IHA Daily Briefing: May 3

HHS Announces Final Conscience Rule
CBO Reports on ACA Coverage and Subsidies
CMS Cites Medicare RAC Review Improvements
S&R, CAH Grant Opportunity for MAT Programs
Briefly Noted

HHS Announces Final Conscience Rule
Yesterday, the U.S. Dept. of Health and Human Services (HHS) Office for Civil Rights (OCR) issued its final conscience rule, protecting individuals and healthcare entities from discrimination on the basis of their exercise of conscience in HHS-funded programs. The final rule clarifies what covered entities need to do to comply with applicable conscience provisions and requires applicants for HHS federal financial assistance to provide assurances and certifications of compliance. The rule also specifies compliance obligations for covered entities, including cooperation with OCR, maintenance of records, reporting, and non-retaliation requirements.

This final rule replaces a 2011 rule and ensures that HHS implements the full set of tools appropriate for enforcing the conscience protections passed by Congress. According to HHS, these federal laws protect providers, individuals, and other healthcare entities from having to provide, participate in, pay for, provide coverage of, or refer for, services such as abortion, sterilization, or assisted suicide.  It also includes conscience protections with respect to advance directives.

More details are available in a final conscience rule fact sheet.


CBO Reports on ACA Coverage and Subsidies
Yesterday, the Congressional Budget Office (CBO) issued a report on the Affordable Care Act (ACA) federal subsidies, taxes, and penalties associated with health insurance coverage for people under age 65 from 2019-2029. The CBO said that during that timeframe, between 240 million and 242 million people are expected to have health insurance primarily from employment-based plans. However, the number of people without health insurance is expected to rise from 30 million in 2019 to 35 million in 2029.

Net federal subsidies for insured people under age 65 are expected to total $737 billion in 2019, according to CBO estimates. By 2029, that amount is projected to reach $1.3 trillion.

Related to the Medicaid program, the CBO says a monthly average of approximately 62 million noninstitutionalized people, under the age of 65, will receive full Medicaid benefits in 2019. That number grows to a monthly average of 64 million by 2029.


CMS Cites Medicare RAC Review Improvements
In a blog posted yesterday, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma discussed the merits of the agency’s Recovery Audit Contractor (RAC) work and its role in preventing and reducing improper Medicare payments. She also pointed out that CMS has responded to various concerns expressed from providers over time regarding the RAC program, including the length of time for the audit process and the lengthy appeal process.

Some specific examples of CMS’ improvements include:

  • Better oversight of the RACs, placing increased accountability on them;
  • Reducing provider burden; and
  • Increasing program transparency.

Verma also points out that even with these improvements, the RAC program recovered approximately $73 million of an identified $89 million of Medicare overpayments in 2018; since its inception in 2009, the program has recouped more than $10 billion for the Medicare program.

The blog posting follows a federal court decision in November ordering the Department of Health & Human Services to achieve the following reductions from its projected backlog of over 400,000 2018 appeal cases: 19% by the end of 2019; 49% by the end of 2020; 75% by the end of 2021 and complete elimination of the back by the end of 2022.


S&R, CAH Grant Opportunity for MAT Programs
In an effort to help rural communities create sustainable Medication Assisted Treatment (MAT) programs, the Health Resources and Services Administration (HRSA) will award grants up to $725,000 for a three-year period to establish or expand MAT programs in eligible settings, which include rural hospitals with 49 or fewer beds, critical access hospitals (CAHs), and Rural Health Clinics.

If interested, please see HRSA's announcement. A webinar for applicants will be hosted by HRSA's Federal Office of Rural Health Policy on Thursday, May 16 from 11-12:30 p.m. CT. The application deadline is June 10.


Briefly Noted
The U.S. Bureau of Labor Statistics released its April employment report today noting that 263,000 jobs were added for the month. Unemployment dropped to 3.6% for the month. Healthcare employment grew by 27,000 in April and 404,000 over the past 12 months. Hospitals added 8,000 jobs in April, while ambulatory healthcare services added 17,000 jobs.