PPACA New Enrollment Season Looms

The Centers for Medicare and Medicaid Services (CMS) finalized a proposed rule under which individuals enrolled under HealthCare.gov will be given notice that they will be automatically reenrolled for 2015 unless they take specific action otherwise. Related health insurers will also notify such individuals of their premium amounts and potential tax credit subsidies if they accept the terms of the reenrollment. Individuals who did not give permission for an update of their income situation will not receive subsidies unless they access the website and provide the information. In five federally facilitated marketplace states (DE, IL, NJ, MO, and OH) employers and agents/brokers will have early access for 2015 coverage to online functionality for the Small Business Health Options Program (SHOP) on HealthCare.gov. The website has also been found to have sustained a breach when malware was found on the server that supports the website. HHS said that personal information was not compromised in that the server in question did not contain personal information.

D.C. Court of Appeals to Rehear Halbig Case

The full U.S. Court of Appeals for the District of Columbia Circuit has scheduled a rehearing of the Halbig v. Burwell case in which a panel found that the Internal Revenue Service (IRS) acted illegally in issuing regulations that allow for federal tax premium subsidies to be given to individuals for coverage obtained through HealthCare.gov (in states that did not elect to set up their own exchanges). The plaintiffs had previously 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.

MedPAC Comments on 2015 Medicare MD Fee Schedule

The Medicare Payment Advisory Commission (MedPAC) sent a letter to CMS with comments on the proposed calendar year (CY) 2015 physician payment schedule in which, among other things, they recommended that CMS encourage clinicians to organize into or join groups that take clinical and financial accountability for their patients (e.g. Affordable Care Organizations and Medicare Advantage plans). They said that it may not be worth the resources required for the agency to put its focus on the performance of individual physicians in connection with the agency’s Medicare quality measurement programs.

CMS Seeks Comments on Improper Payments Program

CMS is requesting comments on a so-called computer matching program (CMP) that will use data from the Department of the Treasury on individuals and organizations that have been blocked from receiving payments, contracts or other benefits from the federal government. CMS will match the data against records maintained in the Medicare Provider Enrollment, Chain, and Ownership System (PECOS) to check payments made to providers and physicians in an effort to halt improper payments.

HHS Makes Healthy Start Grants

HHS announced that the agency has awarded $65 million under the Healthy Start program to 87 organizations in thirty-three states to assist them in helping reduce high infant mortality and other health problems related to pregnancy and mothers’ health. The HHS Secretary said that the program is expected to aid more than 56,000 women and children.

December 31, 1969: | Page 1 Page 2 Page 3



 -  2018