One Policy Ends, More Policies Begin

By Carter L. Alleman, J.D.

April closed on a high note for healthcare professionals. Congress passed, and the President signed the H.R. 2, the repeal of the SGR. Following the repeal, the healthcare policy landscape opened up and changes and advancements are occurring.

Hospital Compare Star Ratings
CMS released its first Hospital Compare Star Ratings. The five-star system evaluates hospitals on 11 measures of performance and one composite summary rating. It looks at how well nurses and doctors communicate with patients, how clean and quiet hospital environments are and how well patients are prepared for follow-up care after discharge.

“The patient experience Star Ratings will make it easier for consumers to use the information on the Hospital Compare website and spotlight excellence in health care quality,” Patrick Conway, acting principal deputy administrator for CMS, said in a statement. “These star ratings also encourage hospitals and clinicians to strive to continuously improve the patient experience and quality of care delivered to all patients.”

ACA Navigators
In Missouri v. St. Louis Effort for AIDS, the U.S. Court of Appeals for the 8th Circuit upheld a lower court ruling which overturned Missouri’s laws limiting the ability of health insurance navigators and other consumer assisters to help people enroll in ACA coverage. The Court found that the State violated federal law when Missouri placed additional licensing requirements and limitations on the navigator engagement with enrollees. The laws in effect made the navigators insurance agents in Missouri and bringing them under state law. The Court found that this violated the ACA and its explicit preemption of such actions. This case is important as at least a dozen other States have enacted a similar type of law.

Following on this decision the Department of Health and Human Services announced it expects to award up to $201 million in grants over the next three years for Obamacare navigators in states that do not operate their own exchanges. The funding is available for consumer assisters who work in the 34 states that have either federal-run or partnership exchanges. Navigators are required to complete at least 20 hours of an HHS training program, pass an exam and be federally certified before they can work with consumers.

Meaningful Use Rulemaking:
The CMS released a proposed rule for the Stage 3 of the EHR Incentive Program. The CMS proposed rule will streamline Stage 3 of the EHR Incentive Programs and allow providers more flexibility for reporting by establishing a single, aligned reporting period for all providers based on the calendar year. The rule will also align quality data for reporting via a single submission method for multiple CMS programs. The rule will simplifying meaningful use reporting requirements to eight objectives that focus on advanced use of EHR technology and quality improvement.

ACOS staff is working with other healthcare professional associations on submitting comments to CMS regarding its proposed rulemaking.