Center for Medicare Advocacy

Advancing Access to Medicare and Healthcare

December 2014 – The Year Ahead and Other Issues

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  • Welcome and Housekeeping  (David Lipschutz, Moderator)
  • Legislative Update:
  • The Year Ahead: Overview (David Lipschutz)
    • Legislative landscape in a new Congress
    • Medicare physician payment (Sustainable Growth Rate, or SGR) – action required by end of March 2015
    • Debt and deficit reform proposals
  • Draft Legislation
    • Hospitals Improvements for Payment (HIP) Act of 2014 (Toby Edelman)
      • On November 19, 2014 the Committee released a draft bill that focuses primarily on changes to hospital payment, but does address observation status. In certain instances, the draft bill proposes to count different types of hospital stays towards the 3-day hospital inpatient requirement for subsequent skilled nursing facility care.  The Committee is currently soliciting feedback on this draft legislation.
    • Protecting Integrity of Medicare Act (PIMA) of 2014 (David Lipschutz)
      • On December 2, 2014, the Committee released a draft bill with provisions that include programs to prevent prescription drug abuse under Medicare Part D, and prohibition of inclusion of Social Security account numbers on Medicare cards
  • Pending Draft Legislation (David Lipschutz)
    • House Energy & Commerce Committee’s 21st Century Cures Initiative – effort to speed drug and device development
  • Administrative Updates
  • Home Health Proposed Rule (Wey-Wey Kwok)
    • Overview of a proposed rule CMS issued on October 9, 2014 to revise the current conditions of participation (CoPs) for home health agencies (79 FR 61164).
    • Comments are due January 7, 2014
  • Litigation and Potential Litigation   (Gill Deford, Ali Bers and Wey-Wey Kwok)
    • Lessler (ALJ Delay Case)
    • Hull (lower level Medicare appeals)
    • Jimmo (Improvement standard)
    • Bagnall (Observation)
    • Haro (Medicare Secondary Payer Recovery)
    • Other litigation
  • General Medicare Q&A (Moderator)
  • Wrap-up  (Moderator)
    • Keep informed: Myths and Truths, other information and updates on the Center’s Website
    • Next Call

REMINDER: Other information available at: https://www.medicareadvocacy.org/Projects/AdvocatesAlliance/AdvocatesAlliance.IssueBriefs.htm. 

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