President urged to protect hospital services for seniors in FY 2015 budget   02/24/2014
AHA today urged President Obama to protect payments for hospital services provided to seniors and the disabled under Medicare in his fiscal year 2015 federal budget. “With total hospital cuts approaching more than $117 billion dollars since 2010, including more than $58 billion in Medicare sequestration cuts, many hospitals are at a breaking point in their ability to ensure patients have access to the care they need, when they need it,” wrote AHA President and CEO Rich Umbdenstock. “…The time is now to work together toward long-term solutions that will set Medicare on a path toward future sustainability and protect the promise of care for our nation’s seniors. Payment cuts that simply reduce funding for hospital services should not be part of that effort, and we ask that you refrain from including such cuts in your FY 2015 budget submission. Our patients and communities depend on all of us to ensure that they get the care they need, today and tomorrow.”
HHS urged to extend EHR certification, meaningful use timelines   02/24/2014
Forty-eight organizations representing health care providers, including the AHA, Friday urged the Department of Health and Human Services to extend through 2015 the timelines for hospitals, physicians and other eligible professionals to implement 2014 Edition Certified Electronic Health Record Technology, and add flexibility in meaningful use requirements to permit as many providers as possible to achieve success in the program. “With only a fraction of 2011 Edition products currently certified to 2014 Edition standards, it is clear the pace and scope of change have outstripped the ability of vendors to support providers,” the coalition said in a letter to HHS Secretary Kathleen Sebelius. “This inhibits the ability of providers to manage the transition to the 2014 Edition CEHRT and Stage 2 [meaningful use] in a safe and orderly manner.” Chantal Worzala, AHA director of policy, said, “We are seeing that as many as 40% of hospitals could be at risk of missing the 2014 certified EHR adoption and meaningful use requirements if they remain the same. We urge HHS to provide the flexibility needed to help these hospitals pass the finish line safely.” Without HHS action, hospitals and EPs that fail to meet the requirements face the loss of incentive payments and significant penalties.
AHA supports proposed approach to 'limited excepted benefits'   02/24/2014
AHA today voiced support for the approach taken by the Departments of Labor, Treasury, and Health and Human Services in their proposed rule clarifying regulatory requirements for group health plans with regard to “limited excepted benefits” and minimum essential coverage under the Affordable Care Act. The proposed rule defines “limited excepted benefits” as benefits provided under a separate policy, certificate or contract of insurance, or generally exempted from the health reform requirements added to the Health Insurance Portability and Accountability Act and ACA. “On balance, this proposed rule would allow employees to benefit from more limited employer-offered benefits and employers to continue to offer these limited benefit packages without requiring an additional premium from the employee or jeopardizing the employees’ access to premium tax credits offered through the marketplaces,” AHA Executive Vice President Rick Pollack said in comments submitted to the DOL.
CMS proposes Medicare Advantage payment and policy updates for 2015   02/24/2014
The Centers for Medicare & Medicaid Services Friday issued its advance notice of proposed changes to Medicare Advantage rates and payment polices for calendar year 2015. The notice includes the preliminary estimates of the national per capita MA growth percentage and Medicare fee-for-service growth percentage, which are key factors in determining the MA capitation rates; and changes in methodologies governing payment for health plan and prescription drug benefits in CY 2015, among other adjustment factors. The Affordable Care Act established a new methodology for calculating each MA county rate as a percentage of Medicare Fee For Service spending in each respective county, and a transitional period during which each county rate is calculated as a blend of the pre-ACA rate and new FFS-based ACA rate. For 2015, most counties will be fully transitioned to the new rate methodology, while others will continue to be based on a blended rate. Overall, MA rates would be reduced as a result, but the actual rates for specific plans would vary substantially. Other changes to the proposed requirements for MA plans (known as the Call Letter), include a variety of changes requiring that enrollees and providers receive greater notice regarding changes to provider networks and that continuity of care for enrollees be assured. CMS said it intends to consider rulemaking that would broaden its authority to limit such changes to certain times during the year. Comments on the proposed changes may be emailed through March 7 to AdvanceNotice2015@cms.hhs.gov.
CMS issues final checklists for end-to-end testing project   02/24/2014
The Centers for Medicare & Medicaid Services has posted final checklists for its end-to-end testing project. The project is using ICD-10 testing to develop a “best practice” for faster and more efficient testing of administrative simplification standards. Hospitals and other entities covered by the Health Insurance Portability and Accountability Act must transition to the ICD-10 coding system by Oct. 1, 2014. Feedback on user experiences with the checklists may be emailed to the project contractor, National Government Services, at ngs.compliancetesting@wellpoint.com.
AHA webinar on March 27 to review latest RAC survey data   02/24/2014
Hospitals are invited to learn more about recent regulatory activity impacting the recovery audit contractor program and review results from the AHA's latest RACTrac survey during a webinar on March 27 at 2 p.m. ET. The free web-based survey helps AHA gauge the impact of Medicare RACs and advocate for needed changes to the program. For more on the AHA's RACTrac initiative, visit www.aha.org/ractrac.