Medicare Regulatory Relief

CMS released proposed regulations which the agency says are designed to increase the ability of health care professionals to devote resources to improving patient care through the elimination and reduction of requirements that impede quality patient care and that divert resources away from providing high quality patient care. The rule also proposes to clarify various provisions relating to proficiency testing referrals under the Clinical Laboratory Improvement Amendments of 1988 (CLIA). CMS estimates that the regulations would allow providers to save nearly $676 million annually and $3.4 billion over five years.

Physician Payment Sunshine Rule

CMS released a final rule, the National Physician Payment Transparency Program: Open Payments, which is designed to reduce conflicts of interest by requiring the manufacturers of drugs, devices and other medical supplies to report certain payments provided to physicians or teaching hospitals. Reports to CMS are due by March 31, 2014 and CMS will release the information on a public website by September 30, 2014.

ESRD Shared Savings Initiative

CMS provided notice to renal care organizations giving them incentive to participate in a three-year “Comprehensive ESRD Care Initiative” under which CMS will enter into “shared financial risk arrangements” with such dialysis facilities, nephrologists and other Medicare providers and suppliers. The so-called shared savings model program is intended to reward providers and suppliers that improve beneficiary outcomes and lower spending and penalize those that do not.

Senate Finance Committee "WFA" Report

Senators Max Baucus, Orrin Hatch and other Senate Finance Committee members released a report providing the recommendations made by over 160 health care organizations on means to improve federal efforts to combat waste, fraud and abuse under Medicare and Medicaid. Five themes emerged from the suggestions: how to reduce improper payments; how to improve beneficiary protections; how to reduce audit burdens; how to improve data management; and how to improve enforcement.

President Re-nominates CMS Administrator

The President announced that he will re-nominate Marilyn Tavenner to become the Administrator of the Centers for Medicare and Medicaid Services after a seven year lapse in a permanent appointment. Currently, Marilyn Tavenner serves as the Acting Administrator.

Upcoming Health Hearings

House Energy and Commerce Committee: will meet to discuss and adopt the committee’s oversight plan for the 113th Congress; 4:00 p.m., 2123 Rayburn Bldg; Feb. 12.

House Energy and Commerce Subcommittee on Oversight and Investigations: will hold a hearing titled “Influenza: Perspective on Current Season and Update on Preparedness;” 10:00, 2123 Rayburn Bldg; Feb. 13.

Senate HELP Committee: will mark up the following legislation: HR 307 — Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 and The Prematurity Research Expansion and Education for Mothers who deliver Infants Early (PREEMIE) Act; 10:00 a.m., 430 Dirksen Bldg; Feb. 13.

House Energy and Commerce Health Subcommittee: will hold a hearing titled “SGR [Sustainable Growth Rate]: Data, Measures and Models; Building a Future Medicare Physician Payment System; 10:15 a.m., 2123 Rayburn Bldg; Feb. 14.

Health Legislation Recently Introduced

S. 195 (MENTAL HEALTH), to amend the Public Health Service Act to revise and extend projects relating to children and violence to provide access to school-based comprehensive mental health programs; FRANKEN; to the Committee on Health, Education, Labor and Pensions, Jan. 31.

S. 214 (DRUGS), to prohibit brand name drug companies from compensating generic drug companies to delay the entry of a generic drug into the market; KLOBUCHAR; to the Committee on the Judiciary, Feb. 4.

H.R. 460 (PRESCRIPTION DRUG COVERAGE), to amend Title XXVII of the Public Health Service Act to limit copayment, coinsurance, or other cost-sharing requirements applicable to prescription drugs in a specialty drug tier to the dollar amount (or its equivalent) of such requirements applicable to prescription drugs in a non-preferred brand drug tier, and for other purposes; MCKINLEY; to the Committee on Energy and Commerce, Feb. 4.

H.R. 467 (MEDICAID), to amend Title XIX of the Social Security Act to redistribute federal funds that would otherwise be made available to states that do not provide for the Medicaid expansion in accordance with the Affordable Care Act to those states electing to provide those Medicaid benefits; CONNOLLY; to the Committee on Energy and Commerce, Feb. 4.

H.R. 473 (MEDICARE/MEDICAID), to amend titles XVIII and XIX of the Social Security Act with respect to the qualification of the director of food services of a Medicare skilled nursing facility or a Medicaid nursing facility; CONNOLLY; jointly, to the committees on Ways and Means and Energy and Commerce, Feb. 4.

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