On the Regulatory Radar Screen

CMS proposed rule on long term care hospital PPS for FY 2009

Issued Jan. 22; Effective July 1.   

CMS proposed rule on inpatient PPS changes for FY 2009

Released April 14; Published April 30; Effective Oct. 1.

CMS proposed rule on inpatient rehabilitation PPS for FY 2009.

Released April 21; Effective Oct. 1.

CMS proposed rule on skilled nursing facility PPS for FY 2009.

Expected May; Effective Oct. 1. 

CMS final rule on long term care hospital PPS for FY 2009

Expected May; Effective July 1.

National rollout of Medicare Recovery Audit Contractor program.

Expected implementation in Spring 2008.

CMS final rule to revise current rules
governing Medicaid provider taxes.

Published Feb. 22, 2008. Effective April 22, 2008.

CMS proposed rule to eliminate federal funding of  Medicaid GME.

Published May 23, 2007; final rule is subject to the one-year moratorium and cannot be issued before May 25, 2008.

CMS final rule changing how states raise Medicaid matching funds through IGTs, CPEs, and UPLs.

Published May 29, 2007; One-year moratorium on implementation through May 25, 2008.

CMS final rule on Medicaid Drug Rebate program that requires state Medicaid programs to use national drug codes for Medicaid hospital outpatient services

Published July 17, 2007; Effective Jan. 1, 2008. Many state Medicaid programs have requested and were granted delays in implementation.

CMS proposed rule to narrow definition of Medicaid hospital outpatient services

Published Sept. 27, 2007. Awaiting final rule.

HRSA proposed rule with changes to the 340B program's contract pharmacy service guidelines

Published Jan. 12, 2007; Effective upon release of final rule

HRSA proposed rule on clarifications to the definition of "patient" for the 340B drug rebate program

Published Jan. 12, 2007; Effective upon release of final rule

HRSA proposed rule changes designation of medically underserved and health professional shortage areas

Published Feb. 29, 2008: Comments accepted until May 29, 2008

IRS released draft instructions and worksheets for Form 990, Schedule H and other schedules tax-exempt hospitals must file, including J on executive compensation

Released April 7, 2008, Comments Due June 1, 2008.  In tax year 2008, hospitals must complete only "Part V Facility Information" on Schedule H, as the remaining sections are not due until tax year 2009.

HOT TOPIC

HOT TOPIC

AHA seeks improvements in IRS' Schedule H form .

The Internal Revenue Service (IRS) on April 7 released for public comment draft instructions and worksheets for Form 990, Schedule H and other schedules tax-exempt hospitals must file, including Schedule J on executive compensation. In tax year 2008, hospitals only are required to complete "Part V Facility Information" on Schedule H, but must complete the entire schedule for tax year 2009.

The IRS last December released the final Form 990 and new Schedule H which allows hospitals to report Medicare underpayment and patient bad debt, and restores community building programs as a reportable benefit. The draft instructions and worksheets are supposed to help tax-exempt hospitals understand the questions and respond accordingly.

Included with the draft instructions are "highlights" designating items on which IRS is particularly interested in receiving comments. In addition to general and line-by-line instructions that are organized according to a consistent format, the draft instructions include a glossary of terms and various lists, tables and examples to help organizations complete Form 990.

"While the IRS clarified a number of issues in the draft instructions [for Schedule H]," the AHA said in an April 15 member advisory, "some parts need to be improved to reflect the accounting and payment complexities in the field. In addition, more examples should be added to increase comparability in the data collected and to reduce misunderstandings. The required facility information appears to be overly broad and its value to IRS, in the context of Schedule H, is not readily apparent."

Click here to view the advisory. The IRS will accept comments on the draft instructions and worksheets

Blocking CMS' Medicaid regulations

On May 25, the yearlong congressional moratorium preventing harmful Medicaid regulations from taking effect will expire. For more than two years, the AHA and hospitals across the country have opposed the Centers for Medicare & Medicaid Services' (CMS) efforts to carry out regulations restricting how states fund their Medicaid programs and pay public hospitals - through changes in the treatment of certified public expenditures and intergovernmental transfers - and eliminating federal support for graduate medical education. The regulations will cut more than $5 billion in hospitals' Medicaid funding over five years, unless Congress intervenes by extending the current moratorium. Blocking the Medicaid rules from taking effect next month is a top advocacy issue for the AHA. The AHA's efforts took a major step forward last week with House passage of the "Protecting the Medicaid Safety Net Act," H.R. 5613, which would extend the current moratorium on these Medicaid rules through next April. (See our story on page 1.) The bill also would delay implementation of several other Medicaid regulations.

The AHA has argued that hospitals will feel the impact of CMS' planned Medicaid cuts and patients will suffer. The AHA, a broad array of health care providers, governors, and consumer and education groups had pressed the House to take action to block all of these regulations, which are estimated to cut Medicaid funding by $20 billion over five years. The House responded by overwhemingly approving H.R. 5613. With last week's success, the scene now shifts to the Senate, and building support for passage of similar legislation before CMS' rules take effect.