More from this month’s View from Washington

In this issue’s View From Washington, Dr. Robert Betz looks at recent developments regarding the implementation of key provisions of the Patient Protection and Affordable Care Act (PPACA). We’ll continue the article in a series of blogs on Other reform topics will include Medicare and Medicaid; Committees, Boards and Commissions; CMS releases proposed MD fee schedule rate and other health reform information. First up: Medicare and Medicaid.

Medicare and Medicaid

Provision:  Accountable Care Organizations (Medicare Shared Savings Program).
Impacted Entities:  Hospitals, physicians, group practices, health care professionals, and insurers.
Summary:  CMS will publish a Notice of Proposed Rulemaking this fall regarding the Medicare shared savings program, which permits the establishment of Accountable Care Organizations (“ACOs”) in the Medicare program.  On Thursday, June 24, CMS held a Special Open Door Forum to discuss the ACO program.  The primary purpose of this teleconference was to solicit comments from interested entities.  Over 1,600 individuals participated in the teleconference and dozens of industry, patient, and provider groups expressed their concerns and suggestions to CMS staff.  As expected, CMS staff did not provide answers to the most pressing issues regarding the ACO program (e.g., stark and anti-kickback concerns, distribution of shared savings, structure and types of ACOs).  The Federal Trade Commission (FTC) has announced a public workshop on competition policy, payment reform, and the new models for delivering high-quality care.  At this workshop, the FTC will focus on how ACOs could affect competition among commercial payers and provide consumers with access to affordable health care.

Provision:  Establishment of the Temporary Certification Program for Health Information Technology (HIT). .
Impacted Entities:  Applicants for Authorized Testing and Certification Body status; indirect impact on eligible Medicare- and Medicaid-participating professionals and hospitals.
Summary:  On June 24, 2010 HHS published a final rule establishing the temporary certification program for health HIT.  Authorized by the American Recovery and Reinvestment Act of 2009, this rule paves the way for adoption of HIT by Medicare and Medicaid providers – a key goal of President Obama’s health reform agenda.  Under this final rule, the National Coordinator for HIT will temporarily authorize qualified organizations to test and certify electronic health records (EHRs), thereby making certified EHRs available to Medicare and Medicaid providers eligible for incentive payments beginning in 2011.  This temporary certification program will sunset on December 31, 2011, or once the permanent certification program is fully constituted.  This final rule was effective June 24, 2010.

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