ALJs' independence threatened with new proposed rule.
You could have a much tougher time getting a fair shake at the administrative law judge level if a new proposed rule is finalized.
The Department of Health and Human Services wants to compel ALJs and the HHS Departmental Appeals Board to follow published guidance issued by HHS or its components--including the Centers for Medicare & Medicaid Services.
The proposed rule aims "to ensure that the final administrative decision of the Department reflects the considered opinion of the Secretary of Health and Human Services," according to a notice in the Dec. 28 Federal Register.
The rule "would permit the Secretary an opportunity to review DAB [and ALJ] decisions to correct errors in the application of law, or deviations from published guidance, in such disputes," the notice adds.
This is exactly the kind of interference providers feared when the ALJs transferred from the Social Security Administration to HHS, opponents say (see Eli's HCW, Vol. XIII, No. 36).
Speak out: HHS will take comments on the rule until Jan. 28. The rule is at
www.access.gpo.gov/su_docs/fedreg/a071228c.html --scroll down to HHS. • Providers in Boston, Chicago and their surrounding areas will be the first to participate in CMS' Post Acute Care Payment Reform Demonstration (PAC-PRD). The demo will pilot the CARE patient assessment tool across post-acute provider settings (see Eli's HCW, Vol. XVI, No. 33 for tool details).
The demo will eventually include 10 cities. Boston providers will begin training and data collection in March, while the remaining nine markets will begin on a staggered schedule between May and September. The other sites are Dallas; Lakeland/Tampa, FL; Lincoln, NE; Louisville, KY; Rapid City, SD; Rochester, NY; San Francisco; and Seattle/Tacoma, WA.
The PAC-PRD, mandated by Congress in the Deficit Reduction Act of 2005, will allow CMS to collect and compare information about the health of beneficiaries and the care or clinical services they received in various post-acute settings, including home health, according to the agency's news release.
To see the news release, go to
www.cms.hhs.gov/apps/media/press_releases.asp and scroll down to Dec. 19, 2007 and "CMS Announces Selection of Sites for Demonstration to Revise Post Acute Payment." • President Bush has signed into law the Medicare package Congress passed last month. On Dec. 29, the President approved S. 2499, the Medicare, Medicaid, and SCHIP Extension Act of 2007, which provides a 0.5 percent Medicare payment increase for physicians for six months and extends the State Children's Health Insurance Program (SCHIP) through March 31, 2009.
Home care providers have heralded the bill as a victory since it contained no additional cuts or rate freezes for them (see Eli's HCW, Vol. XVI, No. 44). Cuts for home health agencies, oxygen providers and wheelchair suppliers were all on [...]
