NJ Legislative Alert: A4093 Concerning Scrap Tire Recycling

A4093 Concerning Scrap Tire Recycling

A4093 is an Act aimed at amending and supplementing New Jersey’s recycling laws to include scrap tires on the list of items legally required to be recycled. This Act concerns the Department of Environmental Protection, scrap tire haulers, scrap tire facilities, and New Jersey recycling centers.
A4093 seeks to:

  • Legally obligate the recycling of scrap tires
  • Prohibit disposal of scrap tires as solid waste
  • Institute a Department of Environmental Protection (DEP) system of scrap tire tracking, collection, recycling, and responsible disposal within 180 days of A4093 enactment
  • Require scrap tire haulers and recycling centers to be licensed by the DEP within 180 days of A4093 enactment
  • Require New Jersey district recycling plans to include source separation of scrap tires from solid waste stream
  • Implement a system of fines of up to $25,000 dollars for violation of A4093
  • Ensure no person in the state of New Jersey knowingly dispose of scrap tires as solid waste after January 1st, 2017
  • Prevent illegal dumping of scrap tires

As mentioned in A4093, the recycling and reuse of scrap tires provides a number of benefits, while limiting landfill overflow. Recycled tires can be used as playground cover material, alternative fuel, and in civil engineering applications, which all could benefit New Jersey greatly.

Status: A4093 has been referred to Assembly Environment and Solid Waste Committee for further review.


Billy Hoffer Contributed to this Report

NJ Legislative Alert: A4158 NJ Call Centers Job Act

A4158 NJ Call Centers Job Act

A4158 is a proposed act in New Jersey that seeks to incentivize call center job retention by utilizing a financial reward and punishment system for call center employers. Under this Act, call centers refer to any office employing 50 or more people who receive phone calls or electronic communications for the purpose of providing customer assistance or other services.

A4158 seeks to:

  • Require outsourcing call center employers to notify the Commissioner of Labor and Workforce Development 90 days prior to the transfer of operations
  • Punish call center employers who outsource the number of employees handling 20% or more of the annual communication volume to foreign countries
  • Bar outsourcing call centers from receiving state grants, guaranteed loans, tax benefits, or any other financial assistance for 36 months after notifying the commissioner of said outsourcing
  • Require outsourcing companies to return unamortized state funds awarded them through state grants, guaranteed loans, tax benefits, or any other financial assistance
  • Give preference when awarding state contracts to call centers retaining jobs in New Jersey
  • Continue to give funds to workplaces for the purpose of supporting training and hiring initiatives including but not limited to veterans, minority groups, and women, regardless of being on the outsourcing companies list

A4158 is aimed at curbing the current trend of outsourcing New Jersey jobs to foreign countries with lower wages. This Act punishes outsourcing companies financially to make operation transfer more expensive than keeping jobs in the state of New Jersey. ·
Current Status: Introduced and referred to Assembly Labor Committee for review

NJ Legislative Alert: A4056 Concerning Massage and Bodywork Therapy

A4056 Concerning Massage and Bodywork Therapy

A4056 is a proposed amendment to the Massage and Bodywork Therapist Licensing Act (P.L. 1999, c.19 (C.45:11-60). Under current law, those seeking to obtain a license in Massage and Bodywork Therapy are required to  complete 500 hours of class study OR successfully complete a comprehensive written exam.

A4056 seeks to:

  • Require applicants for licensure to complete 500 hours of in class study ANDsuccessfully complete a comprehensive written exam
  • Remove provision in current law that provides that the successful completion of any such examination may have been accomplished before the effective date of the act

Status:   A4056 has been referred to Assembly Regulated Professions Committee for further review.

