May 2010

Recent guidance and summary documents regarding Affordable Care Act implementation include the following:

  • CMS has released a brochure for Medicare beneficiaries with details on the tax-free, one-time $250 check for beneficiaries who reach the Part D coverage gap during 2010 and are not eligible for low-income subsidies. The first checks will be mailed June 10

Congressional leaders have been seeking support for a jobs bill with a number of Medicare and other health policy provisions, but to date have been unable to muster the necessary votes for passage before the Congressional Memorial Day break due to concerns about the cost of the package. Among other things, H.R. 4213, “The American

CMS has issued two regulations implementing Affordable Care Act provisions impacting hospital inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment system (PPS) payments.

On May 26, 2010, CMS published a proposed rule to revise the conditions of participation for both hospitals and critical access hospitals to allow for a new credentialing and privileging process for physicians and practitioners providing telemedicine services. According to CMS, the intention of the rule is to eliminate “regulatory impediments and allow for

On May 20, 2010, HHS published a proposed rule to amend the Department’s regulations regarding the responsibility of applicants to promote objectivity in research for which Public Health Service (PHS) funding is sought. The proposed revisions are intended to expand and add transparency to investigator disclosure of significant financial interests and enhance regulatory compliance

HHS has published a notice announcing the availability of an interagency working group draft “Strategic Framework on Multiple Chronic Conditions (MCCs).” The draft plan addresses approaches to improving the health of individuals with concurrent multiple chronic conditions (e.g., arthritis, chronic respiratory conditions, diabetes, heart disease, hypertension, and mental health conditions) by providing options

CMS has updated the Medicare Program Integrity Manual to direct contractors to use Clinical Review Judgments (CRJ) when making complex review determinations about a claim. CRJ involves two steps: (1) the synthesis of all submitted medical record information to create a longitudinal clinical picture of the patient; and (2) the application of this clinical picture

The OIG has established an “OIG Hotline” website to provide “an outlet for the general public to report allegations of wrongdoing in Department programs. “ In addition to providing general guidance, the OIG’s site includes a new online complaint form that is designed to result in more expeditious referral of tips to the field for