|Jo Ann Lawer
From Jo Ann Lawer, Director, Government Affairs
Here is an update on several key state and federal actions. Government Affairs will provide this type of update on a regular basis. Please contact me with any questions about these or other issues that are of interest to you.
Proposed revisions to the regulation governing the confidentiality of substance use disorder patient records do not eliminate current barriers that impede the sharing of information essential for clinical care coordination and population health improvement in today’s patient care environment, the AHA told the Substance Abuse and Mental Health Services Administration.
In a letter to the agency, AHA Senior Vice President and General Counsel Mindy Hatton said the proposal should be re-evaluated to determine how to best align the Part 2 regulation with current Health Insurance Portability and Accountability Act rules “that permit patient information to be used and disclosed for treatment, payment and health care operations without having to obtain individual patient consents. It also will be essential for SAMHSA to work with Congress to eliminate any barriers in the statute underlying the Part 2 regulation that prevent full alignment.”
The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule implementing key provisions of the new physician payment system required by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015. Section 101 of MACRA repeals the Medicare sustainable growth rate methodology for updates to the physician fee schedule and requires CMS to establish new physician quality and value-based payment programs that start in 2019. Eligible clinicians will participate in one of two tracks – the default Merit-based Incentive Payment System (MIPS) or alternative payment models (APMs).
In the rule, CMS proposes most of the requirements of the MIPS for 2019, including performance measures, data submission mechanisms, reporting timeframes, scoring methodology and various administrative processes. As part of the MIPS, the agency proposes to replace electronic health record meaningful use requirements for physicians with a more flexible set of "advancing care information" measures. The rule does not propose parallel changes for hospitals.
CMS also proposes criteria for eligible APMs. Specifically, the agency proposes that an entity that participates in an eligible APM must bear financial risk for any excess Medicare spending over projected expenditures or be a specified medical home. CMS is accepting comments on the proposed rule through June 27. AHA members can access a Special Bulletin with additional information at www.aha.org.
Summary of enacted legislation
PA Department of Health FAQ document about Medical Marijuana Act
This has been shared with the entire Lancaster County delegation to urge their support of this bill.