Health Headlines: Also in the News - May 2014

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CMS Seeks Additional Comments on Sunshine Rule Dispute Resolution and Correction Procedures – CMS is seeking additional comments on dispute resolution and correction procedures under the Sunshine Rule.  According to the notice issued by CMS, comments must be received by June 2, 2014.  

CMS Announces New QIO Contracts – CMS recently announced that Livanta LLC and KePRO will serve as Quality Improvement Organization (QIO) Beneficiary and Family-Centered Care (BFCC) contractors.  As BFCC contractors, these entities will focus on conducting quality-of-care reviews, discharge and termination of service appeals, and other areas of required review.  This is the first phase of CMS’s restructuring of the QIO program to improve patient care and health outcomes.  In the second phase—anticipated to take place in July 2014—CMS will award contracts to organizations that will work directly with providers and communities on data-driven quality initiatives.

Study Says Substantial Number of Medicare Beneficiaries Received Low-Value Treatment – According to a study published on May 12, 2014 in the Journal of the American Medical Association (JAMA), at least a quarter of Medicare beneficiaries received services of “minimal clinical benefit” in 2009.  In addition to analyzing the proportion of beneficiaries receiving low-value services, the study also assessed the per-beneficiary amounts spent on such services and compared spending on the services to overall Medicare spending.  Click here to read an abstract of the JAMA study.

OMB Begins Review of OIG Safe Harbor Rule – The Office of Management and Budget (OMB) recently indicated on its Reginfo.gov website that it is reviewing a proposed OIG rule (RIN: 0936-AA06) regarding revisions to the safe harbors under the anti-kickback statute and the civil monetary penalty rules.  The proposed rule is scheduled to be released in July 2014.

 


DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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