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ACNM Policy Update - 6/2/2014

June 2, 2014


1.  CMS Releases FY
2015 Hospital Inpatient Prospective Payment System Proposed Regulation


2.  CMS Releases New
Payment Methodology for Federally Qualified Health Centers


3.  CMS Releases
Revisions to its Regulations to Reduce Complexity and Burden


4.  CMS Releases
Final Regulation on Medicare Prescription Drug Benefit



1.  CMS Releases FY 2015 Hospital Inpatient Prospective Payment System
Proposed Regulation


On May 15, the Centers for Medicare and Medicaid Services (CMS) published a
proposed regulation establishing payment rates and policy revisions applicable
to inpatient acute care hospital discharges occurring on or after October 1,
2014.  




ACNM has prepared a detailed Issue
Brief
outlining provisions of this regulation that are of particular
concern to midwifery. Notable among them are proposals to include a quality
measure of early elective delivery in the hospital value based payment program
and also to include a breastfeeding and healthy term newborn measure in the
inpatient quality reporting program.  

2.  CMS Releases
New Payment Methodology for Federally Qualified Health Centers


On May 2, CMS published a final regulation implementing a revised
payment methodology for Federally Qualified Health Centers (FQHCs). 


ACNM has prepared a detailed Issue
Brief
outlining provisions of this final regulation.  The regulation
is estimated to result in a 32 percent increase in Medicare payments to FQHCs.
 Since approximately 9 percent of FQHC total billing is paid for by
Medicare, on average they can expect to see a 3 percent increase in their
income as a result of this new payment system, though this increase will vary
among individual FQHCs.  

3.  CMS Releases
Revisions to its Regulations to Reduce Complexity and Burden


On May 12, CMS published a final regulation making various changes to the
Medicare program.  These changes were prompted by an executive order
requiring the various executive branch departments and agencies to make changes
to reduce regulatory complexity and burden.


ACNM
has prepared a detailed Issue
Brief
outlining pertinent provisions of this final rule.  Notable
among them is a clarification with regard to which provider types can
participate on hospital medical staff.  No significant changes, but a nice
clarification and a clear indication that CMS favors inclusion of APRNs on
hospitals' medical staffs.

4.  CMS Releases
Final Regulation on Medicare Prescription Drug Benefit


On May 23, CMS published a final
regulation
with policies related to the Medicare Advantage and Medicare
Part D prescription drug benefit.  One provision of this regulation may be
of interest to midwives.


CMS has required that in
order for a drug to be covered under the Part D program, the provider who
writes the prescription must either be enrolled as a Medicare provider, or have
an affidavit on file with Medicare indicating a decision to opt out of Medicare
participation.  See
this
article
for information on opting out of Medicare.  

Should you have questions about federal issues, please contact Jesse Bushman,
ACNM's Director of Advocacy and Government Affairs at [email protected] or 240-485-1843.


Should you have questions
about state issues, please contact Cara Kinzelman, ACNM's Manager of State
Government Affairs at [email protected]
or 240-485-1841.