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CDC advises providers to consider Ebola in certain travelers   07/29/2014
U.S. health care workers should be alert for signs and symptoms of Ebola Virus Disease in patients with compatible illness who recently traveled to West Africa, where 1,201 EVD cases and 672 deaths have been reported in Guinea, Liberia and Sierra Leone since late March, the Centers for Disease Control and Prevention announced yesterday. The cases include two U.S. citizens working in a hospital in Monrovia, Liberia. “EVD poses little risk to the U.S. general population at this time,” CDC said. “However, U.S. health care workers are advised to be alert for signs and symptoms of EVD in patients with compatible illness who have a recent (within 21 days) travel history to countries where the outbreak is occurring, and should consider isolation of those patients meeting these criteria, pending diagnostic testing.” EVD is characterized by sudden onset of fever and malaise, accompanied by other nonspecific signs and symptoms, such as headache, vomiting and diarrhea. Patients with severe forms of the disease may develop multi-organ dysfunction, leading to shock and death.
IOM panel recommends new financing system for physician training   07/29/2014
An Institute of Medicine committee today recommended replacing Medicare’s separate funds for indirect and direct graduate medical education with one direct payment to program sponsors based on a geographically adjusted national per-resident amount. The report recommends maintaining aggregate support for Medicare GME at the current level while phasing out the current Medicare GME funding provided to hospitals over the next decade. Among other changes, the proposed system would allocate financing to two distinct funds. One fund would support currently approved residency positions and the other would support payment demonstrations (such as performance-based payment) and new training positions in priority disciplines and geographic areas. In addition, the committee calls for a new policy council to develop a strategic plan and federal policies for Medicare GME financing, and a new center at the Centers for Medicare & Medicaid Services to manage GME funds and ensure transparency. Linda Fishman, AHA senior vice president for public policy analysis and development, said, “Today’s report on graduate medical education is the wrong prescription for training tomorrow’s physicians. We are especially disappointed that the report proposes phasing out the current Medicare GME funding provided to hospitals and offering it to other entities that do not treat Medicare patients.”
Report, hearing focus on state Medicaid financing   07/29/2014
The Centers for Medicare & Medicaid Services should take steps to ensure states report accurate and complete data on all non-federal Medicaid funding sources, the Government Accountability Office said today in a report issued at a congressional hearing on the issue. Based on a questionnaire sent to state Medicaid agencies, GAO found that states financed 26%, or more than $46 billion, of the nonfederal share of Medicaid expenditures with funds from health care providers and local governments in state fiscal year 2012. “States have increasingly turned to sources of funds other than state general funds to finance the nonfederal share of their Medicaid programs,” the report concludes. “These sources include levying taxes on health care providers and receiving funding transfers from local governments and local government providers to help finance the nonfederal share of Medicaid. These financing arrangements can have the effect of shifting costs of Medicaid from states to the federal government, while benefits to providers, which may be financing a large share of any new payments, and the beneficiaries whom they may serve are less apparent.” CMS did not concur with the recommendation, but said it will examine efforts to improve data collection for oversight. Witnesses at the hearing, held by the House Committee on Government Oversight and Reform, included CMS Deputy Administrator Cindy Mann and John Haag, director of Medicaid audits for the Department of Health and Human Services.
AHA: CMS proposed rule would help ensure seamless exchange coverage   07/28/2014
The Centers for Medicare & Medicaid Services’ proposed rule for annual eligibility determinations and re-enrollment in health insurance exchanges would help enrollees continue seamless coverage into the next benefit year, AHA said in comments submitted today. The rule would allow exchanges to use the current eligibility redetermination process or an alternative process approved by the Department of Health and Human Services to facilitate continued enrollment, including a process set out by HHS to allow coverage renewal if an enrollee takes no action. “The most significant of these redetermination options is allowing exchanges to automatically enroll QHP enrollees in their current plan if the enrollee makes no changes to his or her selected coverage,” wrote Linda Fishman, AHA senior vice president for public policy analysis and development. “If an individual is currently enrolled in a QHP that will not be available in the next benefit year, the rule would establish a prioritization process for automatic re-enrollment in a different product offered by the QHP issuer. Automatic enrollment allows for greater continuity of coverage and brings coverage offered through the exchange in line with current practices in the existing insurance market.”
