On August 1, Chairman Lamar Alexander (R-Tenn.) and Ranking Minority Member Patty Murray (D-Wash.) of the U.S. Senate Committee on Health, Education, Labor and Pensions announced that the committee will hold hearings the week of September 4th on actions that Congress could take in an attempt to stabilize and strengthen the individual insurance markets in 2018. Senator Alexander also urged President Trump to temporarily continue paying through September to insurance companies the cost-sharing subsidies that result in a reduction in deductibles and co-payments for individuals who earn between 100 percent and 250 percent of the federal poverty line. Senator Alexander advocated that Congress approve a 2018 stabilization package that would include funding for the cost-sharing reductions but also provide greater flexibility for states in approving health insurance policies.
On August 2, the U.S. House of Representatives’ bipartisan 43-member House Problem Solvers Caucus released a proposal intended to buttress the insurance exchanges. The proposal includes: (i) mandatory cost-sharing payments; (ii) a dedicated stability fund that states could access to reduce premiums and limit losses for furnishing coverage to high-cost patients; (iii) certain relief from the employer mandate; (iv) elimination of the medical device tax; (v) permitting insurers to sell insurance across state lines.
On August 2, the Centers for Medicare & Medicaid Services published its Fiscal Year 2018 Medicare Hospital Inpatient Prospective Payment System and Long Term Acute Care Hospital Prospective Payment System Final Rule. The final rule includes an increase in operating payment rates of approximately 1.2 percent for general acute care hospitals paid under the inpatient prospective payment system that successfully participate in the Hospital Inpatient Quality Reporting Program and are meaningful electronic health record users. CMS projects that the rate increase, together with other changes to IPPS payment policies, will increase IPPS operating payments by approximately 1.3 percent and that changes in uncompensated care payments will increase IPPS operating payments by an additional 0.7 percent. In the final rule, CMS is distributing about $6.8 billion in uncompensated care payments in FY 2018 to Medicare disproportionate share hospitals. CMS also finalizes its proposal to incorporate uncompensated care cost data from Worksheet S-10 of the Medicare cost report in the methodology for distributing uncompensated care funds. In the final rule CMS also updates the long term acute care hospital prospective payment system standard federal payment by one percent. Significantly, CMS also implements a regulatory moratorium on application of the 25-percent threshold policy for FY 2018.
Also On August 2, CMS issued a notice with comment period updating FY 2018 Medicare payment policies and rates for Inpatient Psychiatric Facilities under the IPF PPS, such updates to be effective October 1.
On August 1, CMS issued a final rule that updates FY 2018 Medicare payment rates and the wage index for hospices providing care to Medicare beneficiaries, and also updates the hospice quality reporting requirements.
On July 31, CMS issued a final rule outlining FY 2018 Medicare payment policies and rates for the Inpatient Rehabilitation Facility PPS and IRF Quality Reporting Program.
Also on July 31, CMS issued a final rule for skilled nursing facilities including payment rates and quality programs for FY 2018.