, April 12, 2022, July 15, 2022, and October 13, 2022, that a public health emergency exists and has existed since January 27, 2020, nationwide.

‘Kraken’ COVID symptoms: What to Know About the Strain Sweeping Through the U.S. and Now in at Least 28 Other Countries

Fortune Well | By Eleanor Pringle

COVID hospitalizations in the U.S. have spiked 16.1% in the past week as a new “escaped” variant of the virus has continued to sweep across the country.

XBB.1.5— dubbed ‘Kraken’ by Canadian biology professor Dr. Ryan Gregory and his following in the Twitterverse—is the most transmissible COVID variant yet, according to the World Health Organization.

A risk assessment is currently being drawn up for the new mutant strain by WHO’s technical advisory group on virus evolution, Maria Van Kerkhove, technical lead for COVID-19 response at the authority, said on Wednesday.

XBB.1.5 began alarming scientists at the tail end of last year after the number of Kraken cases in the U.S. rose from 1% of all cases at the start of December to 41% just three weeks later.

This week, the U.S. Centers for Disease Control and Prevention projected that it comprised around 75% of infections in regions 1 and 2, which include Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont, New York, New Jersey, Puerto Rico, and the U.S. Virgin Islands.

The strain is believed to be in at least 28 other countries—including Europe—with cases of XBB.1.5 now thought to make up 4% of COVID cases in the U.K.

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