Health Insurance Premiums to Increase for Some in Medicare Part B
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
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
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
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
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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In Case You Missed It: Webinars on MACRA and the Overtime Rule
Over the last month, the National Council has hosted a number of important and informative webinars on key topics that directly affect the work of our members: the Department of Labor’s raising of the overtime salary threshold and the implementation of the Medicare Access and CHIP Reauthorization Act of 2015. If you were unable to participate in them live, don’t worry – we have recordings! Click here for more.
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MACRA: Summer Webinar Series Continues
The National Council’s Summer Webinar Series on MACRA continued this week with a deep-dive into the new Merit-Based Incentive Payment System (MIPS). MACRA – the Medicare Access and CHIP Reauthorization Act of 2015 – made sweeping reforms to how physicians are paid under Medicare. The National Council is running a series of webinars to breakdown this payment structure and what it means for behavioral health providers moving forward.
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MACRA Webinar Series Kicks-Off, Two More Coming in August
On Thursday, the National Council held its first of three webinars related to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the sweeping reforms it makes to payments under Medicare. The first webinar, “MACRA 101” focused on the proposed quality payment program, which completely overhauls how Medicare Part B clinicians will be paid starting in 2017.
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House GOP Releases Plan to Repeal and Replace the ACA
On Wednesday, Speaker of the House Paul Ryan (R-WI) and other House GOP leaders unveiled their alternative to President Obama’s signature health care law, the Affordable Care Act (ACA). While the plan does not include a number of specific details including the overall cost and total number of covered individuals, it does present a broad outline of a potential GOP health reform agenda for the next administration. As in the past, this initiative includes a number of proposals that would directly repeal ACA provisions as well as revamp current practices in Medicare, Medicaid and marketplace health care coverage.
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Take Action: Submit Your Comments on MACRA Regulations
Thank you to all who provided input on the National Council’s comments on the Medicare Access and CHIP Reauthorization Act (MACRA) Proposed Rule. Considered one of the most significant pieces of Medicare legislation in decades, MACRA eliminates the Sustainable Growth Rate formula, and establishes a new Quality Payment Program that will fundamentally change the way in which Medicare reimburses clinicians. Public comments on the proposed rule are being accepted through Monday June 27, 2016.
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House Committee Circulates Compromise Mental Health Draft Bill, Vote Likely in June
On Monday, news broke that House Energy and Commerce Committee Chairman Fred Upton (R-MI) had begun circulating a revised draft of comprehensive mental health reform legislation. According to congressional staff familiar with the situation, the Chairman is pushing a modified bill including provisions from both Rep. Tim Murphy’s (R-PA) bill – Helping Families in Mental Health Crisis Act (H.R. 2646) and Rep. Gene Greene’s (D-TX) bill – Comprehensive Behavioral Health Reform and Recovery Act (H.R. 4435).
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National Council Comments on Proposed Changes to Medicare Part B
The National Council this week submitted comments to the Centers for Medicare and Medicaid Services opposing the agency’s proposed change to drug pricing in the Part B program, noting the detrimental effect it could have on patients’ access to medications.
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Medicare Commission Proposes Restrictions to Antidepressant Access
Last week, the Medicare Payment Advisory Commission (MedPAC) released a draft recommendation that would remove two classes of drugs from the six protected classes under Medicare Part D. The proposed changes would restrict patients’ access to immunosuppressants and antidepressants, a move that could prevent Medicare beneficiaries from accessing the most appropriate, clinically indicated medication for their condition.
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House Speaker, Budget Chair Pitch FY17 Budget Resolution
This week, Speaker of the House Paul Ryan (R-WI) and Chairman of the House Budget Committee Tom Price (R-OK) introduced a budget resolution setting top-line funding numbers for fiscal year 2017. Despite pushback from fiscal hawks in Congress, who wished to see an additional $30 billion in cuts, the resolution’s $1.07 trillion in discretionary spending aligns with the amount agreed upon between the White House and congressional Republicans in the bipartisan Balanced Budget Act of 2015. However, Ryan and Price have also promised a separate initiative to cut $30 billion in mandatory spending from entitlement programs over two years.
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CMS Announces Availability of New Medicare Part D Opioid Drug Mapping Tool
In the midst of a national opioid epidemic, a new tool from the Centers for Medicare and Medicaid Services (CMS) allows providers to track the number of opioid prescription claims in their communities, counties and states. The tool – The Opioid Heat Map – shows local level data of de-identified Medicare Part D opioid prescription claims, comparing it to data across the country. With this new tool, providers will now be able to see real time Medicare data on the prescription of opioids across the country.
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House Subcommittee Approves Amended Helping Families in Mental Health Crisis Act
Lawmakers on a key health subcommittee yesterday approved amendments to Representative Tim Murphy’s Helping Families in Mental Health Crisis Act, sending the bill on to consideration by the full House Energy and Commerce Committee.
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President Obama Nominates Andrew Slavitt as Administrator of CMS
Last week, President Obama nominated Andrew Slavitt to serve as Administrator of the Centers of Medicare and Medicaid Services (CMS), a position he has held on an interim basis since Marilyn Tavenner stepped down in February. Before he can be appointed to the position on a permanent basis, Slavitt must be confirmed by the Senate.
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Bipartisan Legislation Opens Medicare Billing to Additional Behavioral Health Providers
A newly introduced bill in the House would allow Medicare to cover services provided by marriage and family therapists and licensed mental health counselors. By allowing previously ineligible providers to directly bill Medicare, H.R. 2759 would increase patients’ access to behavioral health providers, specifically in underserved, rural areas.
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Medicare Physician Payment Reform Passes Senate, Now Moves to White House
Legislation to reform the Medicare physician payment formula overwhelmingly passed the Senate last night and now heads to the White House where it is expected to be signed by President Obama. The signing of this legislation will stave off looming 21 percent cuts to physician reimbursements and end a perennial headache for legislators and providers alike.
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SGR Deadline Passes, Medicare Processing Will Stall Payment Cuts
Although the Medicare “doc fix” deadline has come and gone without legislative action by the Senate, the Centers for Medicare and Medicaid Services (CMS) ensured providers it will do all it can to prevent the 21% payment cuts from taking effect. In a release yesterday, CMS acknowledged its efforts to limit the impact on providers and beneficiaries by holding claims for a short period of time beginning on April 1st.
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