Federal Watch
April 19th, 2012
AGS is tracking developments of interest to geriatrics health professionals in order to provide weekly updates for our readers via our List Serv, americangeriatrics.org, our Facebook page, and our Twitter feed. This week, we update you on the new Administration for Community Living initiative, ways to avoid the 2013 eRx payment adjustment, and the recent launch of CMS’s national survey focused on patient experiences with Medicare-certified home health agencies. We additionally remind you of upcoming grant application deadlines, and update you on the most recent sign-on letter we supported this week. Finally, we encourage you to take action by contacting your legislators, and urging them to fully address and put an end to the flawed SGR formula.
HHS Announces New Administration for Community Living
Secretary Sebelius released a statement advocating that all Americans – including seniors, should be able to live at home with the supports they need, participating in communities that value their contributions – rather than in nursing homes or other institutions. This has led to the creation of the new Administration for Community Living (ACL), which aims to bring together key HHS organizations and offices dedicated to improving the lives of those with functional needs into one coordinated, focused and stronger entity. ACL will convene the Administration on Aging, the Office on Disability and the Administration on Developmental Disabilities into a single agency that supports both cross-cutting initiatives and efforts focused on the unique needs of individual groups, such as frail older adults with dementia. This new agency will work on increasing access to community supports and achieving full community participation for people with disabilities and seniors. For more information, please visit http://hhs.gov/acl.
Avoiding the 2013 eRx Payment Adjustment
In 2009, the Centers for Medicare & Medicaid Services (CMS) implemented the Electronic Prescribing (eRx) Incentive Program, which is a program that uses incentive payments and payment adjustments to encourage the use of qualified electronic prescribing systems. From calendar year (CY) 2012 through 2014, a payment adjustment that increases each calendar year will be applied to an eligible professional’s Medicare Part B Physician Fee Schedule (PFS) covered professional services for not becoming a successful electronic prescriber. The payment adjustment of 1.0% in 2012, 1.5% in 2013, and 2.0% in 2014 will result in an eligible professional or group practice participating in the eRx Group Practice Reporting Option (eRx GPRO) receiving 99.0%, 98.5%, and 98.0% respectively of their Medicare Part B PFS amount for covered professional services.
Individual eligible professionals and CMS-selected group practices participating in eRx GPRO who were not successful electronic prescribers in 2011 can avoid the 2013 eRx payment adjustment by meeting the specified reporting requirements between January 1 and June 30, 2012. Six-month reporting requirements to avoid the 2013 payment adjustment include:
- Individual Eligible Professionals – 10 eRx events via claims
- Small eRx GPRO – 625 eRx events via claims
- Large eRx GPRO – 2,500 eRx events via claims
For more information on individual and eRx GPRO reporting requirements, please visit here. If you have questions regarding the eRx Incentive Program, eRx payment adjustments, or need assistance submitting a hardship exemption request, please contact the QualityNet Help Desk at 1-866-288-8912 (TTY 1-877-715-6222) or via qnetsupport@sdps.org.
CMS to Publicly Report on Consumer Experiences with Medicare-Certified Home Health Agencies
Results from the Centers for Medicare & Medicaid Services’ (CMS) national survey that asks patients about their experiences with Medicare-certified home health agencies are now available on the agency’s Quality Care Finder (www.medicare.gov/quality-care-finder) website. Acting Administrator Marilyn Tavenner announced the new tool offering prospective patients, their families and caregivers the chance to compare home health agencies by looking at patient survey results. The Home Health Care Consumer Assessment of Healthcare Providers and Systems (HHCAHPS) Survey, which will be updated every four months with new data, will complement the clinical measures already available on the agency’s “Home Health Compare” website. The survey is the first national assessment tool for collecting information on patient experience and will enable valid comparisons among all home health agencies. The survey results are designed to create incentives for home health agencies to improve quality of care, as well as to give patients additional information so they are aware of the types of care they will receive from a particular agency. Additionally, public reporting enhances accountability in health care by increasing transparency. For more information on the survey, visit https://homehealthcahps.org.
Reminders
AHRQ’s New Comparative Effectiveness Research Grants Program – Applications due May 2 (first round)
The Agency for Healthcare Research and Quality (AHRQ) announced a new grants program aimed at training researchers in comparative clinical effectiveness research. The program, Mentored Career Enhancement Award in Patient Centered Outcomes Research (PCOR) for Mid-Career and Senior Investigators (K18), targets established mid-career and senior investigators who are interested in developing new skills in comparative effectiveness research methodology and applying these methods to patient-centered outcome research (PCOR). For additional information on the grants program, click here.
CMS Initiative to Strengthen Primary Care Workforce – Applications due May 21
CMS announced a call for applications for a new Affordable Care Act initiative designed to strengthen primary care in the US. Under the Graduate Nurse Education Demonstration, CMS will provide hospitals working with nursing schools to train advanced practice registered nurses (APRNs) with payments of up to $200 million over four years to cover the costs of APRNs’ clinical training. APRNs—whether they are nurse practitioners, clinical nurse specialists, nurse anesthetists, or nurse midwives—play a pivotal role in primary care. For more information including how to apply, visit the Graduate Nurse Education Demonstration website.
What AGS Did This Week
AGS signed onto the American Medical Association’s letter which responds to CMS’ proposed rule on Reporting and Returning of Overpayments. See the Federal Register notice here. As you are likely aware, the obligation to report and return overpayments carries significant legal and financial penalties. The letter comments on several aspects of the proposed rule, including concerns about the proposed 10-year look back period, reporting requirements, and due process protections.
How You Can Help
AGS encourages you to Take Action by visiting AGS’ Health in Aging Advocacy Center. Contact your members of Congress today, and urge them to call for both the repeal of the SGR and comprehensive Medicare payment and delivery reform. Should you have any questions, please don’t hesitate to contact Susie Sherman, Senior Coordinator of Public Affairs & Advocacy, ssherman@americangeriatrics.org.
Modified On: April 19th, 2012
