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Archive: Medicare

Capitol Connector
Your source for the latest updates from Capitol Hill. We translate policy into practice so you can learn how policy trends will affect your work and how best to prepare.

CMS Proposes Medicare Changes to Address Opioids

Shelley Starkey

The Centers for Medicare and Medicaid Services (CMS) have released its proposed changes to Medicare Advantage and Part D plans for 2019, which include a few provisions to combat the opioid crisis. These changes come in reaction to the soaring opioid prescription and substance use disorder rates among Medicare beneficiaries. CMS is accepting public comments through March 5, and will publish its final rule on April 2.

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Senate Approves Azar as HHS Secretary

January 25, 2018 | ACA | Medicaid | Medicare | Comments

Stephanie Pellitt

Policy Associate, National Council for Behavioral Health

The Senate voted to confirm former pharmaceutical executive Alex Azar as the new Secretary of Health and Human Services (HHS) on Wednesday. Six Democrats and Independent Sen. Angus King (I-ME) joined all but one Republican Senator in supporting Azar. As the nation’s top health official, Azar will oversee critical health programs like Medicaid and Medicare and take over the implementation of the Affordable Care Act (ACA). Azar’s confirmation gives HHS its first permanent leader since September, when former Secretary Tom Price resigned due to a scandal regarding his use of public funds for travel.

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HHS Nominee Appears Before Senate Finance Committee

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

The Senate Finance Committee held a confirmation hearing on Monday on the nomination of Alex Azar as Secretary of Health and Human Services (HHS). This is the second hearing on his nomination Mr. Azar has participated in. In late 2017, he appeared before the Senate Health, Education, Labor and Pensions Committee. The Finance Committee will vote on his nomination in the coming weeks.

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What to Watch for in Health Care in 2018

January 4, 2018 | ACA | Federal Budget | Medicaid | Medicare | Comments

Stephanie Pellitt

Policy and Advocacy Associate

Members of Congress returned to Capitol Hill this week following a holiday break. Neither chamber starts the new year with a clean slate, however, as Congress faces deadlines on government funding and a host of individual programs after voting to delay those decisions at the end of last month. Congress has less than three weeks to avert another government shutdown as well as sort through several competing health care priorities. Here is a preview of what to watch for in early 2018.

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Alex Azar Nominated to Lead HHS

November 16, 2017 | Medicaid | Medicare | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

President Trump, on Monday, nominated former pharmaceutical executive Alex Azar to be his next Secretary of Health and Human Services. Azar, who spent most of the last decade at Eli Lilly and Co., previously served for six years in the George W Bush administration – first as General Counsel for four years and then as Deputy Secretary for two years under President George W. Bush. The Senate will consider his nomination later this month.

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Medicare Payment Rule Finalized

November 16, 2017 | Medicare | Comments

Stephanie Pellitt

Policy and Advocacy Associate

The Centers for Medicare & Medicaid Services (CMS) recently released Final Rule Year 2 (Performance Year 2018) of Medicare’s Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The QPP, which went into effect on January 1, 2017, includes two paths to payment for eligible clinicians who bill Medicare using the Physician Fee Schedule: The Merit-based Incentive Payment System (MIPS), and Advanced Alternative Payment Models (Advanced APMs). Performance in the QPP each year impacts payments two years later; in other words, performance in 2018 will impact Medicare Part B payments in 2020. By moving from volume-based payment to payment for quality and value, both systems change the way behavioral health providers are reimbursed under Medicare Part B.

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October 1 Deadline to Attest for Medicare EHR

Elizabeth Arend

Quality Improvement Advisor

Mark your calendars: all eligible professionals (EPs) who are first time participants in the Medicare electronic health records (EHR) incentive program must attest by October 1, 2017 to avoid a negative payment adjustment in 2018.  EPs who do not successfully demonstrate meaningful use for the 2017 reporting period will receive reduced Medicare payments for that year.

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National Council Submits Comments on New Medicare Payment Rule

August 24, 2017 | Medicare | Comments

Elizabeth Arend

Quality Improvement Advisor

Last week, the National Council submitted comments to the Centers for Medicare and Medicaid (CMS) on a proposed rule that will make changes to Medicare’s Quality Payment Program (QPP) in 2018. The QPP, which went into effect on January 1, 2017, includes two paths to payment for eligible clinicians who bill Medicare using the Physician Fee Schedule: The Merit-based Incentive Payment System (MIPS), and Advanced Alternative Payment Models (APMs). By moving from volume-based payment to payment for quality and value, both systems change the way behavioral health providers are reimbursed under Medicare Part B.

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Bipartisan House Bill Aims to Expand Medicare Coverage for Mental Health Services

June 29, 2017 | Medicare | Workforce | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

A new bipartisan House bill would create greater access to mental health care in rural communities across the country. The bill – the Mental Health Access Improvement Act (H.R. 3032) – would allow marriage and family therapists (MFTs) and licensed mental health counselors to directly bill Medicare for their services. Similar legislation has been introduced in previous sessions of Congress and again has the support of the National Council.

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CMS Proposes New Medicare Payment Rule

June 29, 2017 | Medicare | Comments

Elizabeth Arend

Quality Improvement Advisor

Last week, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule that will make changes to the Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act (MACRA). The Quality Payment Program is part of a larger effort to reform the way clinicians are reimbursed by Medicare by moving from volume-based payment to payment for quality and value. The proposed rule describes how clinician participation in QPP will change in 2018 and beyond. The proposal will take effect on January 1, 2018 and will apply to 2020 Medicare Part B reimbursements. The vast majority of behavioral health organizations that bill Medicare Part B will be subject to these changes in 2017 and 2018.

