Congress poised to begin effort to repeal key provisions of the Affordable Care Act early in 2017

A budget resolution laying the groundwork to repeal key provisions of the Affordable Care Act (ACA) will be the first item on the legislative agenda for the Senate in 2017, Senate Majority Leader Mitch McConnell (R-KY) announced on Tuesday, December 6, 2016.

The move is a central element of an effort being described as “repeal and delay” that Republican congressional leaders have outlined since the November 8, 2016 elections, in which Republicans retained majorities in the Senate and House and Donald Trump was elected President. The plan calls for a vote early in 2017 on legislation that would use the budget reconciliation process to repeal major provisions of the ACA but maintain the availability of premium assistance tax credits for the purchase of health insurance coverage through the ACA Exchanges and expanded eligibility for Medicaid for a transition period of a time to be determined. Some Republicans have called for a transition period of as long as three years, while others have called for a more expeditious transition. The transition period is intended to provide time for Congress separately to develop an alternative health care approach.

Continue reading “Congress poised to begin effort to repeal key provisions of the Affordable Care Act early in 2017”

Pressing ahead: Update on Congress’s oversight of the implementation of MACRA

CMS takes next steps in implementation of new Medicare payment lawPosted by Anne Phelps, US Health Care Regulatory Leader, and Daniel Esquibel, Senior Manager, Deloitte & Touche LLP on March 18, 2016.

On March 17, 2016, Patrick Conway,  Deputy Administrator for Quality and Innovation and Chief Medical Officer at the Centers for Medicare and Medicaid Services (CMS), testified at the House Energy & Commerce Health Subcommittee’s hearing on implementation of the new Medicare payment law, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA).

Overview of MACRA

MACRA repeals the Sustainable Growth Rate (SGR) formula and establishes a path toward a new payment system that will more closely align reimbursement with quality and outcomes measures while steering health care providers to participate in risk-bearing coordinated care models and away from the fee-for-service reimbursement system. Continue reading “Pressing ahead: Update on Congress’s oversight of the implementation of MACRA”

Congress seeks feedback on changes to Medicare payment policy for certain off-campus hospital outpatient departments, site-neutral payments; American Hospital Association weighs in with CMS

US Supreme Court building

Posted by Anne Phelps, Principal, US Health Care Regulatory Leader on February 12, 2016.

A letter seeking comments on site-neutral payments under Medicare went out to the health care community from Congressional leaders on Friday, February 5 and highlighted a recent change in law that will affect Medicare payments for certain provider-based off-campus hospital outpatient departments (PBD HOPDs).

On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015, which included a provision on site-neutral payments for PBD HOPDs. Beginning January 1, 2017, the provision will bar PBD HOPDs that execute CMS provider agreements after November 2, 2015 (the date the law was enacted), from being reimbursed under the CMS Outpatient Prospective Payment System (OPPS). PBD HOPDs barred from OPPS will only be eligible for reimbursement under the Medicare Physician Fee Schedule (PFS) or the Ambulatory Surgical Center Prospective Payment System (ASC PPS), both of which have generally lower reimbursement rates than OPPS.

Continue reading “Congress seeks feedback on changes to Medicare payment policy for certain off-campus hospital outpatient departments, site-neutral payments; American Hospital Association weighs in with CMS”