On August 5, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a “frequently asked question” (FAQ) on income verification requirements for individuals who apply for federal affordability programs (including advance payments of the premium tax credit and cost-sharing reductions) through the state-based exchanges. [More]
On August 2, 2013, the Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1599-F) updating FY 2014 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital Prospective Payment System (LTCH-PPS). [More]
On August 12, 2013, the California Supreme Court unanimously ruled that trained unlicensed school personnel may administer insulin shots to students with diabetes when a school nurse is not available. The ruling overturns two lower court decisions that held that California law only allows a licensed school nurse to administer the shots, a position that was strongly advocated by the American Nurses Association. According to an August 12 Education Week article, 14,000 students in California public schools suffer from diabetes and that, overall, the State has only one nurse per 2,200 students; sixty-nine percent of schools have only a part-time nurse and 26 percent have no nurse at all. [More]
On August 7, 2013 legislation titled “Promoting Adoption and Permanency for Children in Foster Care Act” was introduced to reauthorize and restructure the adoption incentive program. Since 1998, more that $375 million has been distributed to states that have exceeded their adoptive placements from the year that the data was based. The Adoption Incentive Program was part of the implementing legislation of the Adoption and Safe Families Act of 1997 and has been reauthorized twice – in 2003, as part of the Adoption Promotion Act of 2003, and most recently, as part of the Fostering Connections and Increasing Adoptions Act of 2008. Congress must act on reauthorization of the Adoption Incentive Program prior to September 30, 2013 to ensure that the program continues. [More]
In an August 6, 2013 press release, the U.S. Department of Education (ED) announced the approval of a No Child Left Behind ACT (NCLB) waiver for a coalition of eight of California’s largest school districts, making it the first district-level waiver. The coalition, called the California Office to Reform Education (CORE), serves more than one million California students. CORE formed and submitted a joint request for a waiver after the State’s 2012 request was denied and the State elected not to apply for a waiver for the 2013-2014 school year. [More]
On July 31, 2013, CMS issued a final rule for FY 2014 Medicare payment for skilled nursing facilities (SNFs) that includes a 1.3% increase, or $470 million, relative to payments in FY 2013. The increase reflects a 2.3% market basket update, reduced by a 0.5 percentage point forecast error correction and a 0.5 percentage point multifactor productivity adjustment required by law.
The final rule, which was published in the August 6 Federal Register, also rebases and revises the FY 2014 SNF market basket, used to update the SNF prospective payment system annually to reflect data from FY 2010 instead of 2004.
A link to the final rule may be accessed at https://www.federalregister.gov/public-inspection [More]
On August 2, 2013, DHHS posted state-by state data on Affordable Care Act (ACA) benefits, including the percentage of individuals who will be eligible in each state to purchase health insurance coverage through the new exchanges.
For each state, the posting describes the percentage of uninsured who may be eligible for premium tax credits or expanded Medicaid coverage, the number of residents who will benefit from rebates under the ACA’s medical loss ratio, and how much was awarded to fund community health centers, among other details.
The Centers for Medicare and Medicaid Services (CMS) released a bulletin on July 24, 2013 that includes six excellent case studies on innovative care delivery and payment models pioneered in North Carolina, Maine, Vermont, Oregon, Michigan, and Minnesota for Medicaid beneficiaries with complex health needs and a history of costly, episodic care. CMS indicates that five percent of Medicaid beneficiaries currently account for 54 percent of total Medicaid expenditures and one percent of Medicaid beneficiaries account for 25 percent of total Medicaid expenditures. Among that top one percent, 83 percent have at least three chronic conditions and more than 60 percent have five or more chronic conditions. [More]
On July 29, 2013, Desert Trails Preparatory Academy in Adelanto, California became the first school in the nation to open under a “parent trigger” law. According to a July 31 LA Times article, Adelanto parents successfully used California’s parent trigger law to petition the Adelanto School District board to turn over management of the chronically failing Desert Trails Elementary School to the LaVerne Elementary Preparatory Academy, a charter school affiliated with the University of La Verne. Under the 2010 California law, parents representing at least 50 percent of the students at a low-performing school can petition to force out school staff, convert to a publicly funded charter, or close the campus; the Adelanto parents initially represented 70 percent of Desert Trails students. Still, it took two years of dissention and court battles for the petitioning parents to achieve their goal. [More]
On July 23, 2013, the administration of New York Governor Andrew M. Cuomo agreed on a plan to give approximately 4,000 mentally ill institutionalized people the opportunity to move into their own subsidized apartments. The agreement is expected to end a contentious legal battle over the care for such patients that has lasted for a decade. [More]