Tag Archives: emergency care

Surprise Medical Billing:  Bipartisan Consensus on the Problem, but Finding an Effective Fix May be Harder

In a rare display of unity, President Donald Trump and bipartisan Congressional leaders have highlighted their shared commitment to tackling “surprise” medical billing – when an insured patient is subject to unexpectedly high out-of-pocket costs for out-of-network care that is beyond their control.  Such surprise billing can occur when a patient receives emergency care from … Continue Reading

Newest CMS Innovation Model Targets Medicare Payment for Emergency Ambulance Services

The Centers for Medicare & Medicaid Services (CMS) plans to test a new voluntary emergency ambulance service innovation model that seeks promote “the most appropriate level of care at the right time and place.”  In announcing the model, CMS noted that because Medicare regulations now only allow payment for emergency ground ambulance services for transportation … Continue Reading

MedPAC Issues Annual Report to Congress on Medicare and the Health Delivery System

The Medicare Payment Advisory Commission (MedPAC) has released its annual report to Congress on “Medicare and the Health Care Delivery System.” This year’s report includes recommendations for changes to emergency department services policies, along with analyses of potential changes that would impact physicians, medical equipment suppliers, post-acute care providers, and others.  Highlights include the following:  … Continue Reading

President Signs Metabolic Syndrome Support Legislation, Emergency Medication Act

President Trump has signed into law S 920, the National Clinical Care Commission Act, which establishes a national clinical care commission to improve coordination of federal programs that support care for people with complex metabolic syndromes and related autoimmune disorders. In addition, President Trump signed HR 304, Protecting Patient Access to Emergency Medications Act of … Continue Reading

Senate Advances Emergency Medicine Access Legislation

On October 24, 2017, the Senate approved HR 304, the Protecting Patient Access to Emergency Medicines Act, which would clarify that emergency medical services professionals may administer controlled substances pursuant to standing or verbal orders in certain circumstances. While the House passed the legislation in January 2017, the House needs to consider the measure again … Continue Reading

House Takes Early Action on Noncontroversial Public Health Bills

Early in the new Congress, the House of Representatives has approved, without objection, the following bipartisan public health bills: H.R. 309, the National Clinical Care Commission Act, to establish a National Clinical Care Commission to improve coordination of federal programs that support care for people with metabolic syndromes and related autoimmune disorders. H.R. 315, the … Continue Reading

Energy and Commerce Committee Clears Public Health Bills

On September 21, 2016, the House Energy and Commerce Committee unanimously approved the following public health bills: H.R. 4365, Protecting Patient Access to Emergency Medications Act – to amend the Controlled Substances Act (CSA) to enable paramedics and other emergency medical services (EMS) professionals to continue to administer controlled substances to patients under standing orders … Continue Reading

MedPAC Issues Recommendations on Medicare Drug, Post-Acute Care, and Other Payment Policies

MedPAC has released its June 2016 Report to the Congress on Medicare and the Health Care Delivery System. The report includes recommendations for a number of Medicare policy reforms and analyses of various health care market developments. Several chapters address Medicare drug policy, including a review of external factors that influence the prices Medicare pays … Continue Reading

Reexamining HIPAA’s Applicability During Emergencies After the Tragedy in Orlando

Immediately following Sunday’s tragic shooting at a nightclub in Orlando, friends and family frantically gathered at Orlando Regional Medical Center, attempting to get information about their loved ones.  However, hospital officials hesitated to provide specific updates.  Why?  Because the Health Insurance Portability and Accountability Act (HIPAA) and implementing regulations restrict the patient-identifiable health information that … Continue Reading

Congressional Health Policy Hearings & Markups

On January 27, 2015, the House Energy and Commerce Subcommittee on Health held a hearing on bipartisan public health legislation, including: Ensuring Patient Access to Effective Drug Enforcement Act (to improve enforcement efforts regarding prescription drug diversion and abuse); Improving Regulatory Transparency for New Medical Therapies Act (to amend the Controlled Substances Act to improve … Continue Reading

President Obama Signs Post-Acute Care Transformation Act and Other Health Policy Bills

On October 6, 2014, President Obama signed into law H.R. 4994, the Improving Medicare Post-Acute Care Transformation Act of 2014 (the “IMPACT Act”). The IMPACT Act’s provisions will affect a broad range of post-acute care (PAC) providers: home health agencies (HHAs), skilled nursing facilities (SNFs), inpatient rehabilitation facilities (IRFs), and long-term acute care hospitals (LTCHs). … Continue Reading

House Approves GME, Pediatric Research, and EMT Bills

The full House of Representatives has passed three health policy bills recently cleared by the House Energy and Commerce Committee. On February 4, 2013, the House approved H.R. 297, the Children’s Hospital Graduate Medical Education (GME) Support Reauthorization Act of 2013 (which provides support to children’s hospitals for pediatric medical residency programs), and H.R. 225, … Continue Reading

