DCMedical News: Tuesday, May 22, 2018
DCMedical News
Washington, D.C.
Tuesday, May 22, 2018
DCMedical News is published every day either the House or the Senate is in session. Want to subscribe? See below. Add our new domain (dcmedicalnews.org) to your white list. Welcome to our new “courtesy trial” recipients.
THE BIG STORY TODAY IN HEALTH CARE
Spending: CQ reports that the House “punts on rescissions until June”; FY 2019 Appropriations are moving along; but no schedule yet for HHS Appropriation mark-up.
Drugs: Secretary Azar defends the Administration drug price control plans, here, arm-wrestling with doctors over Part B purchase and mark-up practices, appears to the New York Times a “joyful regulator,” here. Opioids the subject of multiple approaches, see below under Pharma in DCMN 5-21.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Nurses and Collaboration: The longer the shift and the greater the amount of overtime, the lower the measures of collaboration. Study from Journal of Nursing Administration, here.
HOSPITALS AND HEALTH CARE FACILITIES
Special series highlights coming hospital changes: our DCMN Special Series on the Inpatient Prospective Payment System for Hospitals continues below. Head’s up: one issue discussed today is the posting of hospital prices. CMS already requires hospitals to post charges. However, as an alternative to that posting, CMS allows the hospital to post policies under which the public may view a list of those charges upon request. The proposed rule for FY 2019 (here) eliminates the alternative.
PHARMA
More on the charitable and low-income care delivered by 340B Hospitals: It turns out that it depends on what you mean by 340 Hospitals. A study in JAMA Internal Medicine finds “Hospitals that entered the program before 2004 and those that entered the program after 2004 differed in terms of financial status and hospital characteristics. Early participants provided significantly more uncompensated care and had lower operating margins, whereas later participants were no different from nonparticipants with respect to uncompensated care provision and operating margins.”
Study here, editorial comment and program history here.
READING AND PUBLICATIONS
GDPR: On May 25th the new European Union data protection law known as the General Data Protection Regulation (GDPR) takes effect. The idea is to give individuals in the EU more control over how data is used, and to put obligations on businesses that process information. You can find the entire GDPR here. For DCMN, our GDPR commitment is easy: We collect no personal information from you, much less sell it. We have no advertising, and no advertisers with whom we share subscription or any other lists. We are entirely supported through personal and institutional subscriptions.
EVENTS & MEETING
May 22
10:00 a.m., Senate HELP Committee, Health Care Workforce, Addressing Shortages and Improving Care, 430 Dirksen SOB.
May 23
1:00 p.m., Hearing, Subcommittee on Health (House Energy & Commerce Committee) Reauthorization of the Children’s Hospital Graduate Medical Education Program, 2322 RHOB, bill here.
May 24
8:30 – Noon, “Health Care Costs in America,” Alliance for Health Policy, Kaiser/Jordan Conference Center, 1330 G Street NW, Washington, DC.
9:00, Senate Finance, Rural Healthcare in America, Challenges and Opportunities, 215 Dirksen SOB.
May 30
9:30 a.m. – 5:00 p.m., HHS Pain Management Task Force (open to the public), inaugural meeting, Federal Register meeting notice and task force membership here.
July 25
7:30 a.m. – 4:30 p.m., Medicare Evidence Development and Coverage Advisory Committee (MEDCAC), volume requirements for aortic valve replacements and percutaneous coronary interventions. Maria Ellis, MEDCAC, (410) 786-0309, maria.ellis@cms.hhs.gov. Federal Register notice here.
Aug. 20
Meeting of Medicare Advisory Panel on Hospital Outpatient Program (through August 21), APCs, OPPS, the works. Evaluation of Advanced Primary Care (APC) groups; packaging of Outpatient Prospective Payment System (OPPS). Information here (Fed Reg 5-3-2018), 7500 Security Boulevard, Baltimore, MD.
MEDICARE, MEDICAID, COMMERCIAL HEALTH INSURANCE
Special Report: Inpatient Prospective Payment System, Hospitals, Long Term Care Hospitals and Critical Access Hospitals, FY 2019, proposed rule. Publication date: May 7, 2018. Comment due date: June 25, 2018.
This is the second part of a multi-part series on the Hospital Inpatient Prospective Payment System (IPPS) FY 2019 proposed rule. Reference to page numbers in this series will be to the 480-page Federal Register document, here.
“Background on the IPPS and LTCH PPS: CMS pays acute care hospitals (with a few exceptions specified in the law) for inpatient stays under the IPPS and long-term care hospitals under the LTCH PPS. Under these two payment systems, CMS sets base payment rates prospectively for inpatient stays based on the patient’s diagnosis and severity of illness. Subject to certain adjustments, a hospital receives a single payment for the case based on the payment classification – Medicare Severity Diagnosis-Related Groups (MS-DRGs) under the IPPS and Medicare Severity Long-Term Care Diagnosis-Related Groups (MS-LTC-DRGs) under the LTCH PPS – which are assigned at discharge.”
“By law, CMS is required to update payment rates for IPPS hospitals annually, and to account for changes in the prices of goods and services used by these hospitals in treating Medicare patients, as well as for other factors. This is known as the hospital ‘market basket.’ The IPPS pays hospitals for services provided to Medicare beneficiaries using a national base payment rate, adjusted for a number of factors that affect hospitals’ costs, including the patient’s condition and the cost of hospital labor in the hospital’s geographic area. Payment rates to LTCHs are typically
updated annually according to a separate market basket based on LTCH-specific goods and services.
The proposed changes, which would apply to approximately 3,330 acute care hospitals and approximately 420 LTCHs, would affect discharges occurring on or after October 1, 2018.”
Interoperability: The proposed rule includes a request for information on how sharing of health care data might be improved, including the possibility of revising the Conditions of Participation (CoP). The CoP represent the basic minimum requirements for hospitals to receive payment for participating in the Medicare program; change in the CoP is always a big “lever” on hospitals, and would undoubtedly create significant problems for most, if not all, hospitals. (See pg. 20551, document is “searchable” for CoP references.)
Continued tomorrow.
FOR REFERENCE
Members of the Senate (here) and Members of Senate Committees (here), Senate Calendar (here).
Members of the House with their House Committees (here), House Calendar (here).
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
DCMedical News is published every day that either the House of Representatives or the Senate is in session.
Past issues can be accessed by clicking on “View this email in your browser.” Subscription information is found at the bottom of these pages. Trial subscriptions may end without notice.
May publication dates: 23, 24, 25.
June publication dates: 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 18, 19, 20, 21, 22, 25, 26, 27, 28, 29.
July publication dates: 9, 10, 11, 12, 13, 16, 17, 18, 19, 20, 23, 24, 25, 26, 27, 30, 31.
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com