For more information, please contact Brett Goldman with DMGS at 215-979-1326 or emailbjgoldman@dmgs.com

Billy Hoffer Contributed to this Report 

NJ Legislative Alert: S2533 Contractors Registration Act

S2533 Contractors  Registration Act is a proposed piece of legislation concerning the requirements of residential general contractors and home renovators. This law aims to better protect the consumer while also updating regulations to ensure contractors are fully covered while completing jobs in a safe and legal manner.
S2533 seeks to:

  • Require contractors to carry a bond amounting to a minimum of 50,000 dollars to provide restitution in the event of a violation of “Contractor’s Registration Act”
  • Rewrite the contractor’s “notice to consumer” regarding the work agreed to be completed with the intention of allowing the consumer a better understanding of state regulation and easier avenue to cancel the work
  • Ensure contractors complete jobs by creating a series of fines of up to 20,000 dollars

Current Status: Referred to Senate Commerce Committee
For more information, please contact Brett Goldman with DMGS at 215-979-1326 or emailbjgoldman@dmgs.com

Billy Hoffer Contributed to this Alert

Weekly Healthcare Update

Rule Ends Required Arbitration for Nursing Home Residents

The Centers for Medicare & Medicaid Services said in a statement that its final rule makes “major changes to improve the care and safety of the nearly 1.5 million residents in the more than 15,000 long-term care facilities that participate in the Medicare and Medicaid programs.” The agency said the policies in the final rule are targeted at reducing unnecessary hospital readmissions and infections, improving the quality of care and strengthening safety measures for residents in these facilities.

A Sept. 28 blog posting by two CMS officials said “the rules of the road for long-term care facilities haven’t had a comprehensive update since 1991. Today, we are pleased to announce that we have finalized new rules to protect and empower residents of long-term care facilities.” The officials—Andy Slavitt, the CMS’s acting administrator, and Kate Goodrich, director of the Center for Clinical Standards & Quality—said in their blog post that, as of Nov. 28, the rule “will prohibit the use of pre-dispute binding arbitration agreements.” This means that facilities may not require residents to sign pre-dispute arbitration agreements as a condition of admission to that long-term care facility, they said.

The agency officials said, “Historically, many facilities require residents to agree to binding arbitration clauses when they are admitted to these facilities. These clauses require the resident to settle any dispute that may arise using arbitration rather than the court system.” The CMS officials added that facilities and residents will still be able to use arbitration on a voluntary basis at the time a dispute arises. “Even then, these agreements will need to be clearly explained to residents, including the understanding that these arbitration agreements are voluntary, and that these agreements should not prevent or discourage residents and families from talking to authorities about quality of care concerns,” the officials said.

The rule (CMS-3260-F; RIN:0938-AR61) will be published Oct. 4 in the Federal Register.

Hospital Merger Stalls After FTC Court Win

Two Pennsylvania hospitals must put their merger on hold while the Federal Trade Commission examines the deal’s competitive impact, a federal appeals court decided (FTC v. Penn State Hershey Med. Ctr., 2016 BL 317602, 3d Cir., No. 16-2365, 9/27/16). The decision by the U.S. Court of Appeals for the Third Circuit vindicates the FTC’s long-established method for calculating market shares in hospital mergers. It also reverses the agency’s first loss on a hospital merger challenge in more than a decade and may bode well for the agency’s lawsuit over another proposed hospital merger currently pending before the Seventh Circuit in Chicago. The Third Circuit applied the FTC’s method for defining the geographic market in hospital merger cases, which is a boost for future cases. The court’s analysis is extraordinarily friendly to the FTC’s hypothetical approach to market definition in these mergers.

House GOP Passes Exemption From Health Insurance Mandate

House Republicans defied unified Democrats in passing a bill that would exempt from penalties people who were enrolled in health plans with one of the 17 failed CO-OPs created under the Affordable Care Act. The House voted 258-165 on Sept. 27 to pass the bill (H.R. 954). Democrats were united in their opposition to the bill, and the White House warned that President Barack Obama would veto the bill if it reached his desk.

The proposed exemption would undermine the individual mandate, the crucial provision of the ACA that requires all Americans to have health insurance or face a penalty, Rep. Jim McDermott (D-Wash.) said Sept. 27 on the House floor.

“This bill undermines the individual shared responsibility provision of the ACA, which is important in making many of its benefits possible, including no one being denied coverage, no pre-existing conditions and no gender discrimination,” Rep. Sander M. Levin (D-Mich.) said. Rep. Adrian Smith (R-Neb.), the main sponsor of the bill, countered that the legislation was narrowly tailored to protect from the tax penalty the few people who were unable to enroll in a new health plan after their Consumer Operated and Oriented Plans (CO-OPs) collapsed.

