IHA Daily Briefing: August 7

HFS Posts Updated Assessment Program Pricing
Sept. 6 Deadline for MA MIPS Waiver Demo
CDC Issues New Report, Updated Interim Guidance on Zika

HFS Posts Updated Assessment Program Pricing Calculators
The Dept. of Healthcare and Family Services (HFS) today issued a notice on Updated Pricing Calculators related to the redesigned Hospital Assessment Program.

HFS indicates that new inpatient and outpatient pricing calculators, updated to include reimbursement changes effective July 1, 2018 as outlined in the Provider Notice dated June 29, 2018, have been posted to the Department’s website.


Sept. 6 Deadline for MA MIPS Waiver Demo
The Centers for Medicare and Medicaid Services (CMS) has announced that the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), Quality Payment Program (QPP) Merit-Based, Incentive Payment System (MIPS) eligible clinicians can apply to participate in the Medicare Advantage Qualifying Payment Arrangement Initiative (MAQI) Demonstration project.

The demonstration, explained in more detail in the Calendar Year 2019 Medicare Physician Fee Schedule (PFS) proposed rule, exempts participating clinicians from the reporting requirements and payment adjustments under MIPS, if they participate to a “sufficient degree.”

Eligibility to participate in the demonstration is contingent on the clinicians meeting minimum Medicare Part B revenue and volume thresholds. As the MIPS program is budget-neutral, the performance scores of participating clinicians would also be excluded from the national MIPS thresholds, thereby potentially affecting MIPS payment adjustments for those clinicians not eligible to participate.


CDC Issues New Report, Updated Interim Guidance on Zika
The Centers for Disease Control and Prevention (CDC) today issued a new Vital Signs report on “Zika-Associated Birth Defects and Neurodevelopmental Abnormalities Possibly Associated with Congenital Zika Virus Infection” in Puerto Rico and other U.S. territories.

CDC indicates one in seven evaluated children of mothers with a confirmed or possible Zika virus infection during pregnancy had a Zika-associated birth defect, a neurodevelopmental abnormality possibly associated with congenital Zika virus infection, or both. Among the 1,450 evaluated children:

  • 6 percent had at least one Zika-associated birth defect;
  • 9 percent had at least one neurodevelopmental abnormality possibly associated with congenital Zika virus infection; and
  • 1 percent had both.

CDC notes that “given that most children did not have evidence of all recommended evaluations, additional anomalies might not have been identified. Careful monitoring and evaluation of children born to mothers with evidence of Zika virus infection during pregnancy is essential for ensuring early detection of possible disabilities and early referral to intervention services.”

For more information, see CDC's bulletin.

CDC also issued an “Update: Interim Guidance on Preconception Counseling and Prevention of Sexual Transmission of Zika Virus for Men with Possible Zika Virus Exposure.”

CDC now recommends that men with possible Zika virus exposure who are planning to conceive with their partner wait for at least 3 months after symptom onset (if symptomatic) or their last possible Zika virus exposure (if asymptomatic) before engaging in unprotected sex. CDC now also recommends that for couples who are not trying to conceive, men can consider using condoms or abstaining from sex for at least 3 months after symptom onset (if symptomatic) or their last possible Zika virus exposure (if asymptomatic) to minimize their risk for sexual transmission of Zika virus.

Recommendations for men with possible Zika virus exposure whose partner is pregnant remain unchanged; these couples should be advised to consistently and correctly use condoms during sex or abstain from sex for the duration of the pregnancy.