The Daily Scan

August 1, 2018

Last Updated: 8:45 AM EST

Legislation 

  • ​The departments of Health and Human Services, Labor and the Tresury issued a final rule to help Americans struggling to afford health coverage find new, more affordable options. Health and Human Services Secretary Alex Azar commented, “Under the Affordable Care Act, Americans have seen insurance premiums rise and choices dwindle, President Trump is bringing more affordable insurance options back to the market, including through allowing the renewal of short-term plans. These plans aren’t for everyone, but they can provide a much more affordable option for millions of the forgotten men and women left out by the current system.” The rule allows for the sale and renewel of short-term, limited duration plans that cover longer periods than the previous maximum period of less than 3 months. (News Release: (HHS.gov), Final Rule: (HHS.gov), Fact Sheet: (HHS.gov))

  • A coalition of state attorneys general joined together in opposition of the Trump administration’s proposal to block clinics that provide abortion services or make referrals from getting federal family-planning funding.13 Democratic AGs joined governors from a growing group of states who have said they will sue the administration over the rule, or have said they will pull the state from the program over such policy changes. In a letter to HHS Secretary Azar, the attorneys general questioned the constitutionality of the proposal, and charged that if adopted, the rule would “result in the invasion of the physician-patient relationship, the trampling of the constitutional rights of patients and providers, the transmission of incomplete, misleading, and medically dangerous information to women, and the frustration of the right to make an informed, independent decision as to whether to terminate a pregnancy.” (The Letter: OAG.CA.gov)

Regulation

  • The U.S.Govenment Accountability Office released a report discussing the status of Health and Human Service's implementation of required prior authorization medical reviews and prior education for chiropractic services. Medicare covers certain chiropractic treatments that improve musculoskeletal or spinal function. Improper payments for chiropractic services have been relatively high, mainly due to errors in how chiropractors document treatments.Recent legislation required prior authorization for chiropractic services in an effort to reduce improper payments, but Medicare hasn't yet implemented the requirement. Once it's implemented, beneficiaries will need approval before they can receive certain services. (GAO.gov)

  • The Office of Inspector General of the U.S. Department of Health and Human Services released a portfolio highlighting vulnerabilities in the Medicare hospice benefit. The OIG is committed to ensuring that beneficiaries receive quality care and to safegarding the hospice benefit. Among other factors, the OIG found during their investigation, the OIG found that hospices do not always provide needed services to beneficiaries and sometimes provide poor quality care. In some cases, hospices were not able to effectively manage symptoms or medications, leaving beneficiaries in unnecessary pain for many days. The OIG recommends that CMS implement 15 specific actions that relate to the 7 areas for improvement. The OIG has commented, "We remain committed to our recommendations and will continue to work with CMS to promote their implementation." (OIG.HHS.gov

Private Sector 

  • Yesterday, Centene and Ascension announced a letter of intent for Medicare Advantage Joint Venture. The MA plan would be established as a preferred model for the respective systems and affiliates for Centene and Ascension in multiple geographic markets beginning in 2020. Michael Neidorff, Chairman and CEO of Centene commented, "We are pleased to pursue this joint venture with Ascension to create a differentiating offering for Medicare Advantageacross multiple markets, this joint venture will bring together two leaders with decades of experience across markets and creates an opportunity for scaled payer-provider collaboration. We share a commitment of serving the underserved and intend to leverage the best capabilities of both organizations to provide high quality, affordable healthcare to support the needs of low-income seniors." (Centene.com

 

 

 

 

 

 

 

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