The Centers for Medicare & Medicaid Services (CMS) has issued several blanket waivers of Medicare requirements as a result of Hurricane Harvey. Examples of requirements that CMS may waive include those relating to conditions of Medicare participation or certification, preapproval requirements, EMTALA requirements, Stark Law self-referral sanctions, and performance deadlines. Providers do not need to apply for an individual waiver if a blanket waiver has been issued. CMS has established a web page entitled “Emergency Response and Recovery” for providers to use.
On August 30, 2017, a bipartisan group of Democratic and Republican governors from eight states (John Kasich, Ohio; John Hickenlooper, Colorado; Brian Sandoval, Nevada; Tom Wolf, Pennsylvania, Bill Walker, Alaska; Terry McAuliffe, Virginia; John Bel Edwards, Louisiana; and Steve Bullock, Montana) sent a letter entitled “Blueprint for Stronger Health Insurance Markets” to Senate and House leadership. The blueprint includes three guiding principles intended to make health insurance coverage more stable and affordable. These three guiding principles with their subcomponents are: (i) immediate federal action to stabilize markets (fund cost sharing reduction payments, create a temporary stability fund, offer choices in underserved counties, and keep the individual mandate for now); (ii) responsible reforms that preserve coverage gains and control costs (maximize market participation, promote appropriate enrollment, stabilize risk pools, and reduce cost through coverage redesign); and (iii) an active federal/state partnership (improve the regulatory environment, support state innovation waivers, and control cost through payment innovation). The Senate Health, Education, Labor and Pensions Committee has scheduled a hearing on health reform for Tuesday, September 6.
State insurance commissioners are to submit their rate filings for 2018 exchange plans to state and federal regulators by today, September 5. Regulators have until September 20 to approve rates, and by September 27 insurers must sign final federal contracts to offer health care plans in 2018. The open enrollment period for 2018 begins on November 1.
On August 31, Department of Health and Human Services’ officials announced that the advertising budget for the coming open-enrollment period will be reduced from $100 million to $10 million. In addition, grants to navigators will be reduced to $36.8 million from the $62.5 million awarded in the previous enrollment period.
U.S. Senator Bernie Sanders (D-VT) announced that Senate Parliamentarian Elizabeth MacDonough has ruled that Republicans’ authority to repeal the Affordable Care Act using reconciliation, which only requires 51 votes rather than 60, expires at the end of the current federal fiscal year, September 30.
CMS has directed Medicare Administrative Contractors (MACs) to use a uniform electronic provider-based checklist to perform uniform reviews of provider-based attestations. In Transmittal 1891 (Change Request 10095 (August 4, 2017)), CMS explained that it reviewed various MAC provider-based checklists and found that they were not consistent. As a result, a workgroup consisting of CMS Regional Office and MAC representatives has developed a comprehensive electronic provider-based checklist to ensure that MACs and CMS Regional Offices perform uniform reviews of provider-based attestations.