Addiction Drug Prescribers Get New Reporting Requirements

Qualified doctors prescribing the addiction treatment drug buprenorphine will be subject to new reporting requirements, according to a final rule released Sept. 23. The final rule will require practitioners to provide information on their annual caseload of patients by month and the number of patients provided behavioral health services and referred to behavioral health services. In addition, the rule will mandate that practitioners report on their plans to counter diversion, or the unauthorized distribution, of buprenorphine.

The rule (RIN:0930-AA22) is part of an expanded administration initiative to combat opioid abuse. It comes as the House and Senate are considering authorizing $37 million in grants to states for opioid abuse prevention. Updated reporting requirements under the rule go into effect Oct. 27. The rule is scheduled for Sept. 27 Federal Register publication.

The final rule is meant to help HHS ensure compliance with a separate final rule from the Substance Abuse and Mental Health Services Administration (SAMHSA) setting requirements for prescribers of buprenorphine. SAMHSA is part of the Department of Health and Human Services. That rule (RIN:0930-AA22), published in the July 8 Federal Register, increased the limit on the number of patients that practitioners can treat with buprenorphine to 275, nearly triple the previous cap of 100 patients. That change went into effectAug. 12.

Proposed Rule Would Bolster Medicaid Fraud Program

The Medicaid anti-fraud programs in each state would get more federal funding and enhanced prosecutorial discretion under a proposed rule released Sept. 19. The proposed rule (RIN:0936-AA07) would codify statutory changes to the Medicaid Fraud Control Unit (MFCU) program that have been made since the program began in 1977, such as increasing the federal matching rate for MFCU operations from 50 percent to 75 percent. The proposal also would formally allow MFCUs to investigate and prosecute patient abuse cases, even in facilities that don’t receive Medicaid funds.

The MFCU rule hasn’t been updated in over 30 years, during which time a number of statutory changes have been made, such as requiring that MFCUs coordinate with Health and Human Services Office of Inspector General investigators and federal prosecutors on cases. The OIG has used program and policy guidance, on-site reviews and reporting requirements to loosen some MFCU requirements and tighten others over the last 30 years.

The proposed rule was jointly released by the Centers for Medicare & Medicaid Services and the OIG. It was published in the Sept. 20 Federal Register (81 Fed. Reg. 64,383), and comments are due by Oct. 31. MFCUs operate in 49 states and the District of Columbia and are designed to investigate and prosecute Medicaid fraud. The OIG has oversight responsibility for MFCUs and determines whether to recertify individual MFCUs on an annual basis.

Medicare Advantage Premiums Down Slightly for 2017

The average Medicare Advantage monthly premium will decrease by 4 percent to $31.40 in 2017, the Medicare agency said Sept. 22. Although premiums vary by county, on average they will drop by $1.19 from $32.59 in 2016, the Centers for Medicare & Medicaid Services said.

The average premium for a basic Medicare Part D prescription drug plan will increase to $34 per month from $32.56 in 2016. The agency said about two-thirds of MA enrollees—67 percent—will not see an increase.

In addition, the agency said over 94 percent of Medicare beneficiaries will have access to a zero-premium Medicare Advantage plan. The decline in premiums is good news for the rising number of Medicare Advantage plan subscribers, according to the CMS. “Medicare enrollees will continue to have access to predictable premiums and high quality care,” Andy Slavitt, the agency’s acting administrator, said in a statement.

John Zang, DMGS Ohio Contributed to this Report

Legislative Overview and Regulatory Matters of Driverless Vehicle Technology

By Danny Restivo, DMGS

Edited by Brett Goldman, DMGS Manager of Special Projects

The popular ride-sharing service Uber introduced a fleet of driverless vehicles to Pittsburgh in September 2016. Days after the launch, President Barack Obama wrote an op-ed in the Pittsburgh Post-Gazette and praised Uber for its innovation and effort to improve safety. “…Too many people die on our roads – 35,200 last year alone – with 94 percent of those the result of human error or choice. Automated vehicles have the potential to save tens of thousands of lives each year.”

