– Comment by July 29. This week, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule for mitigating the impact of significant, anomalous, and highly suspect (SAHS) billing activity on the Medicare Shared Savings Program financial calculations in calendar year 2023. This proposed rule is part of a larger strategy to address significant, anomalous, and highly suspect (SAHS) within ACO reconciliation, and additional information will be forthcoming in the Physician Fee Schedule. Due to a recent, observed increase in Durable Medical Equipment, Prosthetics, Orthotics & Supplies (DMEPOS) billing to Medicare for selected intermittent urinary catheter supplies in CY 2023, CMS proposes to exclude use of these codes from any supplier in 2023 from ACO expenditure and revenue calculations.
