2015 Brings Flurry of Activity on Healthcare Reform in Washington
By Carter L. Alleman, JD 

Healthcare reform has topped the agenda of legislative and regulatory activity in Washington in the early months of 2015. The House of Representatives Energy and Commerce Committee held a hearing in late January on reform of the Medicare sustainable growth rate (SGR) formula. American Osteopathic Association and American Medical Association witnesses testified that the SGR is bad policy and that a repeal needs to occur. Committee members agreed that the SGR is bad policy but said their focus is on “pay-fors” that would be used for the repeal. Congress has few remaining days to vote on an actual repeal. Another patch seems likely, however the length of the patch is undecided. Congress has yet to fully address the repeal of 10-day and 90-day global surgical code reform. The Energy and Commerce Committee’s 21st Century Cures Initiative includes language that would prohibit the Secretary of the Department of Health and Human Services (HHS) from implementing or enforcing the Centers for Medicare and Medicaid Services (CMS) rule making on global surgery codes. The committee has not scheduled a hearing to discuss this piece of legislation. ACOS staff is engaged in discussions on the repeal of the CMS rulemaking.

The Energy and Commerce Committee held a Feb. 11, 2015, hearing on the implementation of ICD-10. While most testimony favored the implementation, there was hesitation by committee members on whether there should be more time allotted for study of updates to ICD-10. ACOS joined a letter to the CMS asking for further study of the implementation of ICD-10 and its impact on physician practices in both patient care and physician reimbursement. The HHS released a blog post signaling a switch from the Medicare fee-for-service payment model to a quality or value-based model through the use of alternative payment models. The HHS has set a goal of tying 30 percent of traditional Medicare payments to an alternative payment model by the end of 2016 with an additional 50 percent by 2018. The agency is working to establish the Health Care Payment Learning and Action Network that will be used to meet the department’s goals. ACOS staff attended a meeting with the National Quality Forum during which improvements to quality measurements were discussed.

HHS also released a policy statement concerning the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. HHS is examining potential rulemakings that would realign hospital EHR reporting periods to the calendar year to allow eligible hospitals more time to incorporate the 2014 edition EHR software into their workflow and to better align with other CMS quality programs. The possible rulemaking will modify other aspects of the program to match long-term goals, reduce complexity, and lessen provider reporting burdens. Also, the potential rulemaking will shorten the EHR reporting period in 2015 to 90 days to accommodate these changes. HHS has not released the rulemaking at this time, however a rule is expected in spring 2015. Members are welcome to contact Carter Alleman, ACOS Manager of Health Policy, with any thoughts or concerns about legislative and regulatory changes. You can contact him at [email protected]  or 800-888-1312, ext. 112.