Uber’s program comes eight months after the United States Department of Transportation announced a multi-billion dollar investment into the technology. In January 2016 Secretary of Transportation Anthony Foxx unveiled a $4 billion, 10-year plan to accelerate driverless technology. “We are on the cusp of a new era in automotive technology with enormous potential to save lives, reduce greenhouse gas emissions, and transform mobility for the American people,” Foxx said in a statement announcing the plan.

In light of the federal government’s investment, Google, Ford, BMW, Tesla, Volvo and General Motors have all begun developing similar driverless programs. As the technology edges closer to highways, the federal government has paved the way for autonomous vehicles to hit the road. On September 20, the National Highway Transportation Safety Administration released proposed guidelines and benchmarks for driverless vehicles. The announcement received applause from the Self-Driving Coalition for Safer Streets, which represents Ford, Uber, Lyft, Volvo and Google. The coalition’s leadership also acknowledged the need for other regulatory entities to follow their lead.

“State and local governments also have complementary responsibilities and should work with the federal government to achieve and maintain our status as world leaders in innovation,” David Strickland, coalition spokesperson and general counsel, said in a statement following the NHTSA’s announcement. “With the guidance now publicly available, we encourage state policymakers to engage with our coalition to develop the appropriate policy solutions, and we stand ready to provide support and expertise for both technological and policy questions.”

The Obama administration’s guidelines provide 15 benchmarks companies must meet before their driverless vehicles can hit the road. Those benchmarks include operational functions and safety procedures. However, the NHTSA has given automakers and tech companies flexibility to meet those benchmarks, as long as detailed explanations are given. While the federal government’s proposal provides a framework, several states have already approved or introduced laws regulating autonomous vehicles. Legislative bodies in Nevada, Michigan, Tennessee, California, Louisiana, North Dakota, Utah, Florida and Washington, D.C., have all approved laws related to driverless vehicles. Meanwhile, Arizona’s governor wrote an executive order in August 2015 that supported efforts to test driverless cars on public roads. In June of that year, Virginia’s governor announced a partnership among the Virginia Department of Motor Vehicles, the Virginia Department of Transportation and the Virginia Tech Transportation Institute to research and develop driverless technology.

Several other states have debated legislation, but their laws often conflict with the nature of driverless technology. For example, many states call for a licensed driver behind the wheel before a vehicle can operate. Moreover, laws related to seatbelts, unattended vehicles, hands on steering wheels and licensing requirements raise questions about legislating the technology. Whether state legislatures approve the federal government’s proposed guidelines remains to be seen.

Eric Martins, Managing Director of DMGS thinks that “if states do not adopt uniform legislation, a patchwork of laws could make autonomous driving through state lines a major challenge for driverless vehicles. This, of course, would be a terrible setback for both consumers, industry, and regulators. Crafting smart legislation and regulations will be key to making this technology thrive.”

Enacted Autonomous Vehicle Legislation

California (CA SB 1298)—Establishes safety and performance standards to be overseen by California Department of Motor Vehicles and the Highway Patrol. Also allows autonomous vehicles to be tested on public roads (2012).

Florida (HB 1207)—Defines autonomous drivers and driverless technology. Also allows a licensed driver to operate an autonomous vehicle with insurance (2012). HB 7027–Eliminates the requirement that a driver be present in the vehicle. Requires autonomous vehicles meet applicable federal safety standards and regulations (2016). HB 7061–Defines autonomous technology and driver-assistive truck platooning technology. Requires a study on the use and safe operation of driver-assistive truck platooning technology and allows for a pilot project upon conclusion of the study.

Louisiana (HB 1143)—Defines autonomous technology (2016)

Michigan (MI S 169 and 663)—Defines automated vehicle technology and modes, and limits the liability an automated driver manufacturer faces in a lawsuit (2013). (SB 995-998)–Allows people to purchase autonomous vehicles upon availability. It also permits autonomous cars without steering wheels and pedals, and it doesn’t require a human operator (2016).

