IHA Daily Briefing: Sept. 12

CMS Issues ACA Hardship Exemption Guidance
Oct. 26 Deadline for Anti-Kickback Law Comments
Survey: More Non-College Youths Smoking Pot
September is National Preparedness Month

CMS Issues ACA Hardship Exemption Guidance
Today, the Centers for Medicare & Medicaid Services (CMS) announced new guidance for consumers on how to claim a tax penalty hardship exemption for not maintaining health coverage in 2018 on their federal income tax returns. The guidance provides additional details on how it is simplifying federal income tax return hardship exemption claims for taxpayers without presenting the documentary evidence or written explanation generally required for hardship exemptions. However, CMS said that consumers should, of course, keep with their other tax records any documentation that demonstrates qualification for the hardship exemption. Consumers can still apply for these exemptions through the health insurance marketplace using the existing application process.

For 2018, the Affordable Care Act (ACA) requires that all Americans get health coverage that qualifies as minimum essential coverage (MEC) or pay a penalty, commonly known as the “individual mandate.” Individuals that do not maintain enrollment in MEC or qualify for an exemption must pay a penalty. An individual may be eligible for a hardship exemption if they experience certain circumstances that prevent them from obtaining coverage, such as homelessness or experience a fire, flood, or other natural disaster.

According to CMS, this new option to claim a hardship exemption through the federal tax filing process responds to President Trump’s first Executive Order, where he directed agencies to minimize the unwarranted economic and regulatory burdens of the ACA. The 2017 Tax Cuts and Jobs Act reduced the individual mandate penalty to $0 for months beginning on or after Jan. 1, 2019.


Oct. 26 Deadline for Anti-Kickback Law Comments
The U.S. Dept. of Health and Human Services (HHS) Office of the Inspector General (OIG) recently issued a Request for Information (RFI) in the Federal Register regarding the federal anti-kickback statute and beneficiary inducements. HHS indicates in its proposal that one of its key priorities is removing unnecessary government obstacles to care coordination, and in conjunction with that, it has established a "Regulatory Sprint to Coordinated Care." Also, the OIG seeks to identify ways to modify or add new safe harbors to the anti-kickback statute, including exceptions to the beneficiary inducements civil monetary penalty definition of "remuneration." The OIG will accept comments on this RFI through Oct. 26.

This solicitation follows an earlier RFI issued by the Centers for Medicare & Medicaid Services (CMS) requesting comments on reducing barriers or concerns that arise from the application of the Physician Self-Referral Law (the “Stark” Law) to innovative quality programs. The comment period for the CMS RFI ended Aug. 24.


Survey: More Non-College Youths Smoking Pot
The National Institute on Drug Abuse released survey results last week that showed daily use of marijuana among non-college young adults is at an all-time high.

More than 13 percent of young adults not in college report daily, or near daily, marijuana use; alcohol use is more common among college students; some opioid use is declining in both groups; and the most sizeable difference is the higher rate of cigarette smoking in the non-college group.

Following are highlights from the 2017 Monitoring the Future survey on drug use among college students compared to their peers not attending college (ages 19-22):

  • Daily, or near daily, marijuana use among non-college young adults has continued to rise, reaching its highest level (13.2 percent);
  • Past month use of vaping marijuana appears to be higher among non-college young adults than among college students (7.8 percent vs. 5.2 percent);
  • Past month alcohol use in college students is higher than in non-college peers (62 percent vs. 56.4 percent). Additionally, mixing alcohol with energy drinks appears to be higher among college students than the non-college group (31.5 percent vs. 26.7 percent) in the past year;
  • Daily smoking for non-college peers is higher than college students (14.4 percent vs. 2 percent). Past month use of vaping nicotine appears to be higher for non-college young adults compared to college students (7.9 percent vs. 6 percent);
  • Past year misuse of Vicodin in both college and non-college peers dropped dramatically since 2009 (8.4 percent in 2009 to 1.1 percent in 2017 and 11.2 percent to 1.8 percent, respectively); and
  • Synthetic drug use over the last year is lower in college students than in non-college peers. Synthetic cannabinoids (K2/spice) use is 0.5 percent vs. 2.4 percent and synthetic cathinones (bath salts) is 0.2 percent vs. 1.5 percent, respectively.

September is National Preparedness Month
With Hurricane Florence ready to make landfall shortly, being prepared for a disaster is a timely topic, especially since September is National Preparedness Month. The Centers for Disease Control and Prevention has a variety of emergency preparedness and response information and resources on their website, including:

The CDC also has a comprehensive reference document on “Preparedness and Safety Messaging for Hurricanes, Flooding and Similar Disaster."