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 finalized financial integrity and oversight standards for Affordable Insurance Exchanges and state Medicaid disproportionate share hospital allotments under the Affordable Care Act (ACA). CMS also has released technical corrections to the CY 2014 proposed rule updating the Medicare Hospital Outpatient Prospective Payment System (OPPS) and ambulatory surgical center payments. HHS has published notices seeking comments on its latest draft Departmental Strategic Plan, a draft National Action Plan for Adverse Drug Event Prevention, and options for streamlining HHS regulations. The Internal Revenue Service (IRS) has finalized ACA individual “shared responsibility” payment requirements.
  • Other CMS Developments. CMS has delayed enforcement of an ACA provision requiring a face-to-face encounter as a condition of Medicare payment for durable medical equipment (DME) items. The agency also issued guidance on admission order and certification requirements for inpatient admissions, released updated Medicare drug payment files, and requested input on the Advanced Diagnostic Imaging (ADI) program.
  • OIG & GAO Reports. The OIG has issued reports on potential Medicare Part B drug rebates, Medicaid drug pricing changes, critical access hospital qualifications; Medicare diabetes test strip payments, Medicaid DME reimbursement, and Medicare program integrity efforts. GAO reports have addressed self-referral of anatomic pathology and IMRT services.
  • Legislative Developments. The House has approved a bill to require verification of ACA individual subsidy eligibility, and Congressional panels have addressed a variety of health policy issues. Several hearings this week will focus on ACA implementation.
  • Health Industry Events. CMS is hosting a call on the 2015 Value-Based Payment Modifier.