CMS releases proposed rules to increase 2018 Medicare payments

At the agencies

The Centers for Medicare and Medicaid Services (CMS) has released a series of proposed rules that would increase Medicare payments to rehabilitation hospitals, nursing facilities and hospices. The agency is proposing a $390 million increase in federal payments to skilled nursing facilities for 2018, roughly a 1 percent increase from 2017. Hospices would receive a 1 percent increase worth $180 million. The proposed regulations would increase reimbursements to rehab hospitals by $80 million for 2018 and would eliminate a penalty on facilities that fail to submit certain data to the federal government on time. CMS is also requesting industry input on regulations that it should overhaul or eliminate following the recent Department of Health and Human Services (HHS) pledge to review all of the agency’s rules in an attempt to cut unnecessary or burdensome regulations.

The Secretary of Health and Human Services, Tom Price, has sent a letter to governors detailing $485 million in grants to be awarded by HHS that are designed to help states and territories combat the opioid crisis. The grants, which originate from the first of two rounds of funding provided by the 21st Century Cures Act, will be issued through the State Targeted Response to the Opioid Crisis Grants program administered by the Substance Abuse and Mental Health Services Administration (SAMHSA). The funding is intended to support an array of prevention, treatment and recovery services. Award allocation to states will be based on the rates of overdose deaths and unmet need for opioid addiction treatment.

CMS Administrator Seema Verma has released a letter celebrating National Minority Health Month at CMS. The letter emphasized several reports on the treatment and patient care experiences for a variety of conditions. The first focused on the racial and ethnic disparities by gender and the differences between black, Hispanic, Asian and Pacific Islander and white Medicare Advantage (MA) beneficiaries in rates of colorectal cancer screening, treatment for chronic lung disease and other conditions, as well as their ability to access care. The second report examined racial and ethnic minorities, people with disabilities, members of the LGBT community, and rural populations in quality of treatment for certain conditions among MA beneficiaries. Verma highlighted the fact that women receive better treatment for chronic lung disease and rheumatoid arthritis, and are more likely than men to receive proper follow-up care after being hospitalized for a mental health disorder.

On the Hill

The Trump Administration, alongside congressional Republican leadership, has unveiled a new Affordable Care Act (ACA) repeal bill. The new bill leaves some elements of the ACA in place but allows states the option to apply for waivers to remove minimum insurance requirements. To be awarded waivers, states must show that their plan to replace minimum ACA requirements will cause premiums to go down, increase coverage, stabilize insurance markets, and continue coverage to people with pre-existing conditions. The language does not make it clear if the coverage costs would increase for people with pre-exiting conditions. While the White House made comments suggesting they were pushing for a vote as soon as this past week, House Republicans have been more cautious and are evaluating support for the new bill before introducing the legislation.

At the White House

After several weeks of consideration, the White House has announced it will encourage lawmakers to fund ACA cost-sharing reduction payments to continue to stabilize ACA exchanges. The White House did not outline where the funding would originate from. The decision, which is seen as essential to maintain ACA exchanges, is currently being litigated in court after House Republicans sued the Obama Administration, calling the payments “unconstitutional.”

The White House announced the nomination of Elinore McCance-Katz as Assistant Secretary for Mental Health and Substance Use, a brand new position at HHS. McCance-Katz previously served as the chief medical officer at SAMHSA and currently serves in the same role in Rhode Island’s behavioral health department. The new position was created last year by the 21st Century Cures Act and is responsible for overseeing SAMHSA and coordinating national mental health and substance abuse treatment programs at other agencies in the federal government. The announcement also mentioned the nomination of Brett Giroir, a former CEO of Texas A&M Health Science Center and current CEO of ViraCyte, a biopharmaceutical company, as HHS Assistant Secretary for Health.

For more information on this topic, or to learn how Baker Tilly healthcare specialists can help, contact our team.