CMS Releases Final Rule for Long-Term Care Facilities

On September 28, CMS released a final rule that overhauls the federal regulations that apply to long-term care facilities and creates new compliance obligations for providers. The measure, which goes into effect November 28, 2016, will implement the new regulations in three phases over the next three years. It will impact more than 15,000 long-term care facilities in the U.S. at an estimated implementation cost of $831 million for the first year and $736 million each subsequent year.

The rule prohibits the use of pre-dispute binding arbitration agreements, a measure that was strongly opposed by providers. In addition to the ban, the final rule also mandates that nursing home operators provide “nourishing, palatable” dietary options that meet residents’ nutritional needs and develop a comprehensive, person-centered care plan for each resident within 48 hours of admission. CMS received nearly 10,000 comments on the rule after it was proposed in July 2015. Additional information can be found in this Hall Render blog post.

Senate Advances Stopgap Spending Bill

On September 28, the U.S. Senate and House of Representatives passed a 10-week continuing resolution (“CR”), which funds the federal government at fiscal year (“FY”) 2016 levels through December 9, 2016. Once lawmakers return to Washington after the November 8 election, Congress will have a mere three weeks of scheduled legislative business to either pass a FY 2017 spending bill or further extend funding at FY 2016 levels. Democratic opposition to the CR was resolved when Congressional leaders reached a deal that includes providing aid to help the water contamination problems in Flint, MI through separate authorizing legislation.

Senate Introduces Comprehensive Rural Health Bill that Continues Medicare Extenders

On September 28, Sens. Al Franken (D-MN) and Pat Roberts (R-KS) introduced a comprehensive rural health bill called the Rural Hospital and Provider Equity Act of 2016 (“R-HoPE”) that would, among other things, extend several Medicare programs that provide access to hospitals, doctors and rural health services, including:

  • Extension of the Medicare-Dependent Hospital Program;
  • Extension to the Medicare inpatient hospital payment adjustment for low-volume hospitals;
  • Reinstatement of Medicare wage index reclassifications for certain hospitals;
  • Extension of the Medicare incentive payment program for physician scarcity areas;
  • Extension of floor on Medicare work geographic adjustment;
  • Removal of Medicare’s 96-hour physician certification requirement for inpatient critical access hospitals services; and
  • Increased Medicare payments for rural ground ambulance services.

With a limited number of days left on the legislation calendar this year, it is very unlikely that R-HoPE (S. 3435) will pass the Senate this Congress. However, the bill is expected to be reintroduced next year, and many of its provisions could be included in other legislative packages in the future.

CMS Awards $347 Million in Hospital Improvement and Innovations

On September 29, CMS announced that 16 national, regional or state hospital associations and health systems were awarded $347 million in Hospital Improvement and Innovation Network contracts. The awards are intended to help reduce patient harm and readmissions in hospitals. Through 2019, these organizations will work to achieve a 20 percent decrease in overall patient harm and a 12 percent reduction in 30-day hospital readmissions as a population-based measure (readmissions per 1,000 people) from the 2014 baseline. A list of the award winners is included in the CMS announcement.

Health-Related Bills Introduced This Week

Rep. Tom Price (R-GA) introduced a bill (H.R. 6226) that would delay the Medicare demonstration program for pre-claim review of home health services for one year to allow Congress and CMS to ensure the program’s application would not negatively impact patient care.

Rep. Price also introduced a bill (H.R. 6276) that would amend the Internal Revenue Code of 1986 to clarify the treatment of locum tenens physicians as independent contractors to help alleviate physician shortages in underserved areas.

Next Week in Washington

Once the continuing resolution was passed, lawmakers left Washington to campaign and will not return until November 14. Before leaving town, Republican leaders in the House and Senate voiced their commitment to passing a package of biomedical innovation bills known as 21st Century Cures (H.R. 6) before the end of the year. Speaker Paul Ryan also listed mental health legislation (H.R. 2646) as another top priority for the November legislative period. However, the price tag of increasing reimbursements for mental health providers could prevent passage.

With Congress out of session until after the election, This Week in Washington will suspend publication until November 18.