CHA News

DFEH Issues Modifications to Proposed CFRA Regulations

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Late last week, the California Department of Fair Employment and Housing (DFEH) modified proposed amendments to the California Family Rights Act Regulations. DFEH initially issued its proposed regulations on Feb. 21. CHA, in conjunction with the CalChamber and several other trade associations, submitted the attached comments during the subsequent 45-day comment period. The most recent revisions to the proposed regulations are deemed to be minor and, therefore, subject to a 15-day comment period. CHA will again work with the CalChamber to determine whether to submit additional comments, due Oct. 25. For more information about the proposed regulations, visit www.dfeh.ca.gov/FEHCouncil.htm.

CMS Seeks Stakeholder Insight on Health Plan Innovation Opportunities

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The Center for Medicare & Medicaid Innovation (CMMI) is responsible for developing and testing new payment and service delivery models that lower costs and improve quality for Medicare, Medicaid and CHIP beneficiaries. As part of its efforts, CMMI is seeking stakeholder perspectives through a formal Request for Information, attached, on health plan innovation opportunities such as:

CHA Submits Comments Regarding Exchange Quality Rating System

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CHA has submitted the attached comments to the Centers for Medicare & Medicaid Services (CMS). The comments address the CMS notice implementing a framework for measures and methodology for the health insurance exchange quality reporting system (QRS), as required by the Affordable Care Act. In the comment letter, CHA supports a phased-in approach to implementation of a QRS and urges CMS to continually evaluate and refine the framework, measures and timing of the rollout as the patient population evolves. CHA also urges CMS to remain actively engaged with the Measures Applications Partnership (MAP) health insurance exchange task force. CHA’s detailed comments provide a number of specific recommendations regarding the QRS goals and principles, measure selection, and organization and hierarchical structure. CHA will continue to work closely with Covered California and CMS in the implementation and evaluation of a QRS.

Budget and SGR Reforms Advance

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Last night the House of Representatives passed the Bipartisan Budget Act of 2013. The Senate is expected to do so today, and the President has indicated he will sign the measure. The vote in the House was 332-62; nine Californians voted against passage. The legislation contains both good news and bad news for California’s hospitals.
Also this week, the House Ways and Means and Senate Finance Committees reported bipartisan legislation to repeal the sustainable growth rate (SGR) for physician Medicare payments. They will continue to work toward a permanent solution during the first quarter of 2014. The financing mechanisms for offsetting the cost of repeal have not been released. Payments to hospitals continue to be vulnerable as the committees look for as much at $150 billion over the next 10 years to pay for the SGR repeal. 
CHA has provided the attached summary of the Bipartisan Budget Act of 2013 with additional information about the hospital-related provisions.

HHS Proposes Quality Rating System for Qualified Health Plans

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The Department of Health and Human Services (HHS) published the attached notice in the Federal Register on Nov. 19, proposing a quality rating system (QRS) for qualified health plans (QHPs) offered through health insurance exchanges. The Affordable Care Act requires HHS to create a system enabling consumers to compare QHPs based on relative quality, price and enrollee satisfaction. The notice outlines a proposed methodology for selecting QRS measures, organizing such measures into broad categories meaningful to consumers (e.g., care coordination, preventive services, patient safety, etc.), and calculating statistically valid global ratings for each QHP (as is now done under the Medicare Advantage 5-star rating system).

CHA Members Take Hospital Message to Capitol Hill

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CHA President/CEO C. Duane Dauner was joined by 10 representatives of CHA member hospitals in Washington, D.C., Dec. 3 for the CHA and American Hospital Association hospital advocacy day. The group met with about half of the California Congressional delegation, including House Minority Leader Nancy Pelosi, House Majority Whip Kevin McCarthy, and Sens. Boxer and Feinstein.

US Supreme Court Same Sex Marriage Rulings Have Major Impact for Employers

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On June 26, 2013, the US Supreme Court’s decision in United States v. Windsor struck down Section 3 of the federal law known as the Defense of Marriage Act (DOMA). Under DOMA and for purposes of federal law, the term “spouse” was limited to individuals of the opposite sex.

OIG Revises Self-Disclosure Protocol

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The U.S. Office of Inspector General (OIG) today issued a revised guidance to its provider Self-Disclosure Protocol (SDP). The guidance addresses a range of issues for providers who wish to voluntarily disclose self-discovered evidence of potential fraud, including conduct eligible (and ineligible) for the SDP, disclosure requirements, calculating damages and reporting potential anti-kickback statute violations. The new protocol also suspends a 60-day overpayment rule (see CHA’s comments) proposed by the Centers for Medicare & Medicaid Services (CMS). The OIG said it would provide further SDP guidance once CMS releases its final rule on the 60-day overpayment issue. The revised SDP is available at http://oig.hhs.gov/compliance/self-disclosure-info/files/Provider-Self-Disclosure-Protocol.pdf.

CMS and ONC Seek Input on Advancing Interoperability, HIE

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The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) have issued the attached request for information (RFI). Seeking input on potential policy and program changes to accelerate electronic health information exchange (HIE) across providers, the RFI specifically addresses the extent to which current CMS payment policies encourage or impede electronic information exchange across health care provider organizations, as well as which current programs are having the greatest impact on encouraging electronic HIE. CMS also asks providers to suggest how CMS and states can use existing authorities to better support electronic and interoperable HIE among Medicare and Medicaid providers — including post-acute, long-term care and behavioral health providers — and how policies could be developed to maximize the impact on care coordination and quality improvement. Comments on the RFI are due April 22.

CHA Comments on Hospital Readiness to Use EHRs for Quality Reporting

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CHA has submitted the attached comments to the Centers for Medicare & Medicaid Services (CMS) on hospital and vendor readiness to report certain clinical quality measures under the Hospital Inpatient Quality Reporting program using certified electronic health record (EHR) technology. Submitted in response to a CMS request for information, CHA’s letter raises concerns about the ability of hospitals to collect and report measures through an EHR when the vast majority of California’s hospitals have not met stage 1 “meaningful use” requirements and the accelerated timeline for implementing and revising measure specifications. CHA also urges CMS to use the Measures Application Partnership to bring the Office of the National Coordinator for Health Information Technology’s quality reporting efforts into better alignment with the Hospital Inpatient Quality Reporting Program.