General Publications January 4, 2019

Alston & Bird Healthcare Week in Review, January 4, 2019

Alston & Bird’s Week in Review provides a synopsis of the latest news in health care regulations, notices, and guidance; federal legislation and Congressional committee action; reports, studies, and analyses; and other health policy news.

I. Regulations, Notices, & Guidance

  • On December 21, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule entitled, Medicare Shared Savings Program; Accountable Care Organizations Pathways to Success and Extreme and Uncontrollable Circumstances Policies for Performance Year 2017. Under the Medicare Shared Savings Program (Shared Savings Program), providers of services and suppliers that participate in an Accountable Care Organization (ACO) continue to receive traditional Medicare fee-for-service (FFS) payments under Parts A and B, but the ACO may be eligible to receive a shared savings payment if it meets specified quality and savings requirements. The policies included in this final rule provide a new direction for the Shared Savings Program by establishing pathways to success through redesigning the participation options available under the program to encourage ACOs to transition to two-sided models (in which they may share in savings and are accountable for repaying shared losses). These policies are designed to increase savings for the Trust Funds and mitigate losses, reduce gaming opportunities, and promote regulatory flexibility and free-market principles. This final rule also provides new tools to support coordination of care across settings and strengthen beneficiary engagement; and ensure rigorous benchmarking. In this final rule, CMS also responds to public comments received on the extreme and uncontrollable circumstances policies for the Shared Savings Program that were used to assess the quality and financial performance of ACOs that were subject to extreme and uncontrollable events, such as Hurricanes Harvey, Irma, and Maria, and the California wildfires, in performance year 2017, including the applicable quality data reporting period for performance year 2017.

Event Notices   

  • January 9, 2019: The Health Resources and Services Administration (HRSA) announced a public meeting of the Advisory Committee on Training in Primary Care Medicine and Dentistry. The meeting will cover the annual report describing the activities of the Committee and recommendations for training programs in oral health and dentistry.
  • January 16, 2019: CMS announced a public meeting of the Advisory Panel on Outreach and Education (APOE). The meeting will allow the public to present oral presentations on issues pertaining to the education of providers and stakeholders with respect to the Affordable Care Act.
  • February 27, 2019: The Substance Abuse and Mental Health Services Administration (SAMHSA) announced a public meeting of the Center for Substance Abuse Treatment National Advisory Council (NAC). The NAC will discuss recovery housing and expanding access to medication-assisted treatment.
  • April 10, 2019: The FDA announced a public meeting entitled, Prescription Drug User Fee Act of 2017; Electronic Submissions and Data Standards. The purpose of the meeting is to fulfill FDA’s commitment to seek stakeholder input related to data standards and the electronic submission systems’ past performance, future targets, emerging industry needs and technology initiatives.

II. Congressional Legislation & Committee Action

U.S. Senate

  • There were no health-related hearings this week.

House of Representatives

  • There were no health-related hearings this week.

III. Reports, Studies, & Analyses

  • On January 3, 2019, the American Hospital Association (AHA) issued a statement claiming Medicare and Medicaid underpaid hospitals by $76.8 billion in 2017, according to its Annual Survey of Hospitals. Further, AHA claimed that hospitals in 2017 provided $38.4 billion in uncompensated care.

IV. Other Health Policy News

  • On January 3, 2019, the House Energy and Commerce Committee Chairman Frank Pallone (D-NJ) announced the first health-related hearing it will hold this year. The hearing will examine the impacts of the recent court decision that held the Affordable Care Act is unconstitutional.
Media Contact
Alex Wolfe
Communications Director

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