CMS Update

The Centers for Medicare and Medicaid Services (CMS) has recently updated the Hospital Compare website, which reports information on quality measures for over 4,000 hospitals nationwide. This update adds new data on quality measures and refreshes the Overall Hospital Star Rating. In addition, CMS posted supporting documents related to the Star Ratings, including Quarterly Specifications, Comprehensive Methodology, and Statistical Analysis System Package. According to CMS Administrator Seema Verma, “CMS is committed to empowering beneficiaries by providing transparent, comprehensive, and reliable information.”

On December 28, 2017, CMS issued a memorandum clarifying its position on the use of text messaging between providers. As an initial matter, CMS reiterated that texting of patient orders remains prohibited regardless of the platform used. That said, “CMS recognizes that the use of texting as a means of communication with other members of the healthcare team has become an essential and valuable means of communication among the team members” and is otherwise “permissible if accomplished through a secure platform.” Moreover, CMS noted its expectation that providers “will implement procedures/processes that routinely assess the security and integrity of the texting systems/platforms that are being utilized, in order to avoid negative outcomes that could compromise the care of patients.” In light of this guidance, health care providers may want to revisit their compliance policies for communicating health information and institute routine assessments of any secure platforms used.

Earlier this month, CMS unveiled a new data submission system for eligible clinicians participating in the Quality Payment Program. The new system replaces legacy programs that required clinicians to submit data on multiple websites. Eligible clinicians may begin using the new Quality Payment Program system immediately for the current submission period. The new system will show real-time initial scoring within each of the MIPS performance categories and will react as new data is reported. According to CMS Administrator Seema Verma, “the new data submission system makes it easier for clinicians to meet MACRA’s reporting requirements and spend more time treating patients instead of filing paperwork.” Click here for the CMS fact sheet on the new Quality Payment Program data submission system.

On January 9, 2018, CMS announced a new voluntary episode payment model, Bundled Payments for Care Improvement Advanced (BPCI Advanced). Characteristics of the new model include: voluntary model; a single retrospective bundled payment and one risk track, with a 90-day clinical episode duration; 29 inpatient clinical episodes; 3 outpatient clinical episodes; qualifies as an Advanced APM; payment is tied to performance on quality measures; and preliminary target prices provided in advance of the first performance period of each model year. 

Anti-Kickback Statute Safe Harbor Update

On December 27, 2017, the Office of Inspector General (OIG) issued its annual notification soliciting proposals and recommendations for new or modified safe harbor provisions under the federal Anti- 2 Kickback Statute (AKS). In reviewing proposed new or modified safe harbors, the OIG will consider, among other things, whether the proposal would result in an increase or decrease in: access to health care services, the quality of health care services, patient freedom of choice among health care providers, competition among health care providers, the cost to federal health care programs, the potential overutilization of health care services, and the ability of health care facilities to provide services in medically underserved areas or to medically underserved populations. Public comments must be delivered by February 26, 2018. 

Cybersecurity Update

The National Health Information Sharing and Analysis Center (NH-ISAC) recently issued an alert relating to cybersecurity threats Meltdown and Spectre. These threats affect hardware by exploiting processor and operating system vulnerabilities, thus allowing an attacker to potentially gain access to data such as PHI. More information about these threats, and actions that health care companies can take to monitor and address them, can be found at NH-ISAC and US-CERT.

Alabama PDMP Enhancements

The Alabama Department of Public Health recently announced enhancements to its Prescription Drug Monitoring Program (PDMP). Under Alabama law, anyone who dispenses Class II, III, IV, V controlled substances is required to report the dispensing of these drugs to the PDMP. Beginning in April, a quarterly Prescriber Report will be emailed to any prescriber who has written at least one opioid prescription in the past six months. The report will include comparisons of prescribing behavior to red flag indicators and to peers, summaries of patient and prescription volumes, and information relating to potential prescriber and pharmacy shoppers. Click here to learn more about the PDMP.