Your Government at Work

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MedPAC Releases June 2019 Medicare Payment Report to Congress

The Medicare Payment Advisory Commission (“MedPAC”) released its annual Report to the Congress: Medicare and the Health Care Delivery System.  Among other topics, this report analyzes the growth of Medicare spending for hospital emergency department services, the Medicare Shared Savings Program’s effect on Medicare spending, payment issues involved in a unified post-acute care prospective payment system, issues surrounding Medicare beneficiaries’ access to primary care, Medicare Part B drug payment strategies, and the modification of Medicare Part D’s design to manage drug spending, restrain drug price increases, and improve protections for Part D beneficiaries. More information on this report can be found here and here.

OIG Updates Work Plan

The Department of Health and Human Services Office of Inspector General (“OIG”) has made updates to its Work Plan.  The OIG Work Plan summarizes new, ongoing, and revised areas of review that the OIG plans to pursue. The OIG updates this Work Plan each month in order to enhance transparency of its continuous work-planning efforts. These latest updates include reviews of Medicare payments for physician office visits in provider-based and freestanding clinics, including hospitals claiming provider-based status for such facilities; the national incidence among Medicare beneficiaries of adverse events in hospitals; the incidence of adverse events in Indian Health Service hospitals; Medicare payments for Clinical Diagnostic Laboratory Tests in 2018; and opioid use in Medicare Part D in 2018.

CMS Releases Corrections for 2020 Medicare Payment Proposed Rule

The Centers for Medicare & Medicaid Services (“CMS”) released a correcting document that identifies and corrects a number of technical errors in the May 3, 2019 proposed rule that dealt with fiscal year 2020 Medicare payment rates and policies under the hospital inpatient prospective payment system (“IPPS”) and the long-term care hospital (“LTCH”) payment system. The correcting document can be found here.

Federal Agencies Release Final Rule on HRAs

The Department of Health and Human Services, in collaboration with the Department of the Treasury and the Department of Labor, has released a final rule that seeks to expand the use and flexibility of employer-funded health reimbursement arrangements (“HRAs”) and other account-based group health plans. This rule, in part, establishes conditions under which certain HRAs and other account-based group health plans could be recognized as limited excepted benefits, permits the integration of HRAs and other account-based group health plans with individual health insurance coverage or Medicare, changes the premium tax credit eligibility for individuals, and creates a special enrollment period in the individual market for certain qualifying individuals. More information can be found here and here.

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