Literature Review
All posts tagged with “Regulatory News | HHS.”
The Inflation Reduction Act and patient costs for drugs to treat heart failure
11/23/24 at 03:40 AMThe Inflation Reduction Act and patient costs for drugs to treat heart failureJAMA Network Open; Erin Trish, PhD; Karen Van Nuys, PhD; Joanne Wu, MS; Nihar R. Desai, MD, MPH; 10/24The 2022 Inflation Reduction Act (IRA) contains several provisions to lower Medicare drug costs, including permitting the Centers for Medicare & Medicaid Services (CMS) to limit the prices of certain medicines and altering the standard Part D benefit to limit patient out-of-pocket costs. CMS has set the prices of 10 drugs effective 2026, including 3 commonly prescribed as part of combination therapy for heart failure (HF): dapagliflozin, empagliflozin, and sacubitril/valsartan. Dapagliflozin and empagliflozin also treat other conditions, including diabetes and chronic kidney disease. In this cross-sectional study of Medicare beneficiary costs ... benefit redesign eliminates the coverage gap in 2025, and caps annual out-of-pocket expenditures, [and] ... will reduce and smooth patient out-of-pocket burden.
Seven of thirty hospices reviewed did not comply or may not have complied with terms and conditions and federal requirements for Provider Relief Fund payments
11/19/24 at 03:00 AMSeven of thirty hospices reviewed did not comply or may not have complied with terms and conditions and federal requirements for Provider Relief Fund payments HHS Office of Inspector General; issued on 11/8/24, posted on 11/14/24Why OIG Did This Audit: The Provider Relief Fund (PRF), a $178 billion program, provided funds to eligible providers for health care-related expenses or lost revenue attributable to COVID-19. ... This audit is part of a series reviewing PRF payments to various provider types. Specifically, this audit assessed whether 30 selected hospices expended taxpayer funds in accordance with Federal and program requirements. ... What OIG Found: ... Of the 30 selected hospices, 23 hospices used PRF funds for allowable expenditures and lost revenues attributable to COVID-19; however, 7 hospices did not comply with or may not have complied with Federal requirements. Of these seven hospices, which received $98.1 million in PRF payments, six hospices claimed a total of $8.3 million of unallowable PRF expenditures and inaccurately reported $1.5 million of lost revenues, and one hospice claimed $4 million in expenditures that may not have been allowable. ... What OIG Recommends: We made two recommendations to HRSA, including that it require the selected hospices to return any unallowable expenditures to the Federal Government or ensure that the hospices properly account for these expenditures. ...
Strengthening nondiscrimination protections and advancing civil rights in health care through Section 1557 of the Affordable Care Act: Fact sheet
11/14/24 at 03:00 AMStrengthening nondiscrimination protections and advancing civil rights in health care through Section 1557 of the Affordable Care ActHHS press release; 11/13/24Publisher's note: While the final rule was released this Spring, compliance deadlines begin this month and might be burdensome for some providers to implement. In addition to the link above, guidance can be found here: final rule, press release, fact sheet.
NAHC re-files lawsuit against HHS, CMS over home health cuts
07/02/24 at 03:00 AMNAHC re-files lawsuit against HHS, CMS over home health cuts Home Health Care News; by Joyce Famakinwa; 6/28/24 The National Association for Home Care & Hospice (NAHC) hasn’t given up on efforts to push back on Medicare home health payment calculations. NAHC has re-filled its lawsuit against the U.S. Department of Health and Human Services (HHS). The lawsuit focuses on the home health PDGM budget neutrality adjustment, which imposed both permanent and temporary calculations with a methodology that NAHC believes is noncompliant with the law. The original lawsuit was filed last summer, and in April the case was dismissed by a federal court in Washington D.C. The case was dismissed on the basis that NAHC did not fully exhaust administrative appeal remedies. ... There are a number of factors that made NAHC decide to re-file the lawsuit, according to [NAHC President, William A.] Dombi. “No. 1, it will be faster,” he said. “No. 2, we are highly likely to get the same judge, as there’s a related litigation standard in an assignment of cases,” he said. One of the biggest factors that heavily contributed to NAHC’s decision was the Supreme Court ruling, which upended the Chevron Doctrine.
HHS to impose penalties on providers that block patients’ health information
06/28/24 at 03:00 AMHHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?
National aging framework outlines governmentwide initiatives promoting home-based care
06/05/24 at 03:00 AMNational aging framework outlines governmentwide initiatives promoting home-based careMcKnight's Home Care; by Adam Healy; 6/3/24The Department of Health and Human Services released a new framework for its National Plan on Aging on Thursday. The framework aims to guide a multifaceted, governmentwide approach to help caregivers and home- and community-based service providers enable older adults to age comfortably in place.
HHS puts $50M toward hospitals' ransomware fight
05/23/24 at 03:00 AMHHS puts $50M toward hospitals' ransomware fightBecker's Health IT; by Molly Gamble; 5/20/24A new agency within the National Institutes of Health is launching a $50 million initiative to develop tools for hospital IT teams that enhance their cybersecurity measures and resources to combat ransomware. On May 20, the Advanced Research Projects Agency for Health introduced its Universal PatchinG and Remediation for Autonomous DEfense, or UPGRADE, program. "What if every hospital could autonomously protect itself and patients from cyber threats?" That is the guiding question for the initiative, which aims to develop a tailored and scalable software suite of remediations and patches for hospitals, reducing the patching time for vulnerable healthcare products to days or weeks.
HHS finalizes disability access rule for healthcare providers
05/06/24 at 03:00 AMHHS finalizes disability access rule for healthcare providers Modern Healthcare, by Kara Hartnett; 3/2/24 The Health and Human Services Department finalized a rule that broadens nondiscrimination protections for individuals with disabilities in healthcare environments. ... When the rule takes effect July 1, healthcare organizations will be required to modify facilities and medical equipment to cater to patients' physical and sensory needs. Facilities will have to update features such as elevators and ramps to ensure they are functional and meet federal standards. In addition, healthcare organizations must ensure websites, mobile apps and virtual care programs are user-friendly for people with disabilities and remove disability status as a factor in clinical support tools.