As has been previously reported, on April 1, 2014, the Protecting Access to Medicare Act of 2014 was signed into law by President Obama after swift passage by the House and Senate. Language was included in this legislation that prohibited the Secretary of Health and Human Services from mandating use of ICD-10 PRIOR to October 1, 2015.
On Tuesday, May 20, 2014, CMS released a proposed rule that would make changes to the current Certified EHR Technologies (CEHRT) requirements and formally extend Stage II of Meaningful Use through 2016.
Earlier this month, CMS released the final version of the Exchange and Insurance Market Standards for 2015. This final rule outlines how the healthcare market places will function in 2015. The rule finalizes policies regarding consumer notices, quality reporting and enrollee satisfaction surveys, the Small Business Health Options Program (SHOP), standards for Navigators and other consumer assisters, and policies regarding the premium stabilization programs, among other standards.
Medicare, the national federal insurance program for Americans aged 65 and older, issued $6.7 billion in 2010 for health care visits that were improperly coded according to the report from the inspector general of the Department of Health and Human Services. But in its reply to the findings, the Centers for Medicare and Medicaid Services, which runs Medicare, said it doesn't plan to review the billings of doctors who almost always charge for the most expensive visits because it isn't cost-effective to do so.
On April 30th, the House Committee on Ways and Means Subcommittee on Health held a hearing to solicit input from the HHS Inspector General’s office (OIG), CMS and the Government Accountability Office (GAO) on ways to improve Medicare oversight and reduce waste, fraud and abuse. Gloria Jarmon, Deputy Inspector General for Audit Services, Office of Inspector General, testified on behalf of HHS; Shantanu Agrawal, M.D., Deputy Administrator and Director, Center for Program Integrity, testified on behalf of CMS; and Kathy King, Director, Health Care testified on behalf of GAO.
Medicare providers who are unable to successfully demonstrate meaningful use for 2013 due to circumstances beyond their control can apply for a “hardship exemption.” CMS is accepting applications for hardship exceptions to avoid the upcoming Medicare payment reductions for the 2013 reporting year.
This week the Centers for Medicare and Medicaid Services (CMS) released raw data on how individual medical providers treat America’s seniors. This is a historical publication into how Medicare expenditures are distributed because access has been denied since 1979, when a Florida court issued a permanent injunction barring the government form releasing information about Medicare Part B payments to individual physicians in any manner that would allow the doctor to be identified. However, in 2011, the parent company of The Wall Street Journal successfully sued to overturn the injunction.
On Tuesday, March 4, the Office of Management and Budget (OMB) released the President’s budget for Fiscal Year (FY) 2015. This budget is not a binding document and will likely result in no real action. The President’s budget is considered an indication of the President’s priorities for the upcoming fiscal year. It is important to understand the budget because certain provisions of it may be included in future proposals and legislation.
March 23rd marked the four-year anniversary of enactment of the Affordable Care Act (ACA). Most of the past four years have been spent developing the infrastructure and refining the policies to implement the law. Implementation began on October 1st, 2013, when the first open enrollment period went live. Now, as the first open enrollment period comes to an end, it seems like an appropriate opportunity to examine the state of the ACA as “phase one” comes to an end.
