Two-Midnight Rule Out
Under the final inpatient payment update released by the Centers for Medicare and Medicaid Services (CMS), the rate reduction associated with the proposed two-midnight rule wouldn’t occur.
The final CMS update for Medicare payments to long-term care hospitals would reduce payments in fiscal 2017, which starts Oct. 1. CMS also said an increase in Medicare drug premiums for the 2017 plan year is needed because of greater-than-expected expenses for high-cost beneficiaries.
House Democrats Open to Zika Compromise
House Democratic leaders Sept. 7 called for a “clean” bill that would completely fund the administration’s Zika response efforts, but didn’t rule out the possibility of including such funding in a fiscal year stopgap measure.
House Minority Leader Nancy Pelosi (D-Calif.) said Congress should use the next three weeks of the session to pass an emergency funding bill to combat the spread of the Zika virus. Pelosi and other Democratic leaders indicated Democrats would support a bill providing $1.1 billion—even though the Obama administration initially requested $1.9 billion in February—as long as it provided funding for a full year and was clean of any policy riders. Pelosi said public health agencies need greater “predictability and assurance that the resources will be there.”
Pelosi’s remarks came a day after the Senate failed for the third time to advance a $1.1 billion Zika funding measure that also included cuts to the Affordable Care Act and restrictions on Planned Parenthood. Pelosi noted public health officials have said the Obama administration has nearly exhausted every other source of money, including transferring money from other sectors to fund Zika vaccine research.
Changes to Health Plan Risk Protection Program Proposed by HHS
Changes would be made to the Affordable Care Act’s program for protecting insurers that cover sicker patients under a proposed rule released Aug. 29 by the Department of Health and Human Services. Beginning in 2017 “the proposed policies will take important steps to strengthen one of the Marketplace’s key tools for protecting consumers’ access to high-quality, affordable coverage options: the risk adjustment program,” the Centers for Medicare & Medicaid Services said in a release. The proposed rule would make the program “even more effective at pooling risk, allowing issuers to focus on meeting the needs of consumers,” it said.
The ACA marketplaces have lost major insurers UnitedHealth Group, Aetna and Humana, among others, as issuers have pulled back because of heavy losses on the plans. A major reason for the losses has been that the marketplaces have attracted a sicker population of enrollees than expected. The HHS Notice of Benefit and Payment Parameters for 2018 (CMS-9934-P) (RIN:0938-AS95), the latest of annual rulemaking governing the ACA marketplaces, is to be published in the Federal Register Sept. 6, with comments due 30 days after publication.
Regulators Want Doctors Sharing Drug Data
Health information technology regulators are pushing health-care organizations and technology companies to make it easier for doctors to have complete records of their patients’ medication history. The Office of the National Coordinator for Health IT has renewed an effort to improve medication lists—electronic prescription drug records—in electronic health records. The work will require pharmacies, physicians’ offices and hospitals to work together to share drug prescribing data to ensure that any doctor who treats a patient will have a complete list of their medication history.
ONC officials hope to make progress before the end of the Obama administration in early 2017 by holding many health-care organizations accountable for the promises they made in February to help Americans more easily access their health records online. Regulators are meeting with health-care organizations about the effort. Some of the country’s largest hospital systems and health IT companies in February submitted plans to the Department of Health and Human Services outlining how they’ll improve consumer access to health records and combat instances of data blocking that hamper the ability of health-care providers to share patient data.
Many of the health IT developers committed to building standardized application programming interfaces (APIs) into their electronic health record systems that would enable the creation of mobile applications and personal health records capable of interacting with doctors’ EHR systems. All health-care organizations pledged to free share patient records. HHS officials said in February they didn’t plan to penalize those organizations that fell short of their promises but would follow up to see if pledging organizations were making progress on their vows to share data.
John Zang contributed to this report