Medical Home Awards/ACO Study

HHS has reported that over $35 million in PPACA funding has been awarded to support patient-centered medical homes through new construction and facility renovations at health centers in 44 states. CMS also issued a study which concluded that PPAC- initiated accountable care organization (ACOs) are unlikely to help Medicare achieve large savings, but that ACOs paid through shared savings may be an important first step toward greater efficiency and quality in the Medicare fee-for-service program.

HHS Argues Courts Should Recognize Alternative to PPACA Contraceptive Coverage Mandate

The issue of whether or not the Administration’s new regulation meets the Supreme Court test of offering an adequate “alternative accommodation” for religious organizations to avoid the direct provision of PPACA mandated contraceptive coverage may soon be tested in federal court. Before the Administration issued an interim final rule (under which non-profit religious organizations will not have to “provide” the contraceptive coverage to which they object on religious grounds, but in the alternative will have to notify HHS/CMS, IRS and the Department of Labor of their objection), in Catholic Conf. v. Burwell the Sixth Circuit disagreed that the religious organizations should be accorded an injunction against the original mandate. However, the plaintiffs have asked the U.S. Court of Appeals for the Sixth Circuit to give such relief. However, the Administration filed a brief arguing that an appeal is unnecessary in that the new regulations offer an adequate alternative accommodation consistent with the Supreme Court’s statement in the Hobby Lobby case that “achieves” the aim of seamlessly providing coverage of recommended health services to women “while providing greater respect for religious liberty”. On another issue--as to whether or not IRS regulations allowing federal tax premium subsidies for coverage obtained through HealthCare.gov (in states that did not elect to set up their own exchanges) are in violation of the language in the PPACA—the successful plaintiffs in the Halbig v. Burwell case argued that the Administration’s petition for an en banc hearing in the D.C. Circuit Court would be a “waste of resources” given that there are split decisions in several circuits and that the Supreme Court should intervene to resolve the matter.

Additional Delays in Open Payment System

CMS announced that it will delay until September 10th the date when providers can review and dispute payment information displayed on the Open Payments system website (created pursuant to the Physician Payments Sunshine Act, which was part of the Affordable Care Act in 2010). The correction period runs from September 11th through September 25th. CMS also reported that the Open Payments system will be inaccessible during a series of scheduled maintenance upgrades on Saturday, September 5th.

CMS Final Rules on Meaningful Use Program

CMS issued a final rule under which providers and hospitals may continue to use electronic health record (EHR) systems certified under the 2011 Edition certification program to qualify for meaningful use program incentive payments in 2014. The agency also delayed the start of Stage 3 of the program until 2017.

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