Final ACO Fraud Waiver Under OMB Review – The White House Office of Management and Budget (OMB) reported on September 9, 2015, that it began its review of the final rule (CMS-1439-F; RIN 0938-AR30), titled “Medicare Shared Savings Program; Final Waivers.” The current waiver regulation, an interim rule (available here), is due to expire in November.
Court Rules House Can Sue Administration Over ACA – In a September 9, 2015 opinion, the U.S. District Court for the District of Columbia ruled that the House of Representatives has standing to sue HHS Secretary Burwell and Secretary of the Treasury Jacob Lew for their departments’ use of allegedly unappropriated funds in a cost-sharing program used to support the implementation of the Affordable Care Act (ACA). The court ruled that the House does not have standing to pursue claims that Secretary Lew improperly amended ACA by delaying and narrowing the scope of the employer mandate, since the claim concerns the implementation of a statute and not adherence to any specific constitutional requirement. A copy of the decision is available by clicking here.
CMS Extends Comment Period for LTC Rule – CMS published a notice on September 11, 2015, reopening the comment period to the July 16, 2015, proposed rule that would update and revise the requirements for long term care (LTC) facilities participating in the Medicare and Medicaid programs. In the notice, CMS explains that it has received inquiries from hospital associations and national industry organizations regarding the need for additional time due to the scope and complexity of the proposal, and states that it has decided to extend the comment period for 30 days to provide ample time for comments. Comments are now due by October 14, 2015.
CMS Releases MLN Matters Article on Updates to Hospice Payment Rates, Cap, Wage Index and Prices for FY 2016 – On September 4, 2015, CMS released a MLN Matters article related to Change Request 9301/Transmittal 3445 directing Medicare’s Administrative Contractors to apply the new hospice payment rates for FY 2016. The MLN Matters article lists the new hospice care payment rates for FY 2016, including the single routine home care rate for care provided from October 1, 2015 through December 31, 2015, the two-tiered payment system rate for routine home care services furnished on or after January 1, 2016, and the service intensity add-on beginning January 1, 2016. The MLN Matters article also provides the aggregate cap value for the 2015 cap year ending October 31, 2015 ($27,382.63) and the hospice wage index for FY 2016. The MLN Matters article is available by clicking here.
