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Call for comments on CMS Draft Measure Development Plan.

In December, CMS released its draft Quality Measure Development Plan (MDP), which outlines its strategic framework for the future of clinician quality measure development to support the transition to the Merit-Based Incentive Payment System (MIPS) and Alternative Payment Models (APMs). In addition to laying out measure development priorities and operational requirements, the MDP also identifies 7 core challenges facing the agency in its quality measure development efforts. These include:
1. Engaging patients in the measure development process
2. Reducing provider burden of data collection for measure reporting
3. Shortening the time frame for measure development
4. Streamlining data acquisition for measure testing
5. Identifying and developing meaningful outcome measures
6. Developing PROMs and appropriate use measures
7. Developing measures that promote shared accountability across settings and providers

CMS is accepting comments on the draft MDP through March 1, 2016. NRHI has prepared a draft comment letter, attached for member review and feedback. We encourage members to review the draft comment letter and provide feedback to us by next Friday, February 25. In particular, we would like to hear your feedback on ways your organizations have overcome some of the challenges outlined by CMS above. Your input will help us make the case that NRHI members should be part of the solution.

SAMHSA proposes updates to rules governing privacy of substance abuse records.

The Substance Abuse and Mental Health Services Administration (SAMHSA) this week released a proposed rule updating rules governing how substance abuse data can be shared. The last substantive update to these regulations was in 1987. SAMHSA said it intends to align the regulation with the digital age and decrease compliance burdens. Under the rule, patients can provide a blanket viewing allowance to their providers through a single consent form, but would have a right to ask who accessed the data pursuant to that consent. In addition, the proposal would provide researchers more access to Medicare claims data describing patients with mental health or substance abuse disorders, and enable linkages to other data sets. SAMHSA is inviting comments on the proposed rule, which are due by April 11, 2016.

Senate HELP Committee approves first round of innovation bills.

On Tuesday, February 9, 2016, the Senate Health, Education, Labor and Pensions (HELP) Committee passed seven bills without amendment, as part of its piecemeal effort to produce companion legislation to the House-passed 21st Century Cures Act. The bills approved all had bipartisan support and were designed to prompt medical innovation. One bill, S. 2511, The Improving Health Information Technology Act, was hailed by Chairman Lamar Alexander (R-TX) as some of the most important work the Committee has done. The legislation aims to decrease the regulatory and administrative burden on eligible providers that participate in the meaningful use program. The bill also aims to increase health IT certification transparency and put an end to information blocking. Additionally, the legislation establishes a definition of interoperability as “the ability to securely exchange electronic health information with and use electronic health information from other health information technology without special effort on the part of the user.” The Committee is expected to hold its next round of innovation-focused mark-ups on March 9, but partisan stand-offs on funding for the NIH and FDA could delay further progress.

Lawmakers develop proposals to require device identifiers.

Lawmakers in both the House and Senate are reportedly drafting legislative proposals that would require insurance forms to include the unique identifying numbers of each medical device used by a patient. The measure, which could be included as part of the larger health innovation package being considered by the Senate HELP Committee, is designed to prevent situations like the duodenoscope-related infection of 68 patients with antibiotic-resistant bacteria. Last year, the Office of the National Coordinator for Health IT said it would require unique device
identifiers in a patient’s electronic health record starting in 2018 as part of the meaningful use program. But CMS, as well as device makers and the American Hospital Association, have been reluctant to also require UDIs in insurance claim forms, depicting such a requirement as costly and burdensome.

White House proposes new bonus payments for hospitals that “cooperate” with APMs.

Tucked into the president’s FY 2017 budget, released last week, is a proposal to “establish a bonus payment for hospitals cooperating with certain alternative payment models.” Under the proposal, hospitals that furnish a sufficient proportion of their services through “eligible alternative payment entities” will receive bonus payments starting in 2022, similar to how the Medicare Access and CHIP Reauthorization Act rewarded physicians who participate in alternative payment models. The hospital bonuses would be paid through the inpatient prospective payment system permanently, and through the outpatient system through 2024, according to HHS. The administration would pay for the bonus payment by reducing inpatient and outpatient payments to all providers. While the budget is dead on arrival in Congress (the House is breaking 40 years of tradition and not even holding hearings on this budget), it is a perennial source of policy ideas and shapes the policy debate.