CMS to host second call on QIO program changes   07/28/2014
The Centers for Medicare & Medicaid Services tomorrow will host a live encore presentation of last week’s webinar on its new contracts with Quality Improvement Organizations. The call, at 2 p.m. ET, will include a question and answer session and be recorded and made available for sharing and playback after the live event. Participants must register online in advance of the event. Presentation slides are available at www.qioprogram.org/resources. The contracts are part of a restructuring of the QIO program under a new statement of work effective Aug. 1. In a significant departure from previous years, the new contracts separate support for case review and monitoring activities from other QIO activities.
HRET honors 2014 TRUST Award recipient   07/28/2014
The AHA’s Health Research & Educational Trust affiliate today released a video honoring 2014 TRUST Award recipient Nancy Schlichting, CEO of Henry Ford Health System. Presented at a reception last week in San Diego, the annual award recognizes individuals who have made significant and lasting contributions to health care, and who share HRET's vision of creating a society of healthy communities and its mission of transforming health care through research and education. For more information or to view the video, which details through interviews Schlichting’s exceptional achievements at HFHS, visit www.hret.org/trust.
Report: Medicare hospital fund solvency extended four more years   07/28/2014
The Medicare Hospital Insurance Trust Fund will remain solvent until 2030, four years longer than projected last year, according to an annual report issued today by the Medicare Board of Trustees. The improved outlook “is primarily due to lower than expected spending in 2013” for most hospital service categories, according to the Treasury Department. Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner cited “major progress in improving patient safety, decreasing hospital readmissions, and establishing new payment models such as accountable care organizations aimed at reducing costs and improving quality. These reforms slow the rise in health care spending while improving the quality of care for beneficiaries.” According to the report, Part B of Supplementary Medical Insurance, which pays doctors' bills and other outpatient expenses, and Part D, which provides access to prescription drug coverage, are both projected to remain adequately financed into the indefinite future because current law automatically provides financing each year to meet the next year's expected costs. The report calls for Congress and the executive branch to “work closely together with a sense of urgency” to address Medicare’s remaining financial challenges.
Senate and House leaders reach agreement on VA bill   07/28/2014
Sen. Bernie Sanders (I-VT) and Rep. Jeff Miller (R-FL), who lead the Senate and House Veterans' Affairs committees, respectively, have reached an agreement on legislation to address ongoing problems at the Department of Veterans Affairs. At a press conference this afternoon, they announced that the agreement closely mirrors Senate-passed legislation (H.R. 3230), which would ease access for veterans seeking health care from non-VA providers. The compromise would provide roughly $17 billion in emergency mandatory funds, of which $10 billion would be dedicated to subsidizing care outside the VA system for veterans facing long waits for treatment or living at least 40 miles from a VA hospital or clinic. Another $5 billion of the emergency mandatory funds would permit the VA to hire additional staff and upgrade facilities to meet health care demands. The chairmen expect to share the draft legislation with conferees tonight and will seek to pass the legislation before Congress adjourns later this week for its August district work period. AHA members will receive more information once the bill language is made available.
IRS issues temporary/proposed rules on premium tax credit   07/25/2014
The Internal Revenue Service yesterday issued identical temporary and proposed rules relating to the premium tax credit for health insurance purchased through an Affordable Care Act exchange. The regulations provide an indexing methodology; clarify how to reconcile tax credits with advance premium payments for certain taxpayers, such as divorced or separated individuals; address the premium deduction for self-employed individuals; and provide relief from the joint filing requirement for victims of domestic abuse and spousal abandonment. Both rules will be published in the July 28 Federal Register, with comments on the proposed rule accepted for 90 days. The temporary rule takes effect upon publication.
NJ hospitals save $113 million in gainsharing demonstration   07/25/2014
A consortium of 12 New Jersey hospitals achieved nearly $113 million in health care savings under a three-year “gainsharing” project that encouraged hospitals and physicians to work together to provide more efficient, high-quality care, the New Jersey Hospital Association reports. About 17% of the savings was shared with physicians based on their performance on quality and efficiency metrics, including performance versus peers and improvement over time. NJHA last year launched a larger demonstration of the model under the Centers for Medicare & Medicaid Services’ Bundled Payments for Care Improvement initiative. CMS requires hospitals participating in the bundled payment demonstration (Model 1) to “guarantee” a certain level of Medicare savings after the first six months. For more on the NJHA project, see the profile on the Agency for Healthcare Research and Quality’s Innovations Exchange.