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News by Topic: Legislation and regulations

CMS: Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2019 Rates; Quality Reporting Requirements for Specific Providers; Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs (Promoting Interoperability Programs) Requirements for Eligible Hospitals, Critical Access Hospitals, and Eligible Professionals; Medicare Cost Reporting Requirements; and Physician Certification and Recertification of Claims Federal Register
Aug 17, 2018 - Notice of final rule from the Centers for Medicare and Medicaid Services to revise the Medicare Hospital Inpatient Prospective Payment Systems (IPPS) for operating and capital related costs of acute care hospitals and to update payment policies and rates for inpatient services provided by long-term care hospitals. Also includes new requirements for eligible health professionals, hospitals and Critical Access Hospitals participating in Electronic Health Record Incentive Programs, among other things. Includes implications for rural facilities throughout. The final rule will be effective on October 1, 2018.
Source: Federal Register
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CMS: Medicare Program: Medicare Shared Savings Program; Accountable Care Organizations Pathways to Success Federal Register
Aug 17, 2018 - Notice of proposed rule from the Centers for Medicare and Medicaid Services to make changes to Accountable Care Organizations (ACOs) operated under the Medicare Shared Savings Program. Among other things, the proposed changes will encourage ACOs to transition to two-side models where they share in savings and are accountable for repaying shared losses. Includes considerations for small and rural providers throughout. Comments on the proposed rule are due by October 16, 2018.
Source: Federal Register
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FCC: Connect America Fund Federal Register
Aug 15, 2018 - Announcement from the Federal Communications Commission that the Office of Management and Budget has approved an information collection associated with the rules for the Connect America Fund Phase II auction, thus making the rules published on July 7, 2016 and April 13, 2018 effective.
Source: Federal Register
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CMS: Agency Information Collection Activities: Submission for OMB Review; Comment Request Federal Register
Aug 13, 2018 - The Centers for Medicare and Medicaid Services is seeking comment by September 12, 2018 on the modification of the Outcome and Assessment Information Set (OASIS) OASIS-C2/ICD-10 that home health agencies are required to collect when participating in the Medicare program.
Source: Federal Register
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CMS: Medicare and Medicaid Programs; Quarterly Listing of Program Issuances - April through June 2018 Federal Register
Aug 13, 2018 - Quarterly listing of Centers for Medicare and Medicaid Services (CMS) manual instructions, substantive and interpretive regulations, and Federal Register notices published from April through June 2018. Also includes contact information for general questions or additional information about a specific section.
Source: Federal Register
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CMS Overhaul of ACO Rules Includes a Nod to Telehealth’s Value
Aug 10, 2018 - Discusses the proposed rule from the Centers for Medicare and Medicaid Services (CMS) that would change rules around Accountable Care Organizations (ACOs). Included in these changes are new reimbursements for some telehealth services under the Telehealth Expansion Benefit Enhancement waiver and expanded coverage in 2020 for some telehealth programs in CMS' Medicare Shared Savings Program. Also touches on the shortened timeline for new ACOs to avoid risk, the reasoning behind the change, as well as concerns over it.
Source: mHealthIntelligence
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CMS, HHS: Patient Protection and Affordable Care Act; Adoption of the Methodology for the HHS-Operated Permanent Risk Adjustment Program for the 2018 Benefit Year Proposed Rule Federal Register
Aug 10, 2018 - Notice of proposed rule from the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS) to adopt the risk adjustment methodology that HHS previously established for the 2018 benefit year. This action is a result of the February 2018 district court ruling that vacated the use of statewide average premium as a basis for the HHS-operated risk adjustment methodology for the 2014-2018 benefit years. Comments are due by September 7, 2018.
Source: Federal Register
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CMS Proposes “Pathways to Success,” an Overhaul of Medicare’s ACO Program
Aug 9, 2018 - The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule that would overhaul the Medicare Shared Savings Program. This program, established by the Affordable Care Act, is the program through which most of Medicare's Accountable Care Organizations (ACOs) operate. Presently, for the first six years ACOs receive a shared savings payment from CMS when they keep costs down, but do not have to pay taxpayers back when costs are high, allowing them to transition to a new service delivery model without risk. The proposed rule would reduce the amount of time that an ACO can remain in the program without taking on risk in an effort to discourage market consolidation which may reduce choices for patients and increase costs. Comments are being accepted through October 16, 2018.
Source: Centers for Medicare and Medicaid Services
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CMS: Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY 2019; Medicare Shared Savings Program Requirements; Quality Payment Program; and Medicaid Promoting Interoperability Program; Correction Federal Register
Aug 9, 2018 - Notice from the Centers for Medicare and Medicaid Services making corrections to Figure A, as filed in the July 27, 2018 proposed rule to revise payment policies under the Physician Fee Schedule.
Source: Federal Register
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CMS Issues Proposed Additional Rule to Address Risk Adjustment Program for the 2018 Benefit Year
Aug 8, 2018 - The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule for the Patient Protection and Affordable Care Act that would adopt the risk adjustment methodology that the U.S. Department of Health and Human Services (HHS) previously established for the 2018 benefit year which uses the statewide average premium in the payment transfer formula. Comments are being accepted until September 7, 2018.
Source: Centers for Medicare and Medicaid Services
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