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Senate Confirms Seema Verma as CMS Administrator

March 16, 2017 | Medicaid | Medicare | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

On Monday evening, the Senate confirmed Seema Verma as the next Administrator of the Centers for Medicare and Medicaid Services (CMS). Ms. Verma – best known for her work on Medicaid issues and her close ties to Vice President Mike Pence – designed Indiana’s Medicaid expansion model known as Healthy Indiana Plan 2.0. As leader of CMS, Ms. Verma will work closely with HHS Secretary Tom Price to oversee and implement any major health care measures that Congress passes.

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Trump Announces Picks to Lead HHS, CMS

December 1, 2016 | Medicaid | Medicare | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Earlier this week, President-elect Donald Trump tapped Rep. Tom Price (R-GA) to lead the Department of Health and Human Services (HHS) and Indiana-based health care consultant, Seema Verma, as the next administrator of the Centers for Medicare and Medicaid Services (CMS). Congressman Price has been a longtime opponent of the Affordable Care Act and is likely to be a key player in any “repeal and replace” efforts from the 115th Congress.

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Senate Finance Bill Would Expand Telehealth in Medicare

November 3, 2016 | Medicare | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

A draft bill out of the Senate Finance Committee would expand payments from Medicare for telehealth and telemedicine services. The CHRONIC Care Act draft, long in the works by the Committee, improves chronic disease care for Medicare beneficiaries and would include provisions to expand access to telehealth services for Medicare Advantage enrollees

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Medicare Part D Prescriber Enrollment Requirement Delayed

November 3, 2016 | Medicare | Comments

Stephanie Pellitt

Policy and Advocacy Associate

The Centers for Medicare and Medicaid Services (CMS) announced this week that it is delaying the February 1, 2017 deadline for Medicare Part D prescribers to enroll in the Medicare program. CMS now expects full enforcement of enrollment to take effect on January 1, 2019. CMS aims to begin targeted enrollment of prescribers in the spring of 2017.

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CMS Finalizes Medicare Payment Rule

October 20, 2016 | Medicare | Comments

Elizabeth Arend

Quality Improvement Advisor

On Friday, October 14th, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) rule, which makes sweeping reforms to how physicians are paid under Medicare Part B. The final rule will apply to the vast majority of eligible behavioral health providers when MACRA goes into effect in 2017 and includes several positive changes made in response to the National Council’s written comments.

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Health Insurance Premiums to Increase for Some in Medicare Part B

October 20, 2016 | Medicare | Comments

Stephanie Pellitt

Policy and Advocacy Associate

Health insurance premiums are expected to increase significantly for about 30% of Medicare Part B beneficiaries, as the result of a 0.3 percent Social Security Cost of Living Adjustment (COLA) announced earlier this week. While most Medicare Part B beneficiaries will not be affected by this change, the impacted group includes: high-income beneficiaries, new enrollees, enrollees not collecting Social Security benefits, and the millions of dually eligible beneficiaries whose Part B premiums are paid by state Medicaid programs.

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New Rural Health Bill Expands Access to Care under Medicare

October 13, 2016 | Medicare | Workforce | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

A new bill introduced by Senator Pat Roberts (R-KS) would provide a robust and comprehensive answer to a myriad of issues facing health care access in rural communities. Among its many provisions including grant reauthorization and provider trainings, the bill – the Craig Thomas Rural Hospital and Provider Equity Act (R-HoPE) – would expand the eligible provider pool by allowing marriage and family therapists (MFTs) and licensed mental health counselors to directly bill Medicare for their services. These provisions are identical to a longtime National Council legislative priority and 2016 Hill Day ask – the Mental Health Access Improvement Act of 2015 (S. 1830/H.R. 2759).

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CMS Announces New Accountable Health Communities Funding Opportunity

September 22, 2016 | Medicaid | Medicare | Comments

Michael Petruzzelli

Manager, Policy and Advocacy, National Council for Behavioral Health

Earlier this month, the Centers for Medicare and Medicaid Services (CMS) announced a new funding opportunity as a part of the Accountable Health Communities (AHC) innovation model. The AHC model aims to address a critical gap between clinical care and the health-related social needs of Medicare and Medicaid beneficiaries, like housing insecurity, hunger and interpersonal violence. Community-based organizations are eligible and encouraged to apply.

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Physicians Paid Under Medicare Get More Time to Adjust to Reporting Requirements

September 15, 2016 | Medicare | Comments

Jacquelyn Sommer

, National Council for Behavioral Health

Providers will now have a year to adjust to the quality measures tied to their reimbursement rates under Medicaid. Centers for Medicare and Medicaid Services (CMS) continues to announce new guidelines ahead of the Medicare Access and CHIP Reauthorization ACT (MACRA) final rule expected by November 1st. In this latest announcement, CMS announced a more flexible approach to the roll out of MACRA, allowing clinicians to essentially “pick their pace of participation” in the upcoming year.

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CMS Releases Federal Disaster Preparedness Requirements

September 15, 2016 | Medicaid | Medicare | Comments

Stephanie Pellitt

Policy and Advocacy Associate

The Centers for Medicare and Medicaid Services (CMS) issued a final rule this week to prevent breakdowns in patient care following natural disasters and other emergencies. These new requirements will directly impact certain mental health providers, including organizations registered with Medicare as Community Mental Health Centers (CMHCs), as well as organizations that may offer mental health services like Federally Qualified Health Centers (FQHCs), Rural Health Centers, and Intermediate Care Facilities (ICFs). The rule requires detailed and coordinated emergency plans for federal, state, and local emergency systems. Affected providers have until November 15, 2017 to implement the new requirements.

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