Nevada (NV AB 511) Permits the operation of autonomous vehicles for licensed drivers, and directs the Nevada Department of Motor Vehicles (DMV) to adopt rules for license endorsement and for operation, including insurance, safety standards and testing in relation to driverless vehicles (2011). (NV SB 140) Permits the use of wireless handheld devices in a legally operated driverless vehicle (2011). (NV SB 313) Requires an autonomous vehicle to have insurance (2013).

Nevada regulations currently require two people in a driverless car that is being tested, which can only occur in approved areas. However, regulators have begun revamping policy for autonomous vehicles in non-testing environments.

North Dakota (ND HB 1065) Commissioned a study to research the implications of autonomous driving in relation to reducing crashes, fatalities and traffic congestion (2015).

Tennessee (TN SB 598) Prohibits local governments from banning vehicles equipped with autonomous driving technology (2015). (TN SB 1561) Establishes a program through the Department of the Safety that would certify autonomous vehicle manufactures before, they could be tested, sold or operated in the State. It also creates a per mile tax structure for driverless vehicles (2016).

Utah (HB 280) Requires certain state agencies to study autonomous vehicle technologies and best practices and report the findings. It also permits agencies to partner with driverless companies and entities (2016).

Washington, D.C. (DC B 19-0931) Defines autonomous driving and requires a prepared human driver to take control of the vehicle in an emergency. It also addresses the liability of the original manufacturer of a converted vehicle (2013)

Introduced Autonomous Vehicle Legislation in 2016

Alabama (S 178) Requires testing of autonomous technology with approval by the Alabama State Law Enforcement Agency. Also requires each driverless vehicle to carry insurance and “authorizes the agency to create a driver’s license endorsement and require testing.” Status: Failed

California (A 1592) Authorizes the Contra Costa Transportation Authority to conduct a pilot project for to test autonomous vehicles that are not equipped with a steering wheel, a brake pedal, an accelerator, or an operator inside the vehicle Status: Sent to the Governor.  

Georgia (S 113) Classified autonomous vehicles and technology with specific provisions. Would allow the operation of autonomous vehicles for testing Status: Failed.

Hawaii (H 2687) Authorizes autonomous vehicles for research and testing purposes. Requires the Department of Transportation to establish an application process to report to the legislature annually. Status: Failed.

(S 630) Requires certain safety features and testing requirements for autonomous vehicles. Also requires an autonomous vehicle operator to hold a driver’s license. Status: Failed.

Illinois: (H 3136) Creates the Automated Motor Vehicle Study and Report Act to be done by the Secretary of State. The feasibility study will cover and record automated vehicle operations. Status: Passed House. In Senate. Placed on Calendar Order Third Reading. Pending Carryover.

Massachusetts (H 4321) Authorizes autonomous vehicles without human operators. Status: In House Committee on Ways and Means.

(S 1841) Defines autonomous vehicles and permits autonomous vehicles to operate on public roads if the vehicle manufacturer meets all safety standards. Status: Pending, Senate Study Order.

Maryland (H 8 & S 126) Establishes a task force that was used to research driverless vehicles and determine the best path for governing autonomous vehicles. Status: Failed.

Michigan (S 927 & S 928) Prohibits and provides penalties for accessing a computer system that operates a vehicle with intent of doing harm or damage. The proposed legislation also provides penalties for such action. Status: Pending in Senate Judiciary Committee.

(S 995 & S 996) Allows for driverless vehicles to operate without a person in the car. Status: Passed Senate. In House Committee on Communications and Technology.

(S 997 & 998) Defines automated driving and allows for the creation of mobility research centers where automated technology can be tested. Provides immunity for automated technology manufacturers when modifications are made without the manufacturer’s consent. Exempts mechanics and repair shops from liability on fixing automated vehicles. Status: Passed Senate. In House Committee on Communications and Technology.

Minnesota (H 3325 & S 2569) Establishes autonomous vehicles task force and demonstration project to serve mobility needs of people with disabilities; provides support for the task force; defines terms; appropriates money. Status: Failed

New Jersey (A 554) Requires self-driving vehicles to have ignition interlock device Status: In Assembly Committee on Law and Public Safety

(A 851 & S 343) Directs Motor Vehicle Commission to establish driver’s license endorsement for autonomous vehicles. Status: In Assembly Committee on Transportation and Independent Authorities/the Senate Committee on Transportation.

