The Department of Veterans Affairs (VA) has issued a
proposed rule implementing provisions of the Veterans
Community Care Program — authorized by the MISSION Act — which
allows covered veterans to receive necessary hospital, medical
and extended care services from non-VA providers.
Under the MISSION Act, veterans enrolled in the VA health system
can seek care from non-VA providers if they meet one of the
following six conditions:
VA does not offer the required care or services.
VA does not operate a full-service medical facility in the
state where the veteran resides.
The veteran was eligible to receive care under the Veterans
Choice Program and is eligible to receive care under certain
The veteran and the referring clinician determine it is in
the veteran’s best medical interest to receive care or services
from an eligible entity or provider based on consideration of
The veteran is seeking care or services from a VA medical
service line that VA has determined is not providing care that
complies with VA’s standards of quality.
The proposed rule also defines which non-VA entities and
providers are eligible to participate in the program and
clarifies payment rates and methodologies for those community
providers. VA previously issued a separate
proposed rule implementing urgent care provisions for
the new program. Comments on the proposed rule are due March 25.
CHA has submitted a
letter to the Centers for Medicare & Medicaid Services (CMS),
responding to its request for information on the
relationship between Medicare-approved accrediting organizations
(AOs), their consultative entities and the health care facilities
CHA has submitted
comments to the Department of Health and Human Services
Office for Civil Rights (OCR) in response to a
request for information about modifying Health Insurance
Portability and Accountability Act (HIPAA) privacy and security
The Centers for Medicare & Medicaid Services (CMS) and Centers
for Disease Control and Prevention have issued a
proposed rule that would update proficiency testing and
referral requirements under the Clinical Laboratory Improvement
The Centers for Medicare & Medicaid Services (CMS) has granted
exceptions under certain Medicare quality reporting, value-based
purchasing and payment programs to providers located in
Butte, Los Angeles and Ventura counties, which have all been
designated by the Federal Emergency Management Agency as major
disaster areas (DR-4407)
due to the impact of the California wildfires.
Last week, CHA sent a
letter to the Centers for Medicare & Medicaid Services (CMS)
outlining concerns about the use of Worksheet S-10 data in the
Medicare uncompensated care (UCC) payment distribution
methodology. CHA urged CMS to delay the current deadline for
cost report audits.
The Department of Veterans Affairs (VA) has proposed access
standards under the new Veterans Community Care Program, as
required by the MISSION Act of 2018. The VA also issued
rule that establishes a new benefit for veterans to access
urgent care services.
The Centers for Medicare & Medicaid Services (CMS) has issued
Part II of its 2020 Advance Notice of Methodological Changes
for Medicare Advantage (MA) Capitation Rates and Part D Payment
Policies and Draft Call letter. CMS proposes a 1.59 percent
increase to baseline Medicare Advantage payment rates for 2020.
The Centers for Medicare & Medicaid Services (CMS) has announced
Part D Payment Modernization model, available through the
Center for Medicare and Medicaid Innovation, for Part D and
Medicare Advantage (MA) drug plans beginning in January 2020.
Yesterday, CHA submitted
comments on the Office of the National Coordinator’s (ONC)
draft strategy to reduce regulatory and administrative burden
related to health information technology and electronic health
record (EHR) use.
The House of Representatives on Wednesday passed legislation
269) that includes the Pandemic and All-Hazards Preparedness
and Advancing Innovation Act. The measure reauthorized the
Hospital Preparedness Program (HPP) at an increased amount,
including reserving a percentage of HPP funds for the purpose of
developing regional health care emergency preparedness and
response systems. CHA supports the measure and is hopeful
that the Senate will act soon.
The Centers for Medicare & Medicaid Services (CMS)
Part I of its 2020 Advance Notice of Methodological Changes for
Medicare Advantage (MA) Capitation Rates and Part D Payment
Policies, including proposed updates to the risk adjustment model
for capitated payments for MA plans, as required by the
21st Century Cures Act.
CHA President & CEO Carmela Coyle co-authored an
opinion editorial earlier this week with Anthony Wright,
executive director of Health Access California, about the threat
to health care access posed by the proposed federal “public
charge” rule. The article was published in Capitol
Weekly, a news publication focused on public policy and
CHA has submitted a joint
comment letter responding to the Department of Health Care
Services’ (DHCS) draft All Plan Letter and Provider Bulletin that
address duplicate discounts within the 340B Drug Pricing Program.
Consistent with the administration’s commitment to reduce burden
under its Meaningful Measures Initiative, the Centers for
Medicare & Medicaid Services (CMS) has released a narrowed
list of 39 measures for future use in federal quality
reporting programs, the majority of which are clinician measures
under consideration for the Merit Based Incentive Payment System.
CHA has released
a summary — prepared by Health Policy Alternatives —
of the Centers for Medicare & Medicaid Services (CMS)
proposed rule revising Medicaid managed care and Children’s
Health Insurance Program (CHIP) regulations.
In an overwhelmingly positive development for California patients
and hospitals, this week the United Network for Organ Sharing
(UNOS) voted to change the way livers for transplantation are
This week, CHA and members of California’s transplant community
letter to the United Network for Organ Sharing (UNOS) board
concerning its upcoming decision on changes to liver