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CHA has prepared the attached first-glance summary of the Centers for Medicare & Medicaid Services (CMS) final rule implementing the Comprehensive Care for Joint Replacement (CJR) payment model. As noted when the rule was issued, CMS has finalized the start date for this program to April 1, 2016, a slight delay from the proposed start date of Jan. 1, 2016. The model will require participation from inpatient prospective payment system hospitals in three California metropolitan statistical areas, as proposed.
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Yesterday the Centers for Medicare & Medicaid Services (CMS) issued its final rule implementing the Comprehensive Care for Joint Replacement model, set to begin April 1, 2016. Acute care hospitals in certain selected geographic areas, including three in California, will receive retrospective bundled payments for episodes of care for hip and knee replacements. The CMS Innovation Center will host a webinar, offered on two dates, to describe the final rule and respond to questions. Online registration for the Nov. 19 and Nov. 30 webinars is now available. CMS urges early registration, as large audiences are expected.
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The Centers for Medicare & Medicaid Services (CMS) has issued the attached final rule implementing the Comprehensive Care for Joint Replacement (CJR) model, in which acute care hospitals in certain selected geographic areas, including three in California, will receive retrospective bundled payments for episodes of care for hip and knee replacements. In response to comments from CHA and other stakeholders, CMS has delayed the date of the first performance period until April 1, 2016, rather than Jan. 1 as proposed.
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The U.S. Environmental Protection Agency (EPA) has issued the attached proposed rules regarding hazardous waste generators and the disposal of pharmaceuticals. The hazardous waste generator improvement proposed rule is intended to enhance the safety of facilities, employees and the general public by improving hazardous waste labeling, as well as emergency planning and preparedness. The EPA states the proposed rule would simplify current federal regulations and provide greater flexibility in how facilities and employees manage their hazardous waste. In addition, the proposed hazardous waste pharmaceuticals rule would prohibit health care facilities from flushing hazardous waste pharmaceuticals down sinks and toilets. The EPA notes that the rule is intended to reduce the burden on health care workers and pharmacists working in health care facilities by creating regulations specific to these facilities, including hospitals, clinics, and retail stores with pharmacies and reverse distributors that generate hazardous waste.
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The Centers for Medicare & Medicaid Services (CMS) has issued a final rule with comment period that aims to allow states and CMS to make better informed, data-driven decisions when considering whether proposed changes to Medicaid fee-for-service payment rates are sufficient to ensure that Medicaid beneficiaries have access to covered Medicaid services. The final rule also intends to strengthen CMS’ ability to review Medicaid payment rates to ensure they are consistent with efficiency, economy and quality of care, as well as ensure sufficient beneficiary access to care under the Medicaid program. CMS also issued a Request for Information (RFI) to gather input into additional approaches that it and states may consider to better ensure compliance with Medicaid access requirements. The RFI asks for comments on the potential development of standardized core set measures of access, access measures for long-term care and home and community-based services, national access to care thresholds, and resolution processes that beneficiaries could use when they have problems accessing essential health care services.
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Action needed:
CHA urges hospital executives to submit comments to the Health Resources and Services Administration (HRSA) on the 340B Drug Pricing Program Omnibus Guidance. Comments can be submitted at www.regulations.gov by searching for Regulatory Information Number (RIN) 0906–AB08, or by email at 340BGuidelines@hrsa.gov, including RIN 0906–AB08 in the subject line of the message.
Timing:
Submit comments before 2 p.m. (PT) Oct. 27.
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The Centers for Medicare & Medicaid Services (CMS) issued the attached request for information (RFI) yesterday seeking public comment on implementation of some of the payment provisions for physicians and professionals in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Those provisions include the merit-based incentive payment system, incentive payments for participation in certain alternative payment models, and physician-focused payment models. CMS also made available a frequently asked questions document on the MACRA provisions. Responses to the RFI will be due 30 days after publication in the Federal Register, which is scheduled for Oct. 1.
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CHA has released the attached summary, prepared by Health Policy Alternatives, Inc., detailing the 340B omnibus guidance released Aug. 28 by the Health Resources and Services Administration (HRSA). The notice with comment period provides guidance for covered entities enrolled in the 340B program and drug manufacturers required by section 340B of the Public Health Service Act to make their drugs available to covered entities under the 340B program.
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CHA has submitted the attached comment letter on the Centers for Medicare & Medicaid Services (CMS) Comprehensive Care for Joint Replacement Payment Model proposed rule.
In the letter, CHA urges CMS to consider several important changes to the proposed rule so that hospitals, physicians and post-acute care providers can collectively continue to provide the highest quality care to Medicare beneficiaries while fulfilling the shared goals of the triple aim. Specifically, CHA urges CMS to delay the start date of the program; narrow the 90-day episode definition to only elective joint replacement procedures; further refine the risk adjustment model; and exclude the Hospital Consumer Assessment of Healthcare Providers and Systems survey from the program.
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The Health Resources and Services Administration (HRSA) has released “mega guidance” for its proposed 340B Drug Pricing Program. The guidance is included in a notice with a 60-day comment period. In the guidance, HRSA provides clarification on the areas of covered entity eligibility, patient definition, group purchasing organization prohibition, contract pharmacy, duplicate discounts and covered entity audits. It also includes enhanced program integrity requirements for pharmaceutical manufacturers participating in the program. CHA is reviewing the proposed guidance and will seek member input on the anticipated hospital impact. Comments are due Oct. 26.
