CMS releases Final Hospital Payment Rule

At the agencies

The Centers for Medicare and Medicaid Services (CMS) released the Final Hospital Payment Rule, which includes 2018 Medicare payment rate increases for both acute care and long-term care hospitals. It also updates hospital discharge policies. In the final rule, CMS includes an $800 million increase in uncompensated care payments made to acute care hospitals (totaling approximately $6.8 billion for fiscal year 2018). Due to the payment rate increase for acute care hospitals and other policies and payment adjustment included in the final rule, acute care hospitals are expected to see an increase in Medicare spending on inpatient hospital payments of $2.8 billion in the next fiscal year, while long-term care hospitals will see a payment decrease of $110 million. CMS also estimates that inpatient psychiatric facilities will see a payment increase of $45 million in fiscal year 2018.

On the Hill

At the end of July, the Senate failed to advance healthcare reform legislation. Although failure to pass either the Better Care Reconciliation Act (BCRA) or the Obamacare Repeal Reconciliation Act (ORRA) was a setback to GOP leadership’s attempt to repeal and replace the Affordable Care Act (ACA), Congress still has opportunities to adopt reforms when the members return in September. The primary concern now is stabilization of the individual health insurance market, which has suffered due to the uncertainty of healthcare reform and possibility that the Trump administration will stop funding cost-sharing reduction (CSR) payments to insurers, who claim CSRs are vital to the stability of the individual insurance market under current law.

Before leaving for August recess, the Senate passed “Jessie’s Law,” which requires the Department of Health and Human Services (HHS) to develop standards for hospitals and physicians regarding the display of a patient’s history of opioid addiction in the medical records where a patient provided information about addiction. The bipartisan legislation received unanimous consent from the Senate.

Dr. Jerome Adams was confirmed as the next Surgeon General, a position that oversees 6,700 public health officers. Dr. Adams served as the health commissioner of Indiana, a post he was appointed to by (then Indiana Governor) Vice President Mike Pence. Dr. Adams is an anesthesiologist by training and an advocate for addressing the opioid epidemic.

Dr. Robert Kadlec was confirmed as the assistant secretary of Health and Human Services for Preparedness and Response. Most recently, Dr. Kadlec served as the Deputy Staff Director for the Senate Select Committee on Intelligence, and he previously served as a Special Assistant to the President for Biodefense Policy for President George W. Bush. 

The Senate confirmed Dr. Elinore McCance-Katz as Assistant Secretary for Mental Health and Substance Use, a new position at HHS. Dr. McCance-Katz previously served as the chief medical officer at the Substance Abuse and Mental Health Services Administration (SAMHSA) and in the same role in Rhode Island’s behavioral health department. The new position was created last year by the 21st Century Cures Act and is responsible for overseeing SAMHSA and coordinating national mental health and substance abuse treatment programs at other agencies in the federal government. 

Lance Allen Robertson was confirmed to be Assistant Secretary for Aging at the Department of Health and Human Services. For the past decade, Mr. Robertson was Oklahoma’s Director of Aging Services. Mr. Robertson is also a past president of the National Association of States United for Aging and Disabilities (NASUAD).

From the administration

The Trump administration signaled an interest in discontinuing cost-sharing reduction (CSR) payments (which are subsidies paid to insurers for coverage provided to certain low-income individuals). In Congress, President Trump’s comments regarding the CSR payments caused concern and prompted discussion of legislation that would guarantee the funding, effectively protecting it from a presidential override. 

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