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Policy

 

As part of the Senate’s flurry of action on proposals to repeal and/or replace the Affordable Care Act, Republicans brought up the same bill to get rid much of the law, without a replacement ready, which had passed through Congress in 2015. This time, it failed, with seven Republicans and all Democrats voting against it.

Republicans in the U.S. Senate voted to open debate on repealing and replacing the Affordable Care Act (ACA), with 50 senators voting in favor of what’s called a motion to proceed, or MTP, opening the door to the chamber offering numerous amendments to craft some sort of repeal bill. The first option put forward—the Better Care Reconciliation Act (BCRA)—failed to pass as expected.

The Congressional Budget Office (CBO) has released reports on two Republican proposals regarding the Affordable Care Act: One which would repeal much of the law while delaying some of those effects for two years and another which replaces it with the Senate's Better Care Reconciliation Act (BCRA).

Enrollment in the individual market would increase while premiums would decrease under Sen. Ted Cruz’s, R-Texas, controversial “Consumer Freedom” amendment, according to an HHS analysis obtained by the Washington Examiner.

Senate Republicans' latest Affordable Care Act replacement plan was introduced on July 13. Four days later, it was declared dead, as four Republican senators had publicly announced they wouldn’t support even holding a vote on the legislation.

 

Recent Headlines

Hospitalists urge Congress to can observation status

A report released today from the Society of Hospital Medicine in conjunction with its testimony before the Senate Special Committee on Aging urges a significant overhaul of the Centers for Medicare and Medicaid Services (CMS) policy on observation status and two-midnight rule definition for inpatient status.

N.J. health commissioner report pushes for full financial transparency for all hospitals

A report released late Friday by New Jersey’s health commissioner, Mary O’Dowd, recommends that the state require that all hospitals, public and private, for-profit and non-profit, publish their quarterly unaudited financial statements on their websites within 45 days of each quarter’s end, and their annual audits within 180 days of the close of a hospital’s fiscal year.

Sunshine rule off to rocky start as doctors encounter error messages on reporting site

Physicians attempting to log in to the Open Payments website to verify information reported about them ahead of that information being made public are encountering a cumbersome log-in process and confusing error messages, reports ProPublica.

AHA and hospitals seek summary judgment in claim denial appeals backlog case

Noting that by their estimates, billions in disputed claims are tied up in the current appeals process for denied Medicare claims and this is causing severe harm to hospitals, the American Hospital Association along with the hospital operators Baxter Regional Medical Center, Covenant Health, and Rutland Regional Medical Center, have asked a Washington, D.C., court to issue a summary judgment in their favor and compel the U.S. Department of Health and Human Services (HHS) to honor the law’s requirement that disputed claims be heard by an Administrative Law Judge (ALJ) within 90 days.

Proposed MPFS seeks to boost payments to primary care

The Centers for Medicare & Medicaid Services (CMS) used the proposed 2015 Medicare Physician Fee Schedule (MPFS) to create some carrots and sticks to encourage moving the care of more patients, particularly the growing percentage of beneficiaries with multiple chronic illnesses, into the lower-cost outpatient primary care setting.

CMS releases proposed 2015 hospital OPPS and ASC rates

The Centers for Medicare and Medicaid Services (CMS) has proposed a 2.1 percent market basket update for services paid under the hospital Outpatient Prospective Payment System (OPPS) in 2015 and to update Ambulatory Surgery Center (ASC) payments by 1.2 percent next year.

Bill introduced in House and Senate to further quality reporting in post-acute care

Leaders from the Senate Finance Committee and House Ways and Means Committee have introduced the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), which would set quality standards and mandatory reporting deadlines for post-acute care provided by long-term care hospitals, inpatient rehabilitation facilities, skilled nursing facilities and home health agencies.

5 take-aways from latest congressional hearing on Medicare fraud

On Wednesday, representatives of the Department of Health and Human Services (HHS), the Centers for Medicare and Medicaid Services (CMS) and the Government Accountability Office (GAO) were once again called upon by House republicans to explain what is being done to combat waste, fraud and abuse in Medicare. Their responses give a glimpse into the agencies current priorities, especially as they affect healthcare providers.

Is your clinical lab sending you illegal kickbacks?

A new Office of Inspector General (OIG) fraud alert warns of two arrangements with clinical laboratories that it considers illegal kickbacks for referrals — specimen processing arrangements and registry arrangements — that are subtle enough that not all ordering physicians who receive the payments may be aware that they are breaking the law.

Mishandled patient record drop off costs Parkview Health System $800,000

Indiana and Ohio non-profit Parkview Health System has reached a deal with the U.S. Department of Health and Human Services Office for Civil Rights (OCR) to settle potential violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule that occurred when boxes of medical records were delivered to the home of a retiring doctor when she was not there.

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