CMS issues proposed rule for Basic Health Program   09/23/2013
The Centers for Medicare & Medicaid Services late Friday issued a proposed rule establishing standards for the Basic Health Program established by the Patient Protection and Affordable Care Act. States may choose to offer the program to low-income citizens and lawfully present non-citizens who do not qualify for Medicaid, the Children’s Health Insurance Program or other minimum essential coverage offered through a health insurance exchange. According to CMS, the rule proposes a framework for program eligibility and enrollment, benefits, delivery of health care services, transfer of funds to participating states, state administration and federal oversight. Benefits must include at least the 10 essential health benefits specified in the ACA, and monthly premium and cost sharing for eligible individuals may not exceed what they would pay if eligible to enroll in the exchange’s silver plan. States operating a Basic Health Program will receive federal funding equal to 95% of the premium tax credits and cost sharing reductions that these individuals would receive if they were eligible to enroll in the Marketplace. The proposed rule will be published in the Sept. 25 Federal Register with comments accepted for 60 days. CMS plans to propose a payment methodology for the program in a future notice.
CMS notifies IPFs of annual payment update reduction and appeals process   09/23/2013
The Centers for Medicare & Medicaid Services recently notified 62 facilities participating in the inpatient psychiatric facility quality reporting program that they may be subject to a 2 percentage point reduction in their annual payment update for fiscal year 2014. That’s about 3% of facilities eligible to participate in the program. The Express Mail notice was addressed to the facility’s CEO from CMS contractor Telligen and includes instructions for submitting reconsideration requests, which are due 30 days after the date on the facility’s notification letter. The reconsideration request form and associated reference guide also are available on QualityNet. IPFs and separately licensed, distinct-part psychiatric units in acute care hospitals paid under the IPF prospective payment system must comply with all data submission requirements and deadlines in the IPF quality reporting program to receive a full payment update in FY 2014 and beyond. Questions about the reconsideration process and general inquiries about the IPF quality reporting program may be directed to Telligen at (888) 961-6425 or
FDA finalizes oversight guidance for developers of mobile medical apps   09/23/2013
The Food and Drug Administration today issued final guidance on regulatory oversight of mobile medical applications. Like the draft guidance, the final guidance focuses FDA oversight on software applications that are used as an accessory to a regulated medical device or which transform a mobile platform into a regulated medical device. Mobile medical apps that undergo review will be assessed using the same regulatory standards and risk-based approach that the agency applies to other medical devices, FDA said, adding that it will not pursue regulatory enforcement for those that pose a low risk to patients. “We have worked hard to strike the right balance, reviewing only the mobile apps that have the potential to harm consumers if they do not function properly,” said Jeffrey Shuren, M.D., director of the agency’s Center for Devices and Radiological Health. “Our mobile medical app policy provides app developers with the clarity needed to support the continued development of these important products.”
CMS reports on Stage 1 meaningful use in first year of Medicare EHR program   09/23/2013
About 17% of eligible hospitals and 10% of eligible professionals successfully attested to Stage 1 meaningful use of electronic health records under the Medicare EHR Incentive Program in 2011, the first year of the program, according to a report released Friday by the Centers for Medicare & Medicaid Services. That’s 833 hospitals and 57,808 EPs. The report analyzes performance by state and specialty type. Stage 1 criteria for eligible hospitals included 14 core measures plus a choice of five out of 10 menu measures. CMS also indicated that a report on 2012 is forthcoming.