Healthcare Week in Review April 14, 2017

Alston & Bird Healthcare Week in Review, April 14, 2017

I. Regulations, Notices, & Guidance

Event Notices
  • May 3, 2017: HHS announced a meeting of the National Committee on Vital and Health Statistics (NCVHS), Standards Subcommittee. The purpose of this NCVHS Standards Subcommittee meeting is to seek further input from the health care industry for disposition and next steps of the health plan identifier (HPID) for health plans.
  • May 3 – 4, 2017: HHS announced a meeting of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria (Advisory Council). May 3, 2017, will be dedicated to the topic of Infection Prevention and Control for Animal Health. The three working groups on Incentives for Diagnostics, Therapeutics/Anti-Infectives, and Vaccines, will report their preliminary findings to the full Advisory Council for deliberation on the second day of the public meeting; no vote will be held.
  • May 8 – 9, 2017: The FDA announced a public advisory committee meeting of the Pharmacy Compounding Advisory Committee (PCAC). The committee will receive updates on certain issues to follow up on discussions from previous meetings, including quality standards and conditions at certain 7 compounding facilities. In addition, the committee intends to discuss six bulk drug substances nominated for inclusion on the section 503A Bulks List. The FDA will discuss the following nominated bulk drug substances: nicotinamide adenine dinucleotide, nicotinamide adenine dinucleotide disodium reduced, nettle (Urtica dioica) whole plant, ubiquinol, vanadyl sulfate, and artemisinin.
  • June 6 -7, 2017: HHS announced a meeting of the National Vaccine Advisory Committee (NVAC). During the June 2017 NVAC meeting, sessions will include an update on the Secretary of HHS’ report on vaccine innovation to Congress in response to the 21st Century Cures Act; presentations on immunization information systems and inter-jurisdictional data exchange; and an update on vaccine confidence-related projects.

II. Congressional Legislation & Committee Action

U.S. Senate
  • The Senate has adjourned and will reconvene on Monday, April 24, 2017.
House of Representatives
  • The House has adjourned and will reconvene on Tuesday, April 25, 2017.
III. Reports, Studies, & Analyses  
  • On April 10, 2017, the Government Accountability Office (GAO) released a report entitled, Medicare Provider Education: Oversight of Efforts to Reduce Improper Biller Needs Improvement. The report found that Medicare administrative contractors (MAC) process Medicare claims, identify areas vulnerable to improper billing, and develop general education efforts focused on these areas. MAC officials state that their provider education departments focus their educational efforts on areas vulnerable to improper billing; however, oversight and requirements for these efforts are limited.
  • On April 13, 2017, CMS released a report entitled, Gender Disparities in Health Care in Medicare Advantage. The report provides data regarding 8 patient experience measures and 24 clinical care measures. The patient experience data was collected from a national survey of Medicare beneficiaries, known as the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

IV. Other Health Policy News

  • On April 13, 2017, CMS issued key dates for calendar year 2017. The key dates relate to the timeline for Qualified Health Plan (QHP) Certification in the Federally Facilitated Exchanges (FFM).
  • On April 13, 2017, CMS issued guidance to States on review of Qualified Health Plan Certification standards in FFMs for Plan Years 2018 and later. The guidance amends the previously released 2018 Letter to Issuers in the FFMs by outlining areas where CMS will rely, starting with plan year 2018, on state reviews of QHP certification standards for states with FFMs, including states with FFMs that perform plan management functions in partnership with CMS.
  • On April 13, 2017, CMS issued the revised Final 2018 Actuarial Value Calculator Methodology. The document announces the revised Actuarial Value Calculator Methodology since the releasing of the final rule entitled, Patient Protection and Affordable Care Act; Market Stabilization.
  • On April 13, 2017, CMS issued a revised guidance on Unified Rate Review Timeline: Revised Timing of Submission and Posting of Rate Filing Justifications for the 2017 Filing Year for Single Risk Pool Coverage; Revised Timing of Submission for Qualified Health Plan Certification Application.
  • On April 13, 2017, CMS issued a FAQ document on compliance standards for issuers in FFMs. According to CMS, they will not use formal enforcement remedies for non-compliance with QHP certification standards when QHP issuers participating in the FFMs in PY 2018 act in good faith and make reasonable efforts to address concerns in an appropriate time frame.
  • Insurers, hospitals and employers are increasing pressure on the Trump Administration and Congress to take decisive action on the ACA cost-sharing reduction (CSR) payments because the window for issuers to price their 2018 plans closes soon. Those industries jointly sent a letter warning that slashing the subsidies would lead to higher premiums, which could drive out middle-class Obamacare customers who do not receive financial assistance, and increase costs for taxpayers. The groups also warn that if fewer individuals have coverage, uncompensated care at hospitals will increase. The letter is signed by America's Health Insurance Plans (AHIP), Blue Cross Blue Shield Association (BCBSA), the Federation of American Hospitals (FAH), the American Hospital Association, American Medical Association, Academy of Family Physicians, American Benefits Council and the U.S. Chamber of Commerce.

V. ACA Repeal News

  • None
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