Federal Watch
May 11th, 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 share several updates including HHS’s new regulation that would increase payments for primary care under Medicaid; new legislation to repeal and reform Medicare’s flawed payment system; and HHS’s announcement of its first batch of Innovations grants. We additionally provide reminders for upcoming grant and application deadlines, as well as news on AGS’s most recent activities. 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.
New Regulation Increases Medicaid Payments to Doctors for Primary Care
Secretary of Health and Human Services Kathleen Sebelius announced a proposed rule that would implement the Affordable Care Act’s requirement that Medicaid reimburse family medicine, general internal medicine, pediatric medicine, and related subspecialists at Medicare levels in CY 2013 and CY 2014. The increase in payment for primary care is paid entirely by the federal government with no matching payments required of States. AGS is currently reviewing the rule to determine whether providers in geriatric medicine will qualify for the increased Medicaid payments.
The Secretary additionally reported that in 2011, over 150,000 primary care providers nationwide received almost $560 million in higher Medicare payments thanks to the Affordable Care Act. This is another way the Affordable Care Act rewards doctors, nurse practitioners, physician assistants, and other primary care providers who are central to our health care system. For more information about the proposed rule, you can visit here.
Legislation to Repeal the SGR Unveiled
Congresswoman Allyson Schwartz (D-PA) and Congressman Joe Heck (R-NV) have introduced legislation to repeal the Sustainable Growth Rate (SGR) formula and replace it, over time, with a series of different payment models for physicians and other providers paid under the fee schedule to choose from. The bill, if passed into law, would be paid for by using the unspent Overseas Contingency Operations funds. AGS staff along with our SWAT team has been working closely with Congresswoman Schwartz on this legislation. For more background, please visit here.
HHS Awards 26 Innovations Grants
In November 2011, the Department of Health and Human Services announced that it would make $1 billion available for grants to providers, local governments, payers, and other organizations to fund health delivery innovation projects. This week, the first 26 Innovations Awards were announced; with the expectation to reduce health spending by $254 million over the next 3 years. A large proportion of the 26 awardees integrate a multi-disciplinary approach, with two projects specifically targeting the geriatric population. These projects include:
- Lifelong Medical Care, CA.
Project Title: “Health Care Innovation Challenge: LifeLong complex care initiative to achieve the Triple Aim” - Regents of the University of California, Los Angeles
Project Title: “UCLA Alzheimer’s and dementia care: comprehensive, coordinated, patient-centered”
For more information about the Innovations Awards, please visit here.
Reminders
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.
Avoiding the 2013 eRx Payment Adjustment
In 2009 the Centers for Medicare & Medicaid Services (CMS) implemented the Electronic Prescribing (eRx) Incentive Program, 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. 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. For more information on individual and eRx GPRO reporting requirements, please visit here.
What AGS Did This Week
AGS submitted comments to the Centers for Medicare and Medicaid Services (CMS) on several important aspects of the proposed rule on the Electronic Health Record Incentive Program—Stage 2. As a specialty society with a mission of advancing efforts that promote high quality care and quality improvement, we generally support the adoption and meaningful use of health information technology, including electronic health records. While we support many aspects of the proposed rule, we provided principal recommendations which you can access by reading our complete letter.
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: May 11th, 2012
