Major health care regulatory activity still to come under the Obama Administration

Posted by Anne Phelps, US Health Care Regulatory Leader, Principal, Deloitte & Touche LLP and Daniel Esquibel, Senior Manager, Deloitte & Touche LLP on September 26, 2016

As many in the US prepare to shift their attention to the upcoming presidential debates and the final weeks of the campaign, the Obama Administration is poised to release some far-reaching regulations, which will have a significant effect on the health care marketplace, including a final rule on the new Medicare payment law and some changes intended to help shore up the health insurance Exchanges established under President Obama’s signature health care law.

Highlights of some of the most significant regulatory actions still to come in the final months of the Obama Administration are provided below.

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T+2 – Shortened Settlement Cycle: Notice of the SEC moving forward

Posted by Bob Walley, Advisory Principal, Deloitte & Touche LLP, James Weber, Advisory Managing Director, Deloitte & Touche LLP, John Sjosten, Advisory Senior Manager, Deloitte & Touche LLP, Ritesh Biswas, Senior Manager, Deloitte Consulting LLP on September 23, 2016.

Overview

One year ago, Deloitte began the journey with the industry and our clients to prepare for shortening of the trade settlement cycle to trade date plus two days (T+2). This work began with the creation of the T+2 Industry Playbook as a guide for financial firms to follow as they prepared for implementing T+2. Deloitte is working closely with SIFMA, ICI and DTCC in the T+2 Command Center function and continues to advance the messages of the shortened settlement cycle by facilitating T+2 workshops for our clients and the industry.

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New York State proposes new cybersecurity regulation for financial institutions

As federal regulators continue to update existing cybersecurity guidance1 and consider new rules governing banks’ cybersecurity practices,2 the New York State Department of Financial Services (DFS), under the direction of Governor Andrew Cuomo, proposed to establish cybersecurity requirements that go beyond those at the federal level.

On September 13, 2016, the DFS issued a proposal3 that would require banks, insurance companies, and other DFS-regulated entities to establish a cybersecurity program and comply with related requirements. Although these institutions are already subject to cybersecurity requirements at both the federal and state levels, the proposal, which the DFS describes as a “first-in-the-nation” regulation, would establish a more prescriptive framework than any existing regulation.

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CMS issues proposed notice of benefit and payment parameters for 2018

Posted by Anne Phelps, Principal, US Health Care Regulatory Leader, Deloitte & Touche LLP and Daniel Esquibel, Deloitte Advisory Senior Manager, Deloitte & Touche LLP on September 14, 2016

The Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would make a number of changes to the public health insurance Exchanges created under the Affordable Care Act (ACA). Many of the proposals are intended to take effect in 2018, but some would begin in benefit year 2017.

The proposed rule follows announcements from several national health insurers that they would reduce their participation in Exchanges in 2017, following continued financial losses.  Policy proposals, such as changes to the risk adjustment program, are intended to help boost the stability of the Exchanges and were addressed in a June 2016 white paper following the Department of Health and Human Services (HHS)-Operated Risk Adjustment Methodology Public Meeting, which was held on March 31, 2016.

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Tackling misconduct risk

Financial Stability Board’s areas of focus and forward agenda

Originally posted by David Strachan, partner and EMEA Lead, Deloitte Centre for Regulatory Strategy,  Kevin Nixon, partner and Global & APAC lead, Deloitte Centre for Regulatory Strategy, and Chris Spoth, Deloitte Advisory Managing Director and Americas Lead, Deloitte Center for Regulatory Strategy, Deloitte & Touche LLP on the Financial Services UK blog on September 7, 2016.

As is now customary, the Financial Stability Board (FSB) published a slew of reports ahead of the G20 Leaders’ Summit in Hangzhou. These documents included a second progress report, published on 1 September, on measures to reduce misconduct risk in financial services. This follows a workplan agreed in May 2015, and a first progress report in November 2015. The latest report describes progress made since the end of 2015.

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CMS provides clinicians flexibility under MACRA but retains 2017 start date for first performance period

Posted by Anne Phelps, Principal, US Health Care Regulatory Leader, Deloitte & Touche LLP and Daniel Esquibel, Deloitte Advisory Senior Manager, Deloitte & Touche LLP on September 9, 2016

In a blog post late Thursday, September 8, 2016, Centers for Medicare & Medicaid Services (CMS) Administrator Andy Slavitt announced two new options for participation in the Merit-based Incentive Payment System (MIPS) that are intended to give clinicians more flexibility to participate in the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Notably, the blog post states that the first performance period will still begin on January 1, 2017.

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CMS proposes Chronic Care Management rule changes to increase access and reduce administrative burden

Posted by Steve Burrill, Partner, National Health Care Providers Advisory Leader, Deloitte & Touche LLP and Ryan Haggerty, Deloitte Advisory senior manager, Deloitte & Touche LLP on August 31, 2016

On Friday July 15, 2016, the Centers for Medicare and Medicaid Services (CMS) released its Proposed Rule for the Calendar Year 2017 Medicare Physician Fee Schedule, which outlines changes to Chronic Care Management (CCM). These changes are significant and seek to provide increased reimbursement for patients that require greater levels of medical decision making, attempts to reduce administrative burden, while also aligning CCM more closely to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).1,2

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