CMS Releases Data on No Surprises Act Complaints. The Centers for Medicare & Medicaid Services (CMS) issued a new report that details the total complaints related to the No Surprises Act and Affordable Care Act compliance. CMS notes that, as of June 2024, it had received more than 16,000 complaints, with providers and consumers receiving $4.18 million in relief. The vast majority of complaints (in excess of 12,000) were associated with No Surprises Act compliance, 248 were related to Affordable Care Act compliance, and about 3,000 cases are still open. Of the No Surprises Act complaints, 10,300 were against providers, facilities and air ambulance services. Just 1,777 complaints were made against non-federal governmental plans and issuers. Approximately 35% of closed cases found no violation.
CMS CMMI Makes New Model Participation Data Available to Researchers. The CMS Center for Medicare and Medicaid Innovation (CMMI) is releasing new participation data for the Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT). This model joins the existing models that have released data since 2022 as part of the CMS Innovation Center Model Data Sharing (CMDS) Initiative. Each model in the release may have a separate file for each of the three types of participation data; entities, providers, and beneficiaries as appropriate; and if data is available. Not all models have data for each type of participation data.
Each set of files will be updated on a quarterly basis, reflecting changes captured for the prior quarter. Quarterly updates will include full replacement files and will contain data from the launch of each model to the current quarter.1 The group of models for which files are available will expand over time to include additional models. Go here for information about the participating models and data files.
Epic Plans to Transition Users to TEFCA. In a statement, the EHR software platform Epic announced its support of Carequality’s plan to align with the Trusted Exchange Framework and Common Agreement (TEFCA) and indicated it would follow suit. Epic expects that by the end of 2024, the full Epic community will have committed to transition to TEFCA with plans to be live by the end of 2025. Epic indicated it will continue to support our customers’ connectivity through Carequality during the transition to help ensure the ongoing success of national health care interoperability.
FDA Updates AI and Medical Devices Resources. The Food and Drug Administration (FDA) updated its website focused on artificial intelligence (AI) and research on AI/Machine Learning (ML)-based medical devices. Updates include new web pages devoted to the Office of Science and Engineering Laboratories regulatory science research activities related to AI/ML. Topics include: (i) Addressing the Limitations of Medical Data in AI and Performance; and (ii) Evaluation Methods for Evolving AI-Enabled Medical Devices. In addition, The agency’s Center for Devices and Radiological Health (CDRH) AI program conducts regulatory science research to safeguard patient use of medical devices using AI/ML.
CISA and FBI Issue Guidance on Software Purchasing. The Cybersecurity & Infrastructure Security Agency (CISA) and the Federal Bureau of Investigation (FBI) issued guidance aimed at assisting organizations purchase safe software products. The guidance highlights questions and identifies resources that organizations buying software can leverage to better understand a software manufacturer’s approach to cybersecurity and ensure that the manufacturer makes secure by design a core consideration.
HHS 405(d) Releases New Malware Video. The Department of Health and Human Services (HHS) 405(d) program, a public-private sector partnership, has released a new video on malware as a part of their Knowledge on Demand “Quick Shot” video series. These short videos highlight critical cybersecurity issues impacting health care organizations. Other topics covered in the series include Botnet, Assess Management, and Encryption. Go here to access the full suite of videos.
CMS Opens QPP Participant Survey. CMS has opened a survey for participants in the agency’s Quality Payment Program (QPP). The survey seeks feedback from those that have viewed their 2023 Performance Year Final Scores. The goal of this survey is to help the Centers for Medicare & Medicaid Services (CMS) better understand the experiences of QPP participants who have received Final Scores for the 2023 Performance Year. Your responses will help CMS identify how the final feedback process can be improved, as well as what’s working well. Eligible clinicians who complete this survey may receive an Improvement Activity credit. Go here to take the survey.
Study: Machine Learning Helps Predict Autism. A study in JAMA Network Open entitled “Machine Learning Prediction of Autism Spectrum Disorder From a Minimal Set of Medical and Background Information” found that deployment of machine learning (ML) can assist in more accurately predicting autism spectrum disorder (ASD). This diagnostic study included 30,660 participants using ML prediction of ASD with only 28 features found high predictive accuracy, sensitivity, and specificity. Validation on independent cohorts showed good generalizability, and developmental milestones and eating behavior emerged as important predictive factors. Researchers contended that model used in the study shows promise in the early identification of individuals with an elevated likelihood of ASD, using minimal information, which could affect early diagnosis and intervention strategies.