Government News of the Week: Latest Issue

May 21, 2012

NOTE: Government News of the Week will not be published May 28 because of the Memorial Day holiday. The next issue will be June 4.

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(1) HHS on May 16 released two major guidance documents related to the application process and operation of state health insurance exchanges, which are slated to begin enrolling members on Oct. 1, 2013 .... (more)

(2) On May 14, the HHS Office of Inspector General released two Medicare compliance reviews .... (more)

Proposed legislation in Massachusetts aims to curtail the rise in medical spend by targeting providers and payors. If legislation is ultimately passed, what impact do you think it will have on other states and on the insurance industry as a whole? Join the conversation at the AIS Blogs.

(3) On May 16, HHS issued corrections to an interim final rule regarding how health insurers must implement the reform law’s medical loss ratio (MLR) requirement .... (more)

(4) Temple University School of Medicine and Joseph Kubacki, M.D., agreed on May 15 to pay the federal government $1.08 million after voluntarily disclosing that they overbilled Medicare for services provided by teaching physicians .... (more)

(5) CMS announced in early May that on April 5 it had resolved another Stark case through its new self-referral disclosure protocol .... (more)

(6) Lenox Hill Hospital agreed on May 4 to pay $11.75 million to the feds to settle allegations that it fraudulently inflated its fees to boost payments from Medicare .... (more)

(7) In an advisory opinion released April 26, the OIG said it won’t impose sanctions on a municipal fire department’s proposed arrangement to share certain costs with hospital-based ambulance providers that participate in the local 911 emergency dispatch system .... (more)

(8) HHS issued a final rule May 11 informing health insurers that they must tell customers receiving a rebate check under applicable MLR standards that the check is a result of the health reform law. That stipulation has raised hackles from critics who see crediting the reform law as politicking ahead of the November general election, according to an article in the May 11 Wall Street Journal. (Reprinted from AIS’s Health Reform Week's e-News Alert)

(9) Illinois Gov. Pat Quinn (D) may issue an executive order to establish a state health insurance exchange despite criticism from Republicans that doing so would be premature ahead of the Supreme Court’s expected June decision on the Affordable Care Act, according to The Associated Press on May 14. A busy calendar precludes action in the legislature on exchanges, but the governor could act on his own in order to secure federal grants and meet a Jan. 1, 2013, deadline to prevent the federal government from running an insurance exchange in Illinois. (Reprinted from AIS’s Health Reform Week's e-News Alert)

(10) HHS Sec. Kathleen Sebelius on May 10 unveiled a slew of new health reform law-generated CMS final rules to eliminate “burdensome” regulations on hospitals and health care providers thatshe says in total will save more than $1 billion per year or more than $5 billion over five years. One example is a change to the Medicare Conditions of Participation rule for hospitals and critical access hospitals that will save $940 million per year, Sebelius says. (Reprinted from AIS’s Health Reform Week's e-News Alert)

(11) Maryland Gov. Martin O’Malley (D) on May 2 signed into law the O’Malley-Brown Administration’s Health Benefit Exchange Act of 2012 .... (more)

(12) Alabama’s Senate blocked a May 9 vote on a bill to create a health insurance exchange .... (more)

Have breaking news or an editorial question? E-mail BJ Taylor, editor of GOVERNMENT NEWS OF THE WEEK, at bjtaylor@aishealth.com. If you are interested in sponsoring GOVERNMENT NEWS OF THE WEEK please contact Bailey Sterrett at bsterrett@aishealth.com.

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