Washington Update - February 2014

On January 17, 2014, President Obama signed into law a $1.1 trillion measure that will fund the government for the remainder of fiscal year (FY) 2014. Obama made the bill law a day after the Senate approved the measure 72-26 and after the House approved it on a 359-67 vote. The bill allocates $158.6 billion for Labor-HHS-Education programs. Senate Labor, Health and Human Services, Education, and Related Agencies Appropriations Subcommittee Chair Senator Tom Harkin (D-IA) unveiled an overview of the subcommittee’s proposed spending plan saying, “This funding will help Americans get preventive care, which we know reduces chronic and rising health care costs.” Some items of interest to the American Geriatrics Society include:

• A small increase for Title VII and VIII Geriatrics Workforce Training Programs under the Public Health Service Act. Title VII will receive approximately $33 million—up from the 30.8 million received in FY 2013. The Title VIII geriatrics nursing program will receive $4.3 million, which is a very slight bump over FY 2013.

• A $1 billion increase for the National Institutes of Health to, among other things, continue current research, begin new studies and trials, and provide new investments in health grants to increase wellness in communities.

• Providing sufficient funding for a proposed initiative to study ways to prevent and cure Alzheimer’s disease.

Almost half of 114 accountable care organizations (ACOs) have reduced Medicare spending since their launch in April, the Centers for Medicare & Medicaid Services (CMS) announced in late January. However, fewer than a third of the organizations have reduced expenditures enough to earn incentive bonuses.

CMS debuted the shared-savings program in April with an initial 27 organizations that “agreed to try to save money and improve quality in exchange for the chance to keep some of the savings they produced,” notes Modern Healthcare. Three months after the initial launch, the program added another 87 organizations. And while fewer than half of all ACOs saved Medicare enough to earn bonuses, the Medicare program will see $128 million in savings as a result of the initiatives. CMS anticipates greater savings in future years.

Decades after deciding against making information about physicians’ Medicare payments public, the program will now share this information. The shift follows a federal judge’s conclusion that a physician’s privacy does not override the public interest in this information which, among other things, may be used to detect fraud.

In January, the Department of Health and Human Services announced that it would begin to respond “to Freedom of Information Act requests for physician payment data,” but would not guarantee that every request would be granted, Modern Healthcare reported. Government officials will use a “balancing test” to determine what information should be released. The new policy is expected to take effect in 60 days after its publication in the Federal Register. “We believe replacing the prior policy with a new policy in which CMS will make case-by-case determinations is the best next step for the agency,” CMS Principle Deputy Administrator Jonathan Blum noted.

Paid caregivers who provide long-term care for Medicaid beneficiaries in home and community settings will have to provide patient-centered care, according to a new Centers for Medicare & Medicaid Services (CMS) policy. Under the new policy, such beneficiaries will be able to plan or help plan their care, as well as to help ensure that their wishes are followed.

Future guidance will provide more information regarding how states can “operationalize” person-centered planning to comply with the new requirements, CMS stated in a fact sheet accompanying the rule (www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-Sheets/2014-Fact-sheets-items/2014-01-10-2.html). Among other things, the new policy “makes it easier for states to access Medicaid funds for home- and community-based care, according to McKnight’s Long Term Care News.