CMS Issues Final Rule on Certifying National Accrediting Organizations – CMS recently issued a final rule related to national accrediting organizations responsible for evaluating Medicare provider compliance with program requirements. The final rule implements new survey, certification, and enforcement standards. The majority of the provisions in the final rule remain unchanged from a proposed rule published by CMS in April 2013. The final rule is effective July 21, 2015, and is available here.
Energy and Commerce Unanimously Approves 21st Century Cures Legislation – On May 21, 2015, the House Energy and Commerce Committee unanimously approved the 21st Century Cures bill (H.R. 6), which will next go to the House for a vote. The latest version of the bill protects Food and Drug Administration user fee programs from budget sequester while providing the agency with an additional $550 million to carry out new programs and requirements of the bill. The Energy and Commerce Committee’s press release is available here.
Sen. Grassley Requests Department of Justice and CMS to Assess Medicare Advantage Plans’ Alleged Altering of Risk Scores – Senate Judiciary Committee Chairman Chuck Grassley has asked Attorney General Loretta Lynch and CMS Acting Administrator Andrew Slavitt to investigate allegations related to certain Medicare Advantage health plans suspected of overcharging the government by altering patient risk scores. Senator Grassley requests the DOJ and CMS to increase safeguards to ensure that insurance companies are not fraudulently inflating their reimbursement. Senator Grassley’s letters are available here and here.
GAO Says CMS Should Improve Medicare Physician Rate-Setting Process – The Government Accountability Office (GAO) recently issued a report recommending that CMS should better document its process for establishing relative values and develop a process to inform the public of potentially misvalued services identified by the American Medical Association/Specialty Society Relative Value Scale Update Committee. GAO also suggested that CMS develop a plan for using funds appropriated for the collection and use of information on physicians’ services in the determination of relative values.
