The Reed Smith Health Industry Washington Watch blog has been updated to report on recent health policy developments, including the following:
- Regulatory Developments. CMS has issued rules addressing the Affordable Care Act (ACA) Pre-Existing Condition Insurance Plan Program and Small Business Health Option Program, Medicare Advantage and Part D plan medical loss ratio rules, the Bundled Payments for Care Improvement initiative, and state Medicaid disproportionate share hospital allotments. The OIG has issued a final rule on data mining by State Medicaid Fraud Control Units. The Administration has issued final ACA wellness program rules and guidance to employers on ACA insurance exchange notices, and a bioethics commission seeks comments on “incidental findings” in research and testing.
- Other HHS Developments. The Medicare Board of Trustees has released a financial assessment of the Medicare trust fund. CMS has released updated Medicare Part B drug payment files, guidance to states on facilitating Medicaid and CHIP enrollment, and draft cancer hospital quality measures. FDA has issued draft guidance on access to investigational drugs.
- OIG & GAO Developments. The OIG has issued its latest semiannual report to Congress, along with reports on high-risk compounded sterile preparations, hospice care, drugs commonly used by dual eligibles, Medicare Part B claims with “G” modifiers, Medicare dialysis payments, and inaccuracies in Medicare enrollment databases. GAO reports have examined state efforts to establish ACA insurance exchanges and government drug purchase prices.
- Legislative Developments. The House of Representatives has approved a drug distribution security plan and ACA repeal legislation, the Senate has confirmed Marilyn Tavenner as CMS Administrator, and Congressional hearings have addressed a number of health policy issues.
- Health Industry Events. Upcoming events include meetings/calls on Medicare clinical laboratory test payment determinations, Medicare hospital outpatient payments, PQRS and eRx Incentive Program payment adjustments, the Medicare Shared Savings Program application process, Medicare and Medicaid EHR Incentive Programs, the HHS insurance market risk adjustment data validation process, and Medicare orders for lower limb prostheses.