Pioneer ACOs Selected

CMS announced that it has selected 32 health care systems to participate in a “Pioneer” accountable care organization (ACO) initiative designed to better coordinate care across providers and lower costs.  Pursuant to the PPACA, the Pioneer initiative will test the effectiveness of several innovative payment models and how they can help experienced organizations to provide better care for beneficiaries, work in coordination with private payers and reduce Medicare cost growth.

Independence At Home DEMO

CMS announced that the PPACA “Independence at Home (IAH)” demonstration will test a service delivery model that uses physician and nurse practitioner directed primary care teams to provide services to chronically ill Medicare beneficiaries in their homes.  The demonstration will reward providers that show a reduction in Medicare expenditures through an incentive payment if they succeed in providing high-quality care while reducing costs.  Applications from providers wishing to participate in the demo are due by February 6th.  Of note, providers cannot participate in both the aforementioned Pioneer ACO program and the three year demonstration project.

Senators Ask IOM to Review GME Program

A bipartisan group of senators--Sens. Bingaman, Tom Udall, Mark Udall, Bennet, Kyl, Grassley and Crapo--have written the Institute of Medicine asking for the agency to do a thorough review of the system of graduate medical education.  They said “We believe our GME system is under increasing stress and the projections for our health care workforce are of significant concern….There is growing concern that the United States is failing to adequately match medical training with our medical needs on a national level.”  Changes to the GME are under discussion in Congress, at MedPAC, at the Accreditation Council for Graduate Medical Education and at various foundations.

Recently Introduced Health Legislation

H.R. 3728 (TAXATION), to amend the Internal Revenue Code of 1986 to make members of health care sharing ministries eligible to establish health savings accounts; SCHOCK; to the Committee on Ways and Means, Dec. 19.

H.R. 3735 (MEDICARE), to provide for enhanced penalties to combat Medicare and Medicaid fraud, a Medicare data-mining system and biometric technology pilot program, and for other purposes; ROS-LEHTINEN; jointly, to the committees on Energy and Commerce and Ways and Means, Dec. 19.

H. RES. 501 (MIDDLE CLASS TAX RELIEF AND JOB CREATION ACT), expressing the sense of the House of Representatives regarding any final measure to extend the payroll tax holiday, extend federally funded unemployment insurance benefits, or prevent decreases in reimbursement for physicians who provide care to Medicare beneficiaries; PRICE of Georgia; jointly, to the committees on Ways and Means, Energy and Commerce, House Administration, and Transportation and Infrastructure, Dec. 19.

H.R. 3737 (DRUGS), to amend the Federal Food, Drug, and Cosmetic Act with respect to fast track approval of certain orphan drugs; STEARNS; to the Committee on Energy and Commerce, Dec. 20.

H.R. 3760 (TOURETTE SYNDROME), to amend the Public Health Service Act to provide for the expansion, intensification, and coordination of the programs and activities of the National Institutes of Health with respect to Tourette syndrome; SIRES; to the Committee on Energy and Commerce, Dec. 20.

H.R. 3762 (OCCUPATIONAL THERAPISTS), to amend the Public Health Service Act to include occupational therapists as behavioral and mental health professionals for purposes of the National Health Service Corps; TONKO; to the Committee on Energy and Commerce, Dec. 20.

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