The Reed Smith Health Industry Washington Watch blog has been updated to report on recent health policy developments, including the following:
- Top Stories. The Affordable Care Act’s Health Insurance Marketplace has opened for business to mixed reviews, and the ongoing partial federal government shutdown is having a varied impact on health care provider operations.
- Regulatory Developments. HHS has published a proposed rule that would establish the ACA Basic Health Program. CMS has issued rules on disproportionate share hospital payment calculations, a new Medicare Federally Qualified Health Center PPS, and enforcement actions for proficiency testing referrals. CMS also has released updated “amount in controversy” threshold amounts and technical corrections to the FY 2014 IPPS/LTCH and SNF PPS final rules.
- Other HHS Developments. CMS has announced that Medicare rates will drop sharply under the DMEPOS competitive bidding “Round 1 Recompete” contracts. Other HHS policy developments involve Medicare ambulance rates for 2014, compliance reviews under the new “2 midnight” inpatient admissions policy, clinical laboratory tests, and the HIPAA Privacy Rule.
- Fraud & Abuse Developments. The Obama Administration has warned consumers about potential “Obamacare” fraud, and the OIG has issued reports on Medicare ambulance transport utilization, Medicare polysomnography claims, and Medicare appeals volumes and timeliness.