Official NTOCC Comments

Review the official comments, letters and responses from the National Transitions of Care Coalition (NTOCC).

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CMS Delays Two-Midnight Rule

Posted on 2/5/2014 by NTOCC ® in Public Policy Updates

Last week, after mounting pressure from the hospital and physician community, CMS announced that it will delay enforcement of the two-midnight rule until October. The punitive measures of the rule were set to go into effect in April, and auditors will now have to wait until after September 30 to start auditing claims under the two-midnights rule.

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HHS Issues Joint Rule Allowing Patients and Designees Direct Access to Lab Test Results

Posted on 2/5/2014 by NTOCC ® in Public Policy Updates

Yesterday, three agencies within the Department of Health and Human Services (HHS)-- the Centers for Medicare & Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and the Office for Civil Rights – jointly issued a final rule that removes legal barriers that prevent medical laboratories from providing lab test results directly to patients or their designees.

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PCORI Transitional Care Funding Opportunity Coming Feb. 5

Posted on 1/23/2014 by NTOCC ® in Public Policy Updates

On February 5, 2014, the Improving Healthcare Systems (IHS) program at the Patient-Centered Outcomes Research Institute (PCORI) plans to release a targeted funding announcement soliciting applications to research the comparative effectiveness of transitional care services. Specifically, PCORI is seeking applications for research to determine which transitional care service clusters work best for patient populations at risk in various healthcare delivery and payment contexts by improving patient-centered outcomes and optimizing utilization rates.

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Senate and House Members Introduce Chronic Care Management Bill

Posted on 1/17/2014 by NTOCC ® in Public Policy Updates

Today, Senators Ron Wyden (D-OR), Johnny Isakson (R-GA) and Representatives Erik Paulsen (R-MN) and Peter Welch (D-VT) introduced legislation that would expand the use of interdisciplinary health teams to improve care coordination for beneficiaries with multiple chronic conditions. The Better Care, Lower Cost Act encourages specialized team-based care, including case management services, with rewards for improving patient’s outcomes and use of telemedicine and knowledge networks to increase access in rural areas. Specifically, the bill creates the “Better Care Program,” allowing health plans and groups of providers to form “Better Care Plans” or “Better Care Practices,” (BCPs). This program would be voluntary and open to Medicare enrollees suffering with chronic illnesses. Participating plans and practices would receive newly calculated risk-adjusted, capitated payments rewarding better health outcomes for enrolled beneficiaries.

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Congress Releases FY 2014 Appropriations Bill

Posted on 1/15/2014 by NTOCC ® in Public Policy Updates

Yesterday evening, House and Senate appropriations negotiators unveiled a $1.1 trillion omnibus spending package to fund federal agencies for the rest of the fiscal year. The measure, which encapsulates all 12 of the annual appropriations measures for federal departments, results in a 2.6 percent increase in discretionary spending from the $986.3 billion sequester-set level of Fiscal Year (FY) 2013. Prior to the proposed measure, spending had been set to fall again to $967 billion under the sequester, but the plan adheres to the new caps on defense spending ($520.5 billion) and domestic discretionary spending ($491.8 billion) set under last month’s House-Senate budget deal.

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House and Senate Committees Approve SGR Proposals; House Passes Budget Bill with 3 Month SGR Fix

Posted on 12/13/2013 by NTOCC ® in Public Policy Updates

Yesterday, the House Ways & Means and Senate Finance Committees approved and reported out their respective bills for the long-term repeal of the sustainable growth rate (SGR) formula. Although this process started with unified bicameral, bipartisan language the bills that were reported out of the two committees today are no longer the same. The biggest difference between the two is that the Ways & Means bill includes a 0.5 percent pay increase for doctors and the Finance Committee bill does not. Additionally, neither Committee addressed the offsets that are needed for this legislation and thus, neither of these bills will be enacted this year. Instead, last night the House passed a two year budget deal which included a three month extension of the current SGR formula to give Members additional time to negotiate a full repeal.

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Key Members of Congress Reach Budget Deal; Short Term SGR Fix Could Be Included

Posted on 12/12/2013 by NTOCC ® in Public Policy Updates

Yesterday evening, House Budget Chairman Paul Ryan (R-WI) and Senate Budget Chairwoman Patty Murray (D-OR) reached a two-year budget agreement in advance of the December 13th deadline. In total, the bipartisan package amounts to $85 billion, which includes about $63 billion to replace the sequestration cuts in 2014 and 2015, and over $22 billion in net deficit reduction. The agreement would set the discretionary spending level for fiscal year 2014 at $1.012 trillion, and $1.014 trillion in FY 2015. In practical terms, if the bill passes and is signed into law, appropriations committees still have to allocate the funds among subcommittees, and the subcommittees have to divide their allocations among their programs. These committees must work fast to come up with appropriations bills in advance of the January 15th deadline, but having a common spending target and budget framework will greatly enhance the likelihood that they can keep the government running and avoid another shut down.

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Mary Naylor Submits Commentary to IOM on Research to Improve Care Coordination and Quality

Posted on 11/19/2013 by NTOCC ® in Public Policy Updates

As a contributor to the Learning Health System Commentary Series of the Institute of Medicine’s (IOM) Roundtable on Value & Science-Driven Health Care, Mary Naylor submitted commentary to IOM outlining the care coordination and quality improvement work that is being done through the Interdisciplinary Nursing Quality Research Initiative (INQRI), an initiative to improve patient care by examining the role nurses play in improving care quality. As co-chair of the INQRI, Naylor highlighted several studies that examined nursing practices and tested interventions that can improve patient care and safety, including “an analysis of the factors that influence the quality of preparation of patients and family caregivers for the transition from hospitals to home and the impact of enhanced preparation on patients’ perceived readiness and rates of re-hospitalization.”

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CMS to Hold Open Forum on Two Midnight Benchmark for Inpatient Hospital Admission

Posted on 9/25/2013 by NTOCC ® in Public Policy Updates

On Tuesday, the Centers for Medicare and Medicaid Services (CMS) announced that it will be holding a special open door forum, “Discussion of the Hospital Inpatient Admission Order and Certification 2 Midnight Benchmark for Inpatient Hospital Admission” on Thursday, September 26th from 2:00pm ET– 3:00pm ET. The conference call will allow hospitals, practitioners, and other interested parties to ask questions on the physician order and physician certification, inpatient hospital admission and medical review criteria that were released on August 2, 2013 in the proposed FY 2014 Inpatient Prospective Payment System (IPPS) and Long-Term Acute Care Hospital Prospective Payment System Payment Rule.

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ONC Requests Comment on Stage 3 Meaningful Use

Posted on 11/29/2012 by NTOCC ® in Public Policy Updates

Yesterday, the Office of the National Coordinator for Health Information Technology (ONC) announced a request for public comment on draft recommendations for the Stage 3 of the Meaningful Use Program. Stakeholders are asked to comment on new and revised meaningful use objectives and measures, proposed certification criteria for information exchanges, as well as a series of questions on clinical quality measures, and privacy and security issues.

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