(Nov. 3, 2023) – HHS Proposes Rule to Establish Disincentives for Providers Who Information Block
The Departments of Health and Human Services released a proposed rule that establishes disincentives for health care providers who commit information blocking. Information blocking is when a provider "knowingly and unreasonably interferes with the access, exchange or use of electronic health information except as required by law or covered by a regulation." The proposed disincentives include the following:
- Critical Access Hospitals – reduce Medicare reimbursement from 101 percent to 100 percent of cost (excluding sequestration)
- Inpatient Prospective Payment System hospitals – the annual market basket update would be reduced by 75 percent
- Merit-based Incentive Payment System physicians – receive a zero score in the promoting interoperability performance category
- Advanced Accountable Care Organizations physicians – would be deemed ineligible to participate in the program for a period of at least one year
Comments will be due 60 days after the date of publication in the Federal Register.
CMS Releases CY 2024 Medicare ESRD PPS Final Payment and Policy Updates
The Centers for Medicare & Medicaid Services released the final calendar year 2024 Medicare End-Stage Renal Disease payment and policy updates. CMS estimates hospital-based ESRD facilities will receive an estimated 3.1 percent increase in Medicare payments while freestanding ESRD facilities will receive an estimated 2 percent increase. CMS estimates ESRD prospective payment system expenditures will increase by $190 million in 2024 as compared to 2023.
Agencies Release Proposed Rules to Improve the Surprise Billing Payment Dispute Process
The Departments of Health and Human Services, Labor, and Treasury released a proposed rule to improve the federal Independent Dispute Resolution process. As part of the No Surprises Act, the IDR is designed to create protections against out-of-network balance billing practices. The newly proposed rule "addresses specific issues critical to improving the functioning of the federal IDR process in response to feedback and challenges noted by interested parties." If finalized, the rule would improve communications between payers, providers and certified IDR entities; establish new batching provisions; and change the administrative fee structure. Comments to the agencies will be due 60 days following publication in the Federal Register.
FMT Releases MBQIP Quality Measures Annual Report
The Flex Monitoring Team released its national and state Medicare Beneficiary Quality Improvement Project Quality Measures Annual Reports based on 2022 data from Critical Access Hospitals. These reports feature The Medicare Beneficiary Quality Improvement Project quality data, including measures in all four MBQIP domains: patient safety/inpatient, outpatient, patient engagement and care transitions.
ACA Marketplace Open Enrollment Begins Nov. 1; CMS Launches Window-Shopping
The Centers for Medicare & Medicaid Services released a reminder that the Affordable Care Act Marketplace open enrollment begins Nov. 1 and will close on Jan. 15, 2024. CMS reports that "thanks to the Inflation Reduction Act, nearly 15 million Americans are saving an average of $800 a year on their health insurance premiums." CMS also states that four in five HealthCare.gov customers will be able to find health care coverage for $10 or less per month for the program year 2024. CMS released additional details about the 2024 plan options, the PY 2024 public use files and information about the Marketplace Quality Initiatives.
MLN Connects Provider eNews Available
The Centers for Medicare & Medicaid Services issued the following updates to MLN Connects Provider eNews:
Before You Go ...
- The Centers for Medicare & Medicaid Services is hosting a webinar, FY 2024 Review of IPF-Specific Reports for Claims-Based Measures, at 1:00 p.m. Thursday, Nov. 9, for hospitals participating in the Inpatient Psychiatric Facility Quality Reporting program. Registration is required.
- The Centers for Medicare & Medicaid Services is hosting a webinar, CY 2023 eCQM Reporting and Data Submission Updates, at 1:00 p.m. Tuesday, Nov. 14, for hospitals participating in the Hospital Inpatient Quality Reporting and Medicare Promoting Interoperability programs. The presentation provides a high-level overview of electronic clinical quality measures reporting requirements and system changes for the calendar year 2023 reporting period. Registration is required.
- A recent study indicates a low rate of naloxone prescribing among emergency departments. The findings of this study should be seen as a reminder to prescribe naloxone to all patients presenting to the ED for any substance use disorder.