Medicare FFS in Crosshairs of Senate Finance Committee Chairman

In a public forum, Senate Finance Committee Chairman Ron Wyden (D-OR) spoke out against fee-for-service (FFS) medical reimbursements, particularly as it applies under Medicare. He said he wants to “take a machete” to the FFS model and hopes to move legislation next year to reform the current sustainable growth rate (SGR)-based Medicare physician payment system.

Autism Act Reauthorization Agreement

Senators Robert Menendez (D-NJ) and Mike Enzi (R-WY) said they have reached a bipartisan/bicameral agreement on a five-year reauthorization of the Combating Autism Act. The House Energy and Commerce Committee recently reported out of committee H.R. 4631 which contains the agreed upon language that changes the name to “the Autism Collaboration, Accountability, Research, Education and Support Act of 2014, i.e. the Autism CARES Act of 2014” and that requires a report from HHS having recommendations on how to make improvements for young adults with autism spectrum disorder and for transitioning them from school-based services to services available to adults.

Reimbursements to Increase for Certain Medicare Hospitals

CMS gave notice that about 600 low-volume hospitals and another 118 Medicare-dependent hospitals will receive payment increases from April 1 through this September 30th as required under the Protecting Access to Medicare Act of 2014.

MedPAC and MACPAC Reports to Congress

This week the House Ways and Means Committee will hold a hearing on the report from the Medicare Payment Advisory Commission (MedPAC) which includes a discussion of the means by which the current Medicare payment rules and quality improvement incentives will need to be reconciled among the Medicare Advantage (MA), Accountable Care Organizations (ACO) and fee-for-service payment programs. MedPAC suggests that Medicare should not pay more for the same care across different sites of service, and savings could be achieved if payments were equalized between skilled nursing facilities and inpatient rehabilitation facilities. A report from the Medicaid and CHIP Payment and Access Commission (MACPAC) recommended that Congress extend funding for the Children’s Health Insurance Program (CHIP) for another two fiscal years to avoid a situation in which currently insured children would go uninsured. The report also addressed the role of Medicaid in financing long-term services.

FDA to Issue Guidance on Off-Label Use

The FDA issued a letter stating that it will issue further guidance to device and drug manufacturers with respect to their responsibilities in making comments about the unapproved or off-label use of their products.

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