Health Headlines: Also in the News - May 2014

by King & Spalding

CMS Proposes Payment Changes for Hospice Providers, SNFs, IRFs and Inpatient Psych Facilities – Last week, CMS issued proposed rules that would make certain payment and policy changes to the payment systems for hospice providers, skilled nursing facilities, inpatient rehabilitation facilities and inpatient psychiatric facilities.  Medicare payments would increase under each of the proposed rules:  hospices by an estimated 1.3 percent ($230 million); SNFs by an estimated 2.0 percent ($750 million); IRFs by an estimated 2.2 percent ($160 million); and IPFs by an estimated 2.1 percent ($100 million).  The SNF and IPF proposed rules will be published in the Federal Register on May 6, the IPF proposed rule will be published on May 7, and the hospice proposed rule will follow in the May 8 publication.  Pre-publication copies are available here.  They are also available by clicking on the following links: Proposed Rule - Hospice; Proposed Rule - SNFs; Proposed Rule - IRFs; and Proposed Rule - Inpatient Psych.   

CMS Finalizes Rule Establishing New Prospective Payment System for FQHCs – CMS issued a final rule with comment on a new payment system for Federally Qualified Health Centers.  Payments to FQHCs under the new system could increase as much as 32 percent.  CMS is accepting comments until July 1, 2014, on how Chronic Care Management policies for physicians billing under the physician fee schedule can be adapted for FQHCs, proposed G-codes, and a modification that would simplify the methodology for calculating coinsurance when a preventive and non-preventive service is on the same claim.

FSMB Adopts Model Telemedicine Policy Guidelines – On April 26, 2014, the Federation of State Medical Boards (FSMB) announced that it had adopted an updated set of guidelines for the safe practice of telemedicine as set forth in the Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine.  The FSMB represents all of the nation’s 70 state and territorial medical licensing boards, but it is an advisory board.  This means state boards are free to adopt the updated policy guidelines, modify them, or retain their own current policies regarding telemedicine.

NQF Report Urges Consideration of Patient Demographics in Quality Ratings – According to a recent draft report released by the National Quality Forum, physicians serving financially disadvantaged patients may be at a disproportionately greater risk of receiving lower ratings, due to the fact that current policy allows for adjustment based on clinical factors but not sociodemographic factors, which have been shown to influence a variety of patient outcomes and some processes.  The NQF generally recommends revision of the NQF criteria related to risk adjustment to include sociodemographic factors as appropriate, but notes that this is not an absolute (i.e., neither an indication that all performance measures should always be adjusted for sociodemographic factors nor that they should never be adjusted for such factors).  The NQF received more than 650 comments on the draft report and expects to issue a final report 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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