Updates & Analysis

On February 9th, President Barack Obama released his FY 2017 Budget proposal. The document sets forth recommendations for federal spending in the coming year, but has no force of law. The $4.1 trillion Budget is projected to reduce the deficit by $2.9 trillion, including $375 billion in health care savings, over the next ten years.…

As you know, the DSRIP program now has multiple funding streams flowing to providers. In addition to a PPS’s net project valuation, providers can also potentially receive money from the Equity Infrastructure Program, the Equity Performance Program, the High Performance Pool, the Additional High Performance Pool, and the Value-Based Payment Quality Improvement Program. In an…

On January 28th, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would refine the methodologies used for resetting benchmarks for accountable care organizations (ACOs) that continue to participate in the Medicare Shared Savings Program (MSSP) after their initial agreement period. CMS will accept comments until March 28th. This document summarizes…

On January 27th, the Centers for Medicare and Medicaid Services (CMS) issued a final rule on the Medicaid program’s face-to-face requirements for home health services and medical equipment. The rule does not apply to Medicaid managed care.  The attached document summarizes several major provisions of the final rule. The provisions will become effective on July…

On January 5th, the Centers for Medicare and Medicaid Services (CMS) announced $157 million in funding for a new Center for Medicare and Medicaid Innovation (CMMI) initiative, the Accountable Health Communities (AHC) Model. The five-year grant program will allow up to 44 award recipients to test approaches for identifying and addressing the unmet health-related social…

The Dormitory Authority of the State of New York (DASNY) has released an amended Request for Applications (RFA), available here, and a Q&A document, available here, for the Nonprofit Infrastructure Capital Investment Program (NICIP). Some important amendments include the following provisions:  Applications are now due January 29, 2016. Additional questions on amended provisions may be…

On December 4th, the New York State Office of Mental Health, Office of Alcoholism and Substance Abuse, and Department of Health released an application to become designated as a Certified Community Behavioral Health Clinic (CCBHCs). This application is part of a one-year planning grant awarded to New York State by the Substance Abuse and Mental…

The New York Office of Mental Health (OMH) has released a Request for Proposals (RFP), available here, for a Non-Profit Behavioral Health and Developmental Disability Providers Health Information Technology (BH-DD HIT) program. The BH-DD HIT program will provide $10 million in one-time funding to help providers acquire technology systems and for other infrastructure costs associated…

On November 20th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule on benefit and payment parameters for benefit year 2017. Key provisions of the proposed rule would include modifications to payment parameters, network adequacy requirements, the Small Business Health Options Program, and the re-enrollment process for coverage purchased through the federal…

On November 16th, the Centers for Medicare and Medicaid Services (CMS) issued a final rule to establish the Comprehensive Care for Joint Replacement (CJR) Model to test mandatory retrospective bundled Medicare payments for hip and knee replacements, referred to as lower extremity joint replacements (LEJRs). The first performance year (PY) for the five-year model will…

On October 29th, the Centers for Medicare and Medicaid Services (CMS) issued a proposed rule on discharge planning requirements for hospitals, long-term care hospitals, inpatient rehabilitation facilities, critical access hospitals, and home health agencies. The proposed rule implements the discharge planning requirements of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act of 2014. The attached…

On October 30th, the Centers for Medicare and Medicaid Services (CMS) issued a final rule for the Calendar Year (CY) 2016 Medicare Physician Fee Schedule (PFS). The final rule includes modifications to existing physician quality reporting programs including the Physician Quality Reporting System (PQRS) and the Physician Value-Based Payment Modifier (Value Modifier). The final rule…