Duane Morris Health Law

February 22, 2011September 10, 2014 by Duane Morris

$45 Million More in Federal Funding to Assist Medicaid Beneficiaries

On February 22, 2011, the U.S. Department of Health and Human Services (HHS) announced that it would provide $45 million in grant funding to 13 states for the startup and operation of Money Follows the Person (MFP) demonstration projects. States operate MFP programs to provide financial support and assist Medicaid beneficiaries with moving from institutions (i.e., hospitals and nursing facilities) and transitioning back into their communities to live in their own homes or other facilities. HHS anticipates that this federal funding will help 13,000 more Medicaid beneficiaries, and it will continue to provide grant funding through 2016 by committing at least $621 million to the state projects.

To read more about this announcement and see the list of 13 states scheduled to receive grant funding, please go to http://www.hhs.gov/news/press/2011pres/02/20110222b.html.

February 18, 2011September 10, 2014 by Duane Morris

Medicare and Medicaid Programs; Requirements for Long-Term Care Facilities; Notice of Facility Closure

Issued by the U.S. Department of Health and Human Services (HHS)on February 18, 2011, this regulation implements section 6113 of the Patient Protection and Affordable Care Act (PPACA). The interim final rule amends existing legislation by introducing new notice requirements associated with long-term care (LTC) facility and skilled nursing facility (SNF) closures. Its purpose is twofold: to protect resident health and safety, and to facilitate a “smooth transition” in the event of a facility’s closure.

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February 16, 2011September 10, 2014 by Duane Morris

HHS Awards $241 Million to Seven States for IT Infrastructure for Health Insurance Exchanges

On February 16, 2011, the U.S. Department of Health and Human Services (HHS) announced the states that will receive a total of $241 million to design and implement the IT infrastructure used to operate health insurance exchanges. The seven states selected by HHS are known as “early innovator” states because the infrastructure that they establish may be adopted by other states to set up their own exchanges. This announcement demonstrates HHS’s commitment to funding the development of user-friendly systems that will enable consumers to easily navigate the exchanges.

To read more about the IT grants and see the list of states scheduled to receive grant funding, please go to http://www.healthcare.gov/news/factsheets/exchanges02162011a.html.

February 9, 2011September 10, 2014 by Duane Morris

$750 Million More in Prevention Funding

On February 9, 2011, the Department of Health and Human Services (HHS) announced that the Prevention and Public Health Fund would make an additional $750 million available to fund prevention initiatives throughout the United States for FY2011. Last fiscal year, the Prevention and Public Health Fund made $500 million available to states. This year, the $750 million will be distributed to states and local communities to address community prevention, clinical prevention, public health infrastructure, and research and tracking. This investment demonstrates the importance of prevention initiatives in improving the nation’s health. For additional information regarding this announcement, please go to http://www.hhs.gov/news/press/2011pres/02/20110209b.html.

February 8, 2011September 10, 2014 by Duane Morris

$12 Million More in Electronic Health Record Funding

On February 8, 2011, the Office of the National Coordinator for Health Information Technology announced the availability of an additional $12 million in grant funding for the adoption and implementation of electronic health records (EHRs) by critical access and rural hospitals throughout the United States. The purpose of the additional grant funding is to help hospitals implement and adopt EHRs such that they meet “meaningful use” requirements. For additional information regarding this announcement, please go to http://www.govhealthit.com/newsitem.aspx?nid=76202.

January 31, 2011September 10, 2014 by Duane Morris

Federal Judge in Florida Strikes Down the Health Reform Law

On January 31, 2011, a United States District Court in Florida held that the individual mandate provision in the Patient Protection and Affordable Care Act (“Act”) is an unconstitutional exercise of Congress’ power under the Commerce Clause of the United States Constitution. The court also held that “[b]ecause the individual mandate is unconstitutional and not severable, the entire Act must be declared void.” The court reasoned that “[i]f [Congress] has the power to compel an otherwise passive individual into a commercial transaction with a third party merely by asserting—as was done in the Act—that compelling the actual transaction is itself ‘commercial and economic in nature, and substantially affects interstate commerce’ . . . it is not hyperbolizing to suggest that Congress could do almost anything it wanted.” In concluding its decision, the court emphasized that the ruling only addressed a constitutional issue and that it was not about whether the Act was good or bad legislation.

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January 20, 2011September 10, 2014 by Duane Morris

New Round of Grants to Help States Establish Exchanges

On January 20, 2011, the Department of Health and Human Services (HHS) announced an additional grant funding opportunity for states to establish their health insurance exchanges. Two types of grants will be available: Level One and Level Two. Level One grants will provide states with funding for up to one year, and subsequent to the first year, states may apply for a second year of Level One funding. Level Two grants, which provide states with funding through December 31, 2014, are available for those states that are further along in the implementation of their exchanges. For states to receive funding at either level, they must submit plans to HHS outlining how they intend to implement the exchanges along with anticipated expenditures. HHS did not disclose the amount of funding available for the grants, but it noted that funding will vary based on state need. For additional information regarding the grants, please see the Health Insurance Exchange Establishment Grants Fact Sheet.

December 28, 2010September 10, 2014 by Duane Morris

OIG Solicits Proposals for New Anti-Kickback Safe Harbors and Special Fraud Alerts

On December 28, 2010, the Office of the Inspector General published a notice of intent to develop regulations in the Federal Register soliciting recommendations for modifications to the safe harbors under the anti-kickback statute and suggestions for new safe harbors and OIG Special Fraud Alerts. The solicitation was published in accordance with Section 205 of the Health Insurance Portability and Accountability Act of 1996, which requires HHS to publish this formal solicitation annually. The notice lists the criteria that HHS will consider in reviewing the proposals submitted and recommends that proposals be accompanied by supporting data and/or justifications.

To read the notice published in the Federal Register, please go to: http://www.gpo.gov/fdsys/pkg/FR-2010-12-28/pdf/2010-32705.pdf.

December 21, 2010September 10, 2014 by Duane Morris

CMS Transmittal Released on Waiving Copayments and Deductibles for Preventative Services Provided at Rural Health Clinics

On December 21, 2010, CMS released Transmittal 2122 providing instructions for waiving coinsurance and deductibles for certain preventative services provided in Rural Health Clinics, as provided for in Section 4104 of the Affordable Care Act. Qualifying preventative services are those recommended by the United States Preventive Services Task Force with a grade of A or B. The transmittal is effective for services provided on or after January 1, 2011.

To read Transmittal 2122, please go to: http://www2.cms.gov/transmittals/downloads/R2122CP.pdf.

December 16, 2010September 10, 2014 by Duane Morris

CMS Will Acquire New Tools to Prevent Fraud

On December 16, 2010, at the regional health care fraud prevention summit in Boston, Massachusetts, HHS Secretary Sebelius and Attorney General Eric Holder announced that CMS will issue a solicitation for new analytic tools to prevent fraud in Medicare, Medicaid and CHIP. In its press release on the subject, HHS stated that the tools will “integrate many of the Agency’s pilot programs into the National Fraud Prevention Program and complement the work of the joint HHS and Department of Justice Health Care Fraud Prevention and Enforcement Action Team (HEAT).” The tools will be designed to prevent fraudulent payments before they occur, including through predictive modeling and identification of real-time trends by tracking billing patterns and other information.

To read the full press release, please go to: http://www.hhs.gov/news/press/2010pres/12/20101216a.html.