What’s Ahead: This Week

Notable Policy Events

  • Monday, December 19 – Tuesday, December 20
    • HHS, Panel of the Technical Advisory Panel on Medicare Trustee Reports. Additional information: http://bit.ly/2hCtS6B
  • Tuesday, December 20
    • Commonwealth Fund, “
    • eHealth Initiative, “Current State of Progress Towards Achieving True Interoperability.” Additional information: http://bit.ly/2hCx5Ts

Weekly Wrap Up: Notable Health Care Developments From Last Week

ACA Implementation

  • On December 14, CMS released an update to its biweekly enrollment snapshot, announcing that over 4 million people have selected Marketplace plans using Healthcare.gov since open enrollment began on November 1, including over 1.1 million new consumers. Press release: http://go.cms.gov/2hCDYUL
  • On December 13, HHS Assistant Secretary for Planning and Evaluation (ASPE) released a compilation of national and state-level data on the ACA’s impact on coverage. Press release: http://bit.ly/2hCIwdK Link to data: http://bit.ly/2hCKTxf
  • On December 12, HHS released a report finding that 125,000 fewer patients died due to hospital-acquired conditions and more than $28 billion in health care costs were saved from 2010 through 2015. Press release: http://bit.ly/2hCW3SY Report: http://bit.ly/2hCRVSX


  • On December 12, CMS released a bulletin providing guidance on a temporary manual adjustment to the January and February 2017 policy-based payments to issuers. Bulletin: http://go.cms.gov/2hCSBYh
  • On December 12, CMS announced that it will begin a pilot for pre-enrollment verification in all states served by Healthcare.gov in June 2017. Fact sheet: http://go.cms.gov/2hCMVOd


  • On December 14, CMS announced the launch of two new compare websites for Inpatient Rehabilitation Facilities (IRFs) and Long-Term Care Hospitals (LTCH). Fact sheets for IRF and LTCH: http://go.cms.gov/2hCpXq6 and http://go.cms.gov/2hCrHzZ
  • On December 15, CMS announced additional opportunities for clinicians to join Advanced Alternative Payment Models (APMs) XXXXX Press release: http://go.cms.gov/2hCAOAI
  • On December 12, CMS released an interim final rule with comment (IFR) amending Medicare’s dialysis facility Patient Rights Conditions for Coverage to improve disclosure requirements and to improve transparency around third-party premium payments. Comments are due by XXX. Fact sheet: http://go.cms.gov/2hCR2JU IFR: http://bit.ly/2hD2rt5


  • On December 13, CMS released a bulletin highlighting steps Medicaid agencies can take to strengthen program integrity in the provision of personal care services. Bulletin: http://bit.ly/2hCZtVH
  • On December 14, CMS released an informational bulletin summarizing provisions relevant to American Indian services in the final Medicaid and CHIP managed care regulation. Bulletin: http://bit.ly/2hCSMmD
  • On December 15, CMS released a document providing responses to frequently asked questions (FAQ) regarding Medicaid beneficiaries in home and community-based settings who exhibit unsafe wandering or exit-seeking behavior. FAQ: http://bit.ly/2hCT399

New Payment and Delivery System Models

  • On December 15, CMS announced a new Medicare-Medicaid Accountable Care Organization (ACO) model that builds on the current Medicare Shared Savings Program to promote care coordination for beneficiaries enrolled in both Medicare and Medicaid. Letters of intent are due by January 20. Press release: http://go.cms.gov/2hCxpSs Fact sheet: http://go.cms.gov/2hCF1UL
  • Also on December 15, CMS announced a second round of solicitations for payers and practices to participate in the Comprehensive Primary Care Plus (CPC+) Model for the 2018 performance year. Proposals from new payers will be due in mid-February and practices in new regions will be able to apply starting in late spring. Fact sheet: http://go.cms.gov/2hCtIvI

Health IT

Zika Virus

  • On December 14, CDC released updated Zika data, indicating that there are now 4,617 and 34,628 cases of the virus in the states and territories, respectively. Data: http://bit.ly/2cddcRi
  • On December 15, HHS Health Resources and Services Administration (HRSA) announced the award of $17 million to health departments in Puerto Rico, the U.S. Virgin Islands, and American Samoa to provide access to care for children and families affected by the Zika virus. Press release: http://bit.ly/2hCZPeP
  • On December 13, Centers for Disease Control and Prevention (CDC) announced evidence showing that the Zika virus persisted in fetuses for more than seven months after the mothers contracted Zika and that it can continue to replicate in infants’ brains after birth. Press release: http://bit.ly/2hCQIej


  • On December 14, HHS issued a final rule restricting states from withholding federal Title X funding for family planning services. Press release: http://bit.ly/2hCEgLA Final rule: http://bit.ly/2hCEoe2
  • On December 15, HHS announced over $50 million in funding for 75 community-based and patient-directed health centers in 23 states, Puerto Rico, and the Federated State of Micronesia. Press release: http://bit.ly/2hCFfLP