(A 3745) Permits testing and use of autonomous vehicles on state roadways under certain circumstances. Status: In Assembly Transportation and Independent Authorities Committee.

New York (A 31) Provides and regulates the operation and testing of vehicles with autonomous technology. Status: To Assembly Committee on Transportation.

(A 10586) Directs a study and report on autonomous vehicles on highways. Also directs the commissioner of the Department of Transportation to support such testing and operation. Status: In Assembly Committee on Transportation

(S 7879) Specifies the law requiring one hand on the steering wheel does not apply if autonomous technology is engaged to perform the steering function. Passed Senate. Pending in Assembly Committee on Transportation.

Pennsylvania (H 2203) Defines terms related to autonomous vehicles. Regulates the testing of autonomous vehicles. Allows the adoption of regulations dealing with autonomous vehicles. Status: In House Rules Committee.

(S 1268) Provides for autonomous and connected vehicles. Status: In Senate Transportation Committee.

Rhode Island (S 2514) Would permit the use of vehicles equipped with autonomous technology on Rhode Island roads. Status: In Senate Judiciary Committee


  1. Obama, Barack. “Barack Obama: Self-Driving, Yes, But Also Safe.” Pittsburgh Post-Gazette. (Pittsburgh) September 19, 2016.  http://www.post-gazette.com/opinion/Op-Ed/2016/09/19/Barack-Obama-Self-driving-yes-but-also-safe/stories/201609200027
  2. Secretary Foxx unveils President Obama’s FY17 budget proposal of nearly $4 billion for automated vehicles and announces DOT initiatives to accelerate vehicle safety innovations.” Nhtsa.gov. January 14. 2016.  http://www.nhtsa.gov/About+NHTSA/Press+Releases/dot-initiatives-accelerating-vehicle-safety-innovations-01142016

  3. Kang, Cecilia. “Self-Driving Cars Gain Powerful Ally: The Government.” The New York Times. (New York) September 19, 2016.  http://www.nytimes.com/2016/09/20/technology/self-driving-cars-guidelines.html?_r=1

  4. Plungis, Jeff. “Self-Driving Cars Must Meet 15 Benchmarks in U.S. Guidance.” Bloomberg Government. September 20, 2016. https://www.bgov.com/core/news/#!/articles/ODT8KW6JIJVF?niReferrerLink=homepageFeed

  5. Self-Driving Coalition for Safer Streets. “Self-Driving Coalition Reacts to NHTSA Autonomous Vehicles Guidance.” September 19, 2016. http://www.prnewswire.com/news-releases/self-driving-coalition-reacts-to-nhtsa-autonomous-vehicles-guidance-300330616.html

  6. Plungis

  7. National Conference of State Legislatures. “Autonomous Self-Driving Vehicles Legislation.”  September 13, 2016. http://www.ncsl.org/research/transportation/autonomous-vehicles-legislation.aspx

  8. National Conference of State Legislatures.

  9. Coy, Brian. “Governor McAuliffe Announces New Partnership to Make Virginia a Leader in Automated-Vehicle Industry.”  Office of the Governor. June 2, 2015. https://governor.virginia.gov/newsroom/newsarticle?articleId=8526

  10. LaFrance, Adrienne. “Anybody Can Test a Driverless Car in Pennsylvania.” The Atlantic. (Washington, D.C.) September 14, 2016. http://www.theatlantic.com/technology/archive/2016/09/anybody-can-test-a-self-driving-car-in-pennsylvania/499667/

  11. National Conference of State Legislatures


Health Care Policy Update


DMGS closely monitors Health Care Policy both at the Federal and State Level.

Feds Defend Plan for More Health E-Record Oversight

A proposal to directly oversee federal certified electronic health records is within the Office of the National Coordinator for Health IT’s authority, the new head of the agency said Sept. 19. As more hospitals and doctors adopt EHR systems and as the use of health IT becomes ingrained in more federal health programs, the ONC should take a more direct role in ensuring that the technologies doctors adopt are functioning properly, Vindell Washington, the national coordinator for health IT, told reporters during a policy briefing hosted by the agency. The ONC currently relies on a few designated organizations in the private sector to ensure certified EHRs are working properly.

“We have less than optimal oversight into the testing that goes into certification,” Washington said. Republican leaders of two influential congressional committees challenged whether the ONC had the authority to respond directly to complaints about certified EHR systems in a July letter to the agency. The ONC sought to change its role in certifying EHRs for the federal meaningful use program in a proposed rule published in March. The final rule could be released soon. The Office of Management and Budget started reviewing the final rule Aug. 16. 

Problems Stall Stricter Reviews for Medicare Home Care Claims

A CMS test project to impose tougher reviews on home health-care claims won’t be expanded as planned, the Medicare agency said recently. Based on the experience in Illinois with the project since it started Aug. 3, it won’t be expanded into other states yet, the Centers for Medicare & Medicaid Services said in suspending the pilot program’s expansion.

The somewhat unusual admission from the CMS that there are problems with the program in Illinois will delay wider implementation of the demonstration. Provider groups and some members of Congress have decried the pilot project, claiming it would be overly burdensome for home health agencies. The demo, which will continue in Illinois, imposes a requirement that prevents a beneficiary from receiving physician-directed home care until a CMS-approved intermediary has reviewed and approved the doctor’s order. The project had been set to start in Florida by Oct. 1.

HHS Can’t Delay Addressing Medicare Appeals Backlog

The HHS won’t get any more time to fix a backlog of 760,000 pending Medicare appeals before facing litigation filed by the American Hospital Association and others (Am. Hosp. Ass’n v. Burwell, 2016 BL 307248, D.D.C., No. 14-cv-851, 9/19/16). The U.S. District Court for the District of Columbia said the Department of Health and Human Services wasn’t making enough progress to reduce the huge backlog of Medicare appeals pending at the administrative law judge level of claim review. Judge James E. Boasberg said the measures outlined by the HHS to the court to address the backlog would only reduce the pace of backlog growth, and that he was obligated to deny the agency’s requested stay of litigation until Sept. 30, 2017, the close of the next federal appropriations cycle.

The court in particular singled out modifications to the Recovery Audit Contractor program (blamed by the AHA for the increase in Medicare appeals) as being insufficient to reduce the ALJ backlog despite the HHS’s discretionary authority to make more sweeping changes to the program. Boasberg’s focus on the modest changes to the RAC program (affecting only 7 percent of RAC appeals), as well as AHA’s concerns, could be a signal that the court plans to include changes to the RAC program in a future court order issued to the HHS. RACs are tasked with detecting and recovering Medicare overpayments and are paid by the government on a contingency-fee basis.

The court repeated its assertion that it was “loath to intervene” in what was essentially an executive and legislative issue, but said some legal action must be taken now given that administrative and congressional fixes appeared unlikely to bring the HHS into compliance with the statutory ALJ review deadline. Boasberg, however, didn’t grant the plaintiff’s request to order the HHS to come into immediate compliance with the statutory ALJ review deadline, but instead ordered the parties to appear on Oct. 3 to “discuss how next to proceed.”

More Patients Viewing Records Online

Nearly every U.S. hospital offers their patients the ability to view their health records online, representing a major policy victory for federal health IT regulators. The percentage of hospitals with the capability to share health records with their patients grew from 24 percent in 2012 to 95 percent in 2016, according to data presented to federal health IT policy advisers recently. The percentage of hospitals that allow patients to download and transmit a copy of their health records also grew during that time, from 10 percent in 2012 to 69 percent in 2016.

Giving patients more control over their health data has long been a goal of the Office of the National Coordinator for Health Information Technology, which advocated for the federal meaningful use program to include requirements for hospitals to give their patients online access to their own health records, the head of the ONC said during a Sept. 13 joint meeting of the Health IT Policy and Standards committees.

John Zang, DMGS Ohio, Contributed to This Report