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ONC Takes Next Step in Advancing Interoperability

A proposed regulation that would require health care organizations that contract with the Department of Health and Human Services to comply with standards for data exchange adopted by HHS’s Office of the National Coordinator for Health Information Technology is the latter’s latest step toward fostering greater interoperability in the use and exchange of health care data. As ONC writes, By aligning on standards that enable interoperability, HHS is ensuring that federal investments do not contribute to the proliferation of proprietary modes of exchange and data silos that inhibit access, exchange, [...]

August 19, 2024|Categories: Medicare, Medicare regulations|Tags: health care data exchange, health IT interoperability, HHS Health IT Alignment Policy, HHS Office of the National Coordinator for Health Information Technology|

Federal Health Policy Update for August 15

The following is the latest health policy news from the federal government for August 9-15. Some of the language used below is taken directly from government documents. Department of Health and Human Services To advance its implementation of the 2009 Health Information Technology for Economic and Clinical Health Act (HITECH Act), HHS has published a proposed regulation that would amend and update its Health and Human Services Acquisition Regulation. The proposed regulation would require health care organizations that contract with HHS to comply with standards for data exchange adopted by [...]

August 15, 2024|Categories: Accountable Care Organization, ACO, Alternative payment models, COVID-19, health equity, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care|Tags: ACO Reach model, and Community Health Model, BlackSuit Ransomware, Emergency Medical Treatment and Labor Act, EMTALA, Government Accountability Office, HHS advancing interoperability, HITECH Act, Inflation Reduction Act, long covid, MACPAC, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, medicaid ltss, Medicare 3-day rule, Medicare and kidney transplants, Medicare ESRD prospective payment system, Medicare hospice payment rates, Medicare negotiates prescription drug prices, Medicare outpatient prospective payment system, Medicare physician fee schedule, MLN Connects, Office of the National Coordinator for Health Information Technology, Parvovirus 19, Realizing Equity Access|

CMS Tinkers With ACO REACH Model

Medicare’s ACO REACH Model will undergo some changes when it heads into its 2025 performance year. To help ensure that the program controls costs and saves money, the Centers for Medicare & Medicaid Services will implement a series of changes in its voluntary Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model. According to the agency, it is: adjusting the financial methodology to improve model sustainability based on the findings in the PY [performance year] 2022 Evaluation Report; responding to feedback from interested parties on improvements [...]

August 14, 2024|Categories: Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Medicare, Medicare reimbursement policy|Tags: Access, accountable care organizations, ACO Reach model, and Community Health Model, Centers for Medicare & Medicaid Services, Medicare, Medicare Accountable Care Organization Realizing Equity, Medicare accountable care organizations|

Court Sides Again With Providers on No Surprises Act

A federal appellate court has affirmed a lower court ruling that the manner in which federal regulations tell No Surprises Act dispute arbiters to evaluate competing fee claims unfairly favors health care payers over providers. At issue is a regulatory directive that arbiters weigh what is known as the qualifying payment amount – the median of what insurers contract to pay providers in a given geographic area – when deciding on payments. In February a federal court ruled that using this measure in what is known as the independent dispute [...]

August 12, 2024|Categories: Uncategorized|Tags: No Surprises Act, No Surprises Act and Texas Medical Association, No Surprises Act independent dispute resolution process, No Surprises Act qualifying payment act|

Federal Health Policy Update for August 8

The following is the latest health policy news from the federal government for August 3-8. Some of the language used below is taken directly from government documents. No Surprises Act A federal appeals court has upheld a February lower court ruling that found that the current No Surprises Act’s arbitration process for addressing payment disagreements between payers and providers favored payers by giving too much weight to “qualifying payment amounts,” which are the median of what insurers contract to pay providers in a given geographic area. Learn more from the [...]

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