Debra A. McCurdy
This week, CMS released a proposed rule that would make significant revisions to the Medicare Advantage and Part D prescription drug program regulations. The agency estimates that the rule changes would reduce Medicare spending by $1.3 billion between 2015 and 2019.
In late December, President Obama signed into law the Bipartisan Budget Act of 2013, which includes the Pathway for SGR Reform Act of 2013. While SGR drew most of the media attention, the Act includes a number of other provisions impacting the Medicare and Medicaid programs.
The Centers for Medicare & Medicaid Services intends to finalize the Medicaid Federal Upper payment Limits (FULs) for multiple source drugs in July 2014. This will mean less drug price variance for state Medicaid programs.
The ongoing partial federal government shutdown is having a varied impact on healthcare provider operations. Some have experienced the impact in the form of curtailed survey and certification activities.
The HHS Office for Civil Rights has made a number of recent announcements regarding HIPAA Privacy Rule implementation.
The Internal Revenue Service has issued final regulations to implement the ACA requirement that every individual have basic health insurance coverage, qualify for an exemption, or make a "shared responsibility" payment when filing a federal income tax return, beginning in 2014.
CMS is applying a 1.8 percent payment update to IRF PPS rates for FY 2014, derived from a 2.6 percent market basket update that is reduced by a 0.5 percentage point multi-factor productivity adjustment and an additional 0.3 percentage point reduction as required by the ACA.
Affinity Health Plan, Inc. recently reached a $1.2 million settlement with the HHS Office for Civil Rights related to potential violations of the Health Information Portability and Accountability Act of 1996 (HIPAA).
CMS has announced updates to the process for making Medicare national coverage determinations (NCDs) to provide clarity and transparency with regard to modifications made to the coverage process since the Medicare Modernization Act.
On July 26, 2013, CMS announced temporary moratoria on enrollment of new home health providers and ambulance suppliers under Medicare, Medicaid and the Children's Health Insurance Program (CHIP) in three parts of the country identified as "fraud hot-spots."