CMS Proposes Updating Hospice Payment Rates and Rules Changes

On May 2, CMS issued a proposed rule that would update Medicare payment rates and the wage index for hospices serving Medicare beneficiaries.  As proposed, hospices would see an estimated 1.3% ($230 million) increase in their payments for FY 2015.  This increase is up from 1.0% in FY 2014 and 0.9% in FY 2013.

CMS also proposed that Medicare hospice cap determinations be completed within 150 days, not the current 16 to 24 months.  The proposed rule addresses an ongoing issue regarding imprecise hospice diagnosis codes. The agency is soliciting comments on possible definitions of "terminal illness" and "related conditions."

Public comments on the proposal will be accepted until July 1, 2014.

CMS Final Rule Eases 'Obsolete' and 'Burdensome' Regulations

On May 7, CMS issued a Final Rule to reform Medicare regulations identified as unnecessary or excessively burdensome on hospitals.  CMS estimates the rule could save hospitals nearly $660 million annually and $3.2 billion over five years.  The changes are part of the Obama administration's "regulatory lookback," which prompted an earlier round of loosened requirements in 2012.

One change is that a physician would no longer have to be present at some rural health facilities once every two weeks - a recognition of physician shortages in remote areas and advances in telemedicine. According to the CMS press release, other rules relax supervision requirements for dieticians and nuclear medicine technicians and another eliminates "unnecessary requirements" for ambulatory surgical centers to perform relevant radiological services.

The Final Rule will be published in the May 12 Federal Register, with most provisions effective 60 days after publication.

Burwell Faces Senate in Confirmation Hearing

On May 9, HHS nominee Sylvia Burwell began her Senate confirmation hearings by testifying before the Senate Health, Education, Labor and Pensions Committee.  Much of the hearing focused on Burwell's strong support for the Affordable Care Act ("ACA") as Republican senators pressed her on possible changes to the law.

Burwell did not commit to any specific changes, saying numerous times she would look for balance and examine how the pieces of the ACA work together.  Despite the concerns, Burwell will be confirmed.  Senate rules require only a majority vote and with Democrats in the majority plus a number of Republicans pledging their support, the question is not if but when.  The Senate Finance Committee is expected to formally vote on the confirmation in the coming weeks.

CMS Cancels 2014 ICD-10 Testing Due to Delayed Implementation

On May 3, CMS's announced plans to conduct ICD-10 testing during July 2014 have been delayed until 2015.  CMS now plans to conduct testing with providers in 2015, though no date was specified.  The move comes on the heels of CMS recently announcing it would move forward with the transition to ICD-10 on October 1, 2015, following Congress' open-ended mandate that the agency put off implementation of the new coding for at least a year.

Bills Introduced This Week

Rep. Jim Gerlach (R-PA) introduced a bill (H.R. 4592) that would amend the Public Health Service Act to improve the diagnosis and treatment of hereditary hemorrhagic telangiectasia.

Next Week in Congress

The House is in recess but the Senate will be in session.   The Senate will likely abandon debate on the Keystone pipeline without a vote.  Next on the agenda is tax extenders legislation as well as the confirmation of HHS Secretary nominee Sylvia Burwell.