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NASL Continues to Press Senate on SGR/ Therapy Caps - Vote Expected Mid-April
NASL continues to keep the pressure on the Senate to vote on the SGR repeal and replace bill (H.R. 2, Medicare Access & CHIP Reauthorization Act) following the current recess. The SGR patch and therapy cap exceptions process expired on March 31. CMS is allowed to hold Medicare claims for physician services up to 10 business days, so the Senate will have one day to deal with the SGR when it returns from recess on April 13 before CMS will have to resort to holding claims. Check out NASL's action alerts here.
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Budget Proposals Overhaul Health Care with Repeal of the ACA
The U.S. House of Representatives and U.S. Senate passed Fiscal Year (FY) 2016 budget resolutions that make policy statements about future objectives, including deficit targets. On March 25, the House approved its budget resolution (H. Con. Res. 27) by a 228-199 vote. The Senate approved its proposal (S. Con. Res. 11) March 27 by a 52-46 vote. Read more.
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CMS’ Improper Payments Rate Highlighted
The House Committee on Ways & Means' Subcommittee on Oversight held a March 24 hearing on “The Use of Data to Stop Medicare Fraud.†The hearing was an opportunity to review the federal government’s use of data analysis, and particularly the Centers for Medicare & Medicaid Services (CMS) Fraud Prevention System (FPS), which is used to identify emerging trends and stop Medicare fraud. Read more.
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Bicameral Observation Stay Legislation Reintroduced
Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Bill Nelson (D-FL) and Shelley Moore Capito (R-WV) reintroduced legislation, which amends a Medicare law that requires a beneficiary to have an “inpatient†hospital stay of at least three days in order for Medicare to pay for post-hospitalization skilled nursing care. The Improving Access to Medicare Coverage Act (S. 843) would allow patients’ time under “observation status†to count toward the requisite three-day hospital stay for coverage of skilled nursing care. Congressman Joe Courtney (D-CT) reintroduced the House companion bill (H.R. 1571). Read more.
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MedPAC Recommendations Address Observation Status & 3-Day Stay Requirement
Today, the Medicare Payment Advisory Commission (MedPAC) met in Washington, DC and approved several recommendations for Congress. A summary of the recommendations, including hospital short stay policy issues, is being shared in an email to the NASL membership. Review the hospital short stay presentation here.
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CMS DME List Requiring Face-to-Face Encounter
In 2012, CMS issued an initial list of DMEPOS products for which a physician must document that a physician, physician assistant, nurse practitioner or clinical nurse specialist has had a face-to-face encounter with a beneficiary within 6 months prior to a written order for the product. That list was to be updated annually. In a notice published in the March 27 edition of the Federal Register, CMS announced that it would not add more products to this list requiring a face-to-face encounter. Read the notice.
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NASL to Comment on ONC's Interoperability Roadmap
NASL's IT Committee is working on comments regarding the draft Nationwide Interoperability Roadmap released by HHS' Office of the National Coordinator for Health Information Technology (ONC). NASL will post its comments once submitted to ONC on April 3, 2015.
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