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CMS ISSUES RULES FOR NEW MEDICAID HOME/COMMUNITY CARE OPTIONS |
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 CMS issued a final rule implementing the Community First Choice Option. The Patient Protection and Affordable Care Act program will provide a 6 percentage point increase in federal Medicaid matching funds to states that provide home and attendant services to help low-income residents receive care in the community rather than a nursing home or institution.
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GROWTH IN ENROLLMENT, NOT COSTS, DRIVING MEDICARE/MEDICAID SPENDING |
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 Growth in enrollment, rather than spending per enