POLICY BRIEFINGS


Agencies Push for UDI in Claims


Acting Administrator of the Centers for Medicare and Medicaid Services (CMS) Andy Slavitt and Commissioner of the Food and Drug Administration (FDA) Robert Califf have written to the Accrediting Standards Committee X12 in support of the inclusion of unique device identifiers (UDIs) for implantable devices on health insurance claims forms. The UDI is a part of FDA’s strategy to improve post-market surveillance. CMS has previously been reluctant to endorse UDIs, because of concerns from hospitals that coders will face difficultly incorporating the lengthy numbers into the form. Advocates for UDIs say that they will improve value-based reimbursement based on device performance. The Accrediting Standards Committee X12 Committee is responsible for updating claims forms, and their work on the next version of the forms is expected to be released in December for public comment . The form will not be revised again until for another decade. It would cost at least an estimated $300 million to complete the UDI switchover.


Half of Doctors Unfamiliar with MACRA


Half of non-pediatric physicians have never before heard of the Medicare Access and CHIP Reauthorization Act (MACRA), according to a new study by Deloitte. Only 21 percent of self-employed or small-group physicians and just nine percent of physicians employed by hospitals or larger groups reported that they were even somewhat familiar with the 2015 law. Fifty-eight percent of survey respondents attested that they would join a larger organization in order to diminish their financial risks, while 80 percent expect the law to prompt physicians to join larger organizations or networks. MACRA designs a new reimbursement plan that will put four percent or more of physician payments at risk beginning in 2019. The Centers for Medicare and Medicaid Services’ (CMS) own projections show that the vast majority of physicians in small groups will suffer penalties under the law.


Recently Introduced Health Legislation


H.R.5712 (introduced by Rep. Luke Messer): A bill to amend the Internal Revenue Code of 1986 to flatline the individual mandate penalty; to the House Committee on Ways and Means; July 11

H.R.5713 (introduced by Rep. Patrick J. Tiberi): A bill to provide for the extension of certain long-term care hospital Medicare payment rules, clarify the application of rules on the calculation of hospital length of stay to certain moratorium-excepted long-term care hospitals, and for other purposes; to House Energy and Commerce; July 11

H.R.5717 (introduced by Rep. Leonard Lance): A bill to amend title XIX of the Social Security Act to improve collection of Medicaid data and to expand coverage of tobacco cessation services to mothers of newborns; to the House Committee on Energy and Commerce; July 11

H.R.5721 (introduced by Rep. Lynn Jenkins): A bill to amend title XVIII of the Social Security Act in order to improve the process whereby medicare administrative contractors issue local coverage determinations under the Medicare program, and for other purposes; to House Energy and Commerce; July 11

H.R.5723 (introduced by Rep. Sander M. Levin): A bill to amend title XVIII of the Social Security Act to provide for a temporary exception to the site neutral payment rate for certain discharges from long-term care hospitals that involve severe wounds; to House Energy and Commerce; July 11

H.R.5772 (introduced by Rep. Raul Ruiz): A bill to amend title XVIII of the Social Security Act to establish a system to educate individuals approaching Medicare eligibility, to simplify and modernize the eligibility enrollment process, and to provide for additional assistance for complaints and requests of Medicare beneficiaries that relate to their enrollment in the Medicare program, and for other purposes; to the House Committee on Energy and Commerce; July 13



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BRIEFING ARCHIVE


 -  2018