Last week, I wrote about Labor Day and the launch of the 2016 campaign season. However, even as focus shifts toward the November elections and what the landscape will look like after, numerous policy issues will be decided before any of the candidates on the current slate take an oath of office.
Next week, Missouri lawmakers will return for the annual veto session. Although Gov. Nixon’s vetoes of legislation relating to guns and voter identification have attracted the most attention, several bills with implications for hospitals and health care may face override. The bills include transparency requirements for providers and fees for Medicaid enrollees’ inappropriate emergency department use, among others. Nixon is a lame duck and his vetoes face Republican supermajorities in both chambers.
In Washington, D.C., lawmakers and federal agencies are working against the clock on the appropriations process, rulemaking and implementation of several key transformational laws, and on measures to address short-term crises with long-term implications. For example, funding for Zika virus protection programs has run out. Congress will need to authorize additional spending to address the crisis. In addition, policy and spending plans for the efforts to combat opioid misuse and abuse remain unfinished.
Although there are limited legislative work days left before the November election, it’s almost certain that some of that time will be dedicated to the issue of pharmacy pricing. The recent and shocking cost increases in the EpiPen rescue medication once again has focused the spotlight on pharmaceutical pricing. Public hearings certainly will drive the discussion and increase public outrage. Meanwhile, in quieter corners of health policy development, phase one of the Centers for Medicare & Medicaid Services’ demo for Medicare Part B drugs will have a high profile conclusion. The results will presage the value-based purchasing demo introduction scheduled to launch in January 2017.
Although the 2017 health care marketplace officially doesn’t open until Nov. 1, there’s certain to be lively discussion about the stability of the system and value of offerings in the interim. Rate and coverage reviews are ongoing. With the announced departures of several large insurers, many market areas will have fewer options for consumers in 2017. In addition, the Department of Justice action in the proposed mergers of insurance giants Aetna-Humana and Anthem-Cigna will continue — adding drama and potentially shaping the marketplace this year and into the future.
Last, but not least, CMS will be implementing new programs and trying to keep everything running smoothly on existing programs. Medicare outpatient and physician payment rules are due, with the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015 reshaping physician payments for the first time in more than a decade. Other rules will elbow their way in the process as part of the effort to keep CMS moving and to shape the Obama health care legacy. These include the 340B program mega guidance and the updated Medicaid disproportionate share hospitals audit rule.
The nitty gritty of health care policy usually happens in the trenches, not the spotlight. The noise focused elsewhere during the campaign doesn’t mean that the battle to make health care better has ended. In fact, retrenchment continues. The election will only shape the direction. And, that’s what we should expect from a sector that encompasses nearly 20 percent of the nation’s gross domestic product.
Let me know what you’re thinking.
In This Issue
Herb B. Kuhn
MHA President and CEO
CMS Announces New MACRA Options
CMS Finalizes Emergency Preparedness Rule
CMS Finalizes Emergency Preparedness Rule
Staff Contacts: Sarah Willson or Jackie Gatz
Yesterday, the Centers for Medicare & Medicaid Services released the emergency preparedness final rule for health care providers and suppliers. The new requirements center around four common industry best practice standards: emergency planning, policies and procedures, communication, and training and testing. The final rule includes several changes from the proposed rule. MHA has resources available to assist with compliance, which will be updated with training opportunities throughout the next several months. The final rule is effective 60 days from the anticipated publication date of Friday, Sept. 16, in the Federal Register, with full compliance expected one year after the effective date.
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September 8, 2016
U.S. House Subcommittee Receives Testimony About Medicare’s Pay-For-Performance
MLN Connects Provider eNews Available
July MUR Available On HIDI Analytic Advantage®
September 7, 2016
MHA Distributes Analysis For FFY 2017 Final LTCH PPS
CMS Announces 2017 Marketplace Navigator Grant Awardees
TJC Proposes Changes To Medication Management Standards
CMS Releases FY 2017 Medicaid Hospice Payment Rates
September 6, 2016
DOJ Finalizes New Higher Civil Monetary Penalties
CMS Announces ICD-10 Flexibility Period Deadline
Board Of Pharmacy Provides Sterile Compounding Emergency Rule Resources