reform: where is the money – Duane Morris Health Law

September 28, 2011September 10, 2014 by Duane Morris

Affordable Care Act Funds Support Healthier Communities

The U.S. Department of Health & Human Services (HHS) recently rolled out its Community Transformation Grants program under the Affordable Care Act, geared towards fighting chronic disease and creating healthier communities. The five year grants will be used to address the “root causes” of chronic diseases through creating tobacco-free living, supporting active lifestyles and healthy eating, and reducing health disparities. 35 of the grantees will receive funding to implement intervention programs, and 26 grantees will receiving funding to build sustainable community prevention efforts.

HHS Announces Launch of Primary Care Bonus Initiative

The U.S. Department of Health & Human Services (HHS) recently announced the launch of its new Primary Care initiative to provide bonuses to primary care doctors for improvement of care coordination and cost efficiency. The goal of the initiative, created under the Affordable Care Act, is to facilitate care that is focused on the patient, coordination, and higher quality. The bonuses will be offered through commercial and state health insurance plans, and will come in the form of monthly fees above and beyond Medicare fees received for patient care. HHS has identified five primary areas that the fees will support including personalized care plans for chronically ill patients, 24-hour access to care and health information, preventive care, patient and family participation in care, and coordination among providers.

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September 28, 2011September 10, 2014 by Duane Morris

CMS Expands Medicaid Money Follows the Person Program

The Centers for Medicaid & Medicare Services (CMS) recently expanded the Money Follows the Person grant program to provide additional assistance to state grantees’ implementation of quality improvement strategies. The Money Follows the Person program was created through the Affordable Care Act (ACA), and fifteen states received funds under the program in January 2011. Due to increases in demand from states and programs under the ACA, additional funds were needed to support the new individuals benefitting from the program including support for quality mechanisms addressing the needs of vulnerable populations. Through its recent notice, CMS announced its $1.2 million expansion of the program to be used for developing technical assistance to grantee staff and subcontractors, home and community-based services programs, CMS staff oversight, and web-based technical assistance.

Access the full notice here.

September 27, 2011September 10, 2014 by Duane Morris

Medicare Advantage Premiums Falling and Enrollment Up for 2012

HHS recently announced its expectation that Medicare Advantage premiums will fall approximately four percent in 2012, with enrollment expected to increase by 10 percent. This drop in premiums has been supported by the Affordable Care Act, which allowed CMS to prevent substantial cost increases or program cuts through elimination of co-pays and deductibles for Medicare-covered preventive services and additional discounts for Medicare beneficiaries that reach the prescription coverage “donut hole.” CMS is also offering high-quality performance incentives, including financial rewards and continuous marketing and enrollment to Five-Star Medicare Advantage and Part D plans.

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September 15, 2011September 10, 2014 by Duane Morris

Accountable Care Act Funding Awarded to Community Health Centers

On September 15, 2011, HHS awarded $10 million in Accountable Care Act funds to 129 organizations seeking to become community health centers, which are geared toward meeting the primary health needs in economically distressed or other vulnerable areas. The funds were specifically directed toward organizations that seek to provide primary healthcare services, or to expand existing services, to vulnerable populations. Likewise, the development of the community health centers will boost local economic growth and support local job markets. For more information on the community health centers program, see http://bphc.hrsa.gov/about/index.html.

August 23, 2011September 10, 2014 by Duane Morris

Bundled Payments for Care Improvement Initiative Announced

On August 23, 2011, the U.S. Department of Health and Human Services announced the Bundled Payments for Care Improvement Initiative (“Initiative”). Developed by the Center for Medicare and Medicaid Innovation, the Initiative is designed to give providers “new incentives to coordinate care, improve the quality of care and save money for Medicare.” For providers participating in the Initiative, Medicare will bundle payments for a package of services provided during an episode of care instead of paying separately for each individual service provided. Four different models of bundled care are available. Providers can apply to participate in the program and will be able to choose which episodes of care and services will be bundled together. To apply, providers must submit a Letter of Intent by September 22, 2011 or November 4, 2011 and a completed application by October 21, 2011 or March 15, 2012, depending on which model of the Initiative they choose.

For more information please go to http://www.hhs.gov/news/press/2011pres/08/20110823a.html and http://www.innovations.cms.gov/areas-of-focus/patient-care-models/bundled-payments-for-care-improvement.html#.

July 29, 2011September 10, 2014 by Duane Morris

$71.3 Million in Federal Funding to Expand Nursing Workforce

On July 29, 2011, the U.S. Department of Health and Human Services (HHS) announced that it would provide a total of $71.3 million in grant funding to expand the education and training of nurses and nursing diversity. The monies will be distributed among six types of awards: Nurse Education, Practice, Quality and Retention; Nursing Workforce Diversity; Nurse Faculty Loan Program; Advanced Nursing Education Program; Advanced Education Nursing Traineeships; Nurse Anesthetist Traineeships. Monies from these awards will support all levels of education from entry-level nursing to advanced traineeships, increase opportunities for individuals from disadvantaged backgrounds, and provide partial loan-forgiveness for nursing faculty.

To read more about this announcement and see details of each of the awards, please go to http://www.hhs.gov/news/press/2011pres/07/20110729a.html.

April 12, 2011September 10, 2014 by Duane Morris

New Public-Private Partnership To Focus on Improving Quality, Safety and Affordability of Health Care

On April 12, 2011, The U.S. Department of Health and Human Services (HHS) announced its intentions to form a public-private partnership with stakeholders such as patient advocates, healthcare providers and leaders at major hospitals. Called Partnership for Patients, this national initiative was created to improve quality and safety in health care, while also substantially reducing health care costs. HHS estimated that the partnership could save up to $35 billion in health care costs. Under the authority of the Affordable Care Act, HHS will invest $1 billion dollars towards this endeavor.

The two main goals will be to assist hospital patients by (1) preventing injury and further illness and (2) eliminating or mitigating complications that would adversely affect patient recovery. To learn more about the Partnership for Patients, please visit HealthCare.gov.

April 1, 2011September 10, 2014 by Duane Morris

FTC and DOJ Propose Enforcement Policy for Healthcare Antitrust Laws

The Federal Trade Commission and the U.S. Department of Justice have jointly issued a proposed enforcement policy for the application of the antitrust laws to healthcare collaborations among otherwise independent providers and provider groups that seek to participate as accountable care organizations (ACOs) under the Medicare Shared Savings Program. The agencies seek public comments until May 31, 2011, on the proposed enforcement policy and the new antitrust “safety zone” it would create.

For more information and the proposed antitrust policy, please visit the FTC and DOJ’s Proposed Statement.

March 31, 2011September 10, 2014 by Duane Morris

CMS Releases Long-Awaited Proposed Rule on Accountable Care Organizations

On March 31, 2011, the Centers for Medicare & Medicaid Services (CMS) and Health and Human Services (HHS) unveiled the long-awaited federal rule on accountable care organizations. This proposed rule would implement section 3022 of the Affordable Care Act, which allows service providers and suppliers to continue receiving traditional Medicare fee-for-service payments under Parts A and B, and to be eligible for additional payments based on meeting specified quality and savings requirements.

To view the proposed rule, please visit the Office of the Federal Register website.