CMS Proposes Changes to Medicaid Eligibility, Benefits, and Appeals Rules

On January 22, 2013, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule designed to provide states with additional flexibility in administering their Medicaid, Children’s Health Insurance Program (CHIP), and Affordable Care Act (ACA) Exchange programs. Among many other things, the rule would enhance the ability of states to coordinate eligibility determinations, appeals … Continue Reading

House Energy and Commerce Committee Approves GME, Pediatric Research, and EMT Bills

The House Energy and Commerce Committee approved three health policy bills on January 22, 2013, versions of which were passed by the full House during the last Congress. Specifically, the panel voted to approve: H.R. 297, the Children’s Hospital Graduate Medical Education (GME) Support Reauthorization Act of 2013 (which provides support to children’s hospitals for … Continue Reading

CMS Seeks Comments on Measures of Patient Experiences with Emergency Department Care

CMS has published a notice requesting information that will be used to develop a survey regarding patient experiences with emergency department care. The survey is intended to support the goals of HHS’s National Quality Strategy under the ACA. In issuing the request for comments, CMS notes that while CMS and the Agency for Healthcare Research … Continue Reading

House Approves IPAB Repeal/Medical Liability Reform Legislation

On March 22, 2012, the House approved by a 223-181 vote H.R. 5, the “Protecting Access to Healthcare Act,” which would repeal the ACA’s controversial Independent Payment Advisory Board (IPAB), paid for with medical liability reforms.  IPAB is charged with submitting detailed proposals to Congress and the President to reduce Medicare per-capita spending if projected … Continue Reading

CMS Demonstration Program Seeks to Improve Quality of Psychiatric Emergency Care

CMS has announced that 11 states and the District of Columbia have been selected to participate in the ACA’s Medicaid Emergency Psychiatric Demonstration. The demonstration will test whether Medicaid beneficiaries experiencing a psychiatric emergency get more immediate, appropriate care when institutions for mental diseases (IMDs) receive Medicaid reimbursement. The demonstration will provide up to $75 … Continue Reading

Congressional Hearings on Health Policy Issues

A number of Congressional panels have held hearings this month on health policy issues, including Senate Health, Education, Labor and Pensions (HELP) Committee hearings entitled “First, Do No Harm: Improving Health Quality and Patient Safety” and “Diverting Non-Urgent Emergency Room Use: Providing Better Care and Lower Costs.” Both the House Energy & Commerce Subcommittee on Health and … Continue Reading

OIG Examines Medicare Radiology Services in Emergency Departments

The OIG has issued a report entitled “Medicare Payments for Diagnostic Radiology Services in Emergency Departments.” According to the OIG, because of insufficient documentation, Medicare erroneously allowed 19% ($29 million) of claims for interpretation and reports for computed tomography and magnetic resonance imaging, along with 14% ($9 million) of claims for interpretation and reports for x-rays … Continue Reading

CMS Calls: Provider Compliance Group National Outreach/OIG Reports (March 22-24)

CMS is hosting three listening sessions on provider compliance issues March 22-24, 2011, focusing on a number of OIG reports. The schedule is as follows: Tuesday, March 22 • Inappropriate Medicare Payments for Transforaminal Epidural Injections Services • Medicare Part B Services During a Non-Part A Nursing Home Stays: Mental Health • Medicare Part B services … Continue Reading

CMS to Consider New EMTALA Rules

On December 23, 2010, CMS published an advance notice of proposed rulemaking soliciting comments on the need for a proposed rule to address two policies related to the Emergency Medical Treatment and Labor Act (EMTALA). Specifically, CMS is requesting comments regarding its need to revisit rules adopted in 2003 and 2008 concerning the applicability of EMTALA … Continue Reading

HHS Program Seeks to Ease Verification of Volunteer Health Professionals’ Credentials

HHS has launched a new national website for the Emergency System for Advance Registration of Volunteer Health Professionals (ESAR-VHP), a national network of state-based programs that verifies the identity, licenses, and credentials of health professionals prior to an emergency. By providing a single point of entry for potential volunteers, HHS expects the ESAR-VHP website to … Continue Reading

Regionalization of Emergency Medical Care Delivery Systems — Demonstration Model Development

The HHS Emergency Care Coordination Center has issued a request for information (RFI) that will be used to help development demonstration programs that design and evaluate innovative models of regionalized, coordinated and accountable emergency care and trauma systems. Responses to the RFI will be accepted until September 30, 2009.   … Continue Reading

Emergency Department Crowding

A new GAO report on emergency department overcrowding concludes that emergency department crowding continues to occur in hospital emergency departments, with about one-fourth of hospitals reporting diverting ambulances at least once in 2006. Wait times in emergency department have increased nationally, and in some cases exceeded recommended time frames. Boarding of patients in the emergency … Continue Reading