POLICY BRIEFINGS


EFT Interim Final Rules


CMS released an interim final rule which adopts standards for the format and data content of electronic funds transfers for claims payments between health plans and financial institutions.  The rule also requires the use of a trace number that automatically matches the payment and the remittance advice notice.  CMS says the new tracking system will allow health care providers to eliminate costly manual reconciliations and could cut as much as $4.5 billion from administrative costs for providers and plans over ten years.


Quality Measures for Medicaid Beneficiaries


HHS released a final core set of quality measures which states, insurers and providers can elect voluntarily to monitor and help improve health care delivered to adults enrolled under Medicaid.  The 26 quality measures approved by AHQR and CMS fall into six categories: prevention and health promotion; management of acute conditions; management of chronic conditions; family experiences of care; care coordination; and availability of care.  Perhaps indicative of future quality measures for additional populations, the HHS statement said “These core set measures will support HHS and its state partners in developing a quality-driven, evidence-based, national system for measuring the quality of health care provided to Medicaid-eligible adults.”


Participants Selected in Innovation Advisors Program


CMS announced that it has chosen seventy three individuals from 27 states among 920 applicants to participate in the Innovation Advisors program to work with the Center for Medicare and Medicaid Innovation agency to test new models of care delivery and form partnerships with local organizations to drive delivery system reform.  The PPACA authorized funding of up to $20,000 per participant.


NIH Announces New NIGMS Divisions


NIH said that the agency is creating two new divisions under the National Institutes of General Medical Sciences: the Division of Training, Workforce Development and Diversity and the Division of Biomedical Technology, Bioinformatics and Computational Biology.  Funding and staffing will remain unchanged from the programs previously administered by the National Center for Research Resources.



January 9, 2012: | Page 1 Page 2

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