Health Policy Wonk | Caffeine & Whisk(e)y Enthusiast | Powerlifting | Video Games | Opinions as strong as my coffee & are my own
Joined August 2009
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11 Mar 2025
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.
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…
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11 Mar 2025
There’s only a 30-day comment period - tight turn on this one!
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19 Sep 2024
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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4 Sep 2024
@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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2 Jul 2024
The MPFS finally cleared OMB — a fourth of July present indeed for the physician societies 🤪
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Kayla L. Amodeo,PhD retweeted
28 Jun 2024
Everyone who actually lives in DC tonight
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28 Jun 2024
QIP— CMS is proposing to add and remove several measures for PY2027 and PY2028. (KT/V changes 😱).
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28 Jun 2024
RFIs on LVPA, ETC, and QIP (health equity and data validation).
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28 Jun 2024
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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28 Jun 2024
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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28 Jun 2024
LVPA— CMS is not proposing any other changes to the rural facility adjustment in this rule.
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28 Jun 2024
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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28 Jun 2024
TDAPA—There are no major changes proposed to the existing TDAPA or post-TDAPA payment policies.
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28 Jun 2024
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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28 Jun 2024
🧵: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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28 Jun 2024
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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28 Jun 2024
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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25 Jun 2024
Coming out of X retirement (lol) to tell you all the ESRD PPS has cleared OMB. Get ready kidney folks :)
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