President Donald Trump called on Congress to pass right-to-try legislation. According to reports, the right-to-try’ legislation that aims to help terminally ill patients access experimental therapies and drugs that have not been approved by the Food and Drug Administration outside of clinical trials, was passed through the Senate and is now undergoing disputes from doctors, ethicists, and lawyers. The medical providers and supporters who strongly oppose the bill argue that giving … [Read more...] about Doctors, Lawyers want Congress to halt ‘Right-To-Try’ Legislation for Terminally-Ill Patients
Proposed Women’s Health Care Law Requires Insurers to Cover Women’s Preventative Care
With the looming threats by the Republican-led White House to repeal the federal health care law (Obamacare), a new health care bill, Defending Access to Women’s Health Care Services Amendment Act, was introduced to prevent insurance companies from charging more specifically for women's health services like cancer screenings or contraceptive costs. According to news sources, Washington officials signed legislation requiring all insurance companies in the Washington, D.C. to cover a list of … [Read more...] about Proposed Women’s Health Care Law Requires Insurers to Cover Women’s Preventative Care
HHS OIG Releases Report Regarding Group Homes and Critical Incident Reporting
This January, the Office of Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS) in conjunction with the Administration for Community Living (ACL) and the Office for Civil Rights (OCR) at HHS issued a report which detailed that "health and safety policies and procedures were not being followed. Failure to comply with these policies and procedures left group home beneficiaries at risk of serious harm. These are not isolated incidents but a systemic problem – 49 … [Read more...] about HHS OIG Releases Report Regarding Group Homes and Critical Incident Reporting
New Law gives Healthcare providers and Nurses Religious Protections
According to reports, a newly created division of the Department of Health and Human Service’s Office for Civil Rights will oversee and protect health care workers who decline to partake in certain medical procedures for patients due to moral or religious objections. HHS’ Centers for Medicare & Medicaid Services (CMS) released a proposed rule on "protecting life" and “conscience rights” that will further protect health-care providers who think they are being punished or discriminated … [Read more...] about New Law gives Healthcare providers and Nurses Religious Protections
2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies
The Centers for Medicare & Medicaid Services (CMS) released Part I of the 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies (the Advance Notice), which contains key information about proposed updates to the Part C Risk Adjustment Model and the use of encounter data. According to the Press release: The 2019 Advance Notice is being published in two parts this year due to requirements in the 21st Century Cures Act, which mandated … [Read more...] about 2019 Advance Notice of Methodological Changes for Medicare Advantage Capitation Rates and Part D Payment Policies
CMS Launches Data Submission System for Clinicians in the Quality Payment Program
In a press release, CMS announced that doctors and other eligible clinicians participating in the Quality Payment Program can begin submitting their 2017 performance data using a new system on the Quality Payment Program website (qpp.cms.gov). The Quality Payment Program has two tracks you can choose:Advanced Alternative Payment Models (APMs) orThe Merit-based Incentive Payment System (MIPS)The data submission system is an improvement from the former systems under the CMS legacy programs, which … [Read more...] about CMS Launches Data Submission System for Clinicians in the Quality Payment Program
Medicare program’s penalty protocols for Nursing homes change under Trump Administration
In 2016, the nursing home industry requested the change in the Medicare program's penalty protocols and now, according to reports, a new policy from the Trump administration will roll back fines against nursing homes cited for mistreatment or neglect. The New York Times research found that nearly 6,500 nursing homes in the U.S. have received at least one citation for a serious violation since 2013 and about two-thirds of those have been fined by Medicare.According to this New York Times excerpt … [Read more...] about Medicare program’s penalty protocols for Nursing homes change under Trump Administration
Texas to receive $25 Billion in Medicaid Funding after Approval of the 1115 Demonstration Waiver
According to The Office of Texas Government news release, the Texas Health and Human Services Commission and the Centers for Medicare and Medicaid Services have reached an agreement to continue a critical part of the state’s Medicaid program over the next five years.The approval of the 1115 Demonstration Waiver will allow the state to continue expanding managed care to Medicaid clients while also preserving supplemental payments to hospitals and other critical Medicaid providers. According to … [Read more...] about Texas to receive $25 Billion in Medicaid Funding after Approval of the 1115 Demonstration Waiver
PPAT Notice For Draft Rule Amendments Regarding Abuse, Neglect & Exploitation
Texas Health and Human Services (HHS) implemented rules that address changes in the authority of the DFPS Adult Protective Services (APS) Provider division, as amended by SB 1880 and SB 760, 84th Legislative Session (2015). The changes give the APS Provider division the authority to investigate an allegation of abuse, neglect, or exploitation (ANE) of an adult or child who receives a service from a provider who contracts with HHSC to provide Medicaid waiver or Medicaid state plan services and … [Read more...] about PPAT Notice For Draft Rule Amendments Regarding Abuse, Neglect & Exploitation
Proposed Amendments to streamline ICF/IID & HCS/TxHmL Provider Cost Report Rules
HHSC Report- Effective January 1st 2018, information contained in PPAT on cost report rule changes to be adopted by March 2018, address the implementation of a cost report reform initiative for HCS/TxHmL and ICF/IID providers as required by Texas Health and Human Services Commission (HHSC)On Jan. 1st, HHSC requires only even-year cost reports beginning with the providers’ 2018 fiscal year cost reports for HCS/TxHmL (§355.722(a) and ICF/IID(§355.105(c)(1) )providers. HHSC also proposes … [Read more...] about Proposed Amendments to streamline ICF/IID & HCS/TxHmL Provider Cost Report Rules
