ACA SMALL BUSINESS EXCHANGES DELAYED

On Thursday, September 26, 2013, U.S. Department of Health and Human Services (HHS) announced that it would delay online enrollment in the health insurance exchanges for small businesses. However, applicants may still enroll by phone, mail or fax starting October 1, 2013. Coverage will start January 1, 2014.

The Affordable Care Act program, known as the Small Business Health Options Program (SHOP), will initially serve businesses with 50 or fewer full-time employees, and is expected to expand to larger businesses in the coming years. In contrast to the individual exchanges, which will have set enrollment periods, SHOP will be open throughout the year. The Congressional Budget Office estimates that approximately 4 million individuals will find coverage through this exchange.

TWO-MIDNIGHT ADMISSION POLICY GOES INTO EFFECT

Today, October 1, 2013, marks the start of a new policy that requires inpatient admissions to span at least two midnights to qualify for reimbursement.

The policy, which is set forth in the FY 2014 Inpatient Prospective Payments Systems final rule, is a break from the Centers for Medicare & Medicaid Services’ previous 24-hour standard. CMS has stated that the new rule should “reduce uncertainty regarding the requirements for payments to hospitals … related to when a Medicare beneficiary should be admitted as a hospital inpatient.”

The rule has been criticized by hospitals and by the American Hospital Association, who have called for further clarification and guidance from CMS.