Congress Slowly Works on Budget Reconciliation; ACA Reform Proposals Still Up in the Air: The FY 2016 budget resolution, which was agreed to by Congress this past April, included broad reconciliation instructions directing the House and Senate committees to explore policy options for reducing the deficit. With the deadline to propose these budget recommendations coming up this Friday, July 24th, details are slowly starting to emerge regarding potential deficit reduction strategies. Notably, while the committees charged with the reconciliation instructions have repeatedly promised that the Friday deadline will be met, stakeholders are increasingly skeptical that meaningful recommendations will be ready by the end of the week. Congressional analysts believe that there is a significant block of GOP lawmakers who would like to use the reconciliation process to repeal some or major parts of the health reform law, especially following the Supreme Court ruling preserving the health insurance exchange tax subsidies in King v. Burwell. However, the conventional wisdom is that the President would veto any attempt to defund the law, thus wasting the reconciliation process to enact more achievable budget reducing initiatives. Instead, some GOP leaders are working to potentially use reconciliation on sequestration, tax reform, or other areas that could achieve broad consensus support. Speaking on the process, House Budget Committee Chairman Tom Price (R-GA) said that the July 24th deadline was self-imposed and missing the mark would not impact proposals coming later in the year. The real deadline for reconciliation will come next spring, before the next budget resolution is adopted. Health care stakeholders in particular, are largely hoping that lawmakers can find common ground around potential ACA “fixes” such as amending the 30-hour work week definition, repealing the “Cadillac tax” provision, and also reversing Medicare sequestration.
Implementation of the Affordable Care Act
GAO Investigation Finds Issues with Healthcare.gov: The GAO reported enrolling 11 fake accounts through HealthCare.gov last year, and all of them were able to renew coverage this year. The investigation revealed many issues with the system, including that fake enrollees even got more subsidies than before and that the marketplace sent incorrect 1095-A tax forms to three of the applicants, and some of the letters it sent the fake applicants referenced impossible events.
Federal Regulatory Initiatives
CMS Identifies & Prevents $820 Million in Improper Payments: The Centers for Medicare & Medicaid Services (CMS) reported that the agency’s advanced analytics Fraud Prevention System identified or prevented $820 million in inappropriate payments in the program’s first three years. The Fraud Prevention System uses predictive analytics to identify troublesome billing patterns and outlier claims for action, similar to systems used by credit card companies.
CMS Proposes Long-Term Care Facility Rule: CMS released a proposed rule to revise the requirements that long-term care (LTC) facilities must meet in order to participate in Medicare and Medicaid. Among other things, the proposal would expand requirements to improve care and safety and highlights EHRs as a means of doing so. In conjunction with the proposal, the agency released the 2013 Medicaid Expenditures for Long-Term Services and Supports Report which documents “the significant progress the Medicaid program has made to promote community living for older adults and people with disabilities.”
CMS Releases Home Health Star Ratings: CMS published star ratings on Home Health Compare, CMS’s public information website for Home Health Agencies (HHA). This is the first time CMS has published these ratings which are intended to help consumers identify difference in quality and identify areas for improvement for HHAs.
White House Holds Conference On Aging: The White House held its Conference on Aging, which aimed to “identify and advance actions to improve the quality of life of older Americans” Speakers included: HHS Secretary Sylvia Mathews Burwell, Surgeon General Vivek Murthy, HHS Assistant Secretary for Aging Kathy Greenlee, and newly appointed HHS Chief Technology Officer Susannah Fox.
AHRQ Grant for Patient-Centered Outcomes: The Agency for Healthcare Research and Quality (AHRQ) announced a new funding opportunity to drive implementation of patient-centered outcomes research. Funding will be awarded for creation of learning networks and tools to extend or support clinical decision-based findings.
AHRQ Studies EHRs Impact on Time: AHRQ released a study examining the impact of health IT and EHR systems on time spent in medical practices. The report finds that, while such technologies increase the number of patients clinics can see per day, there can be a “diminished ability” to pay attention to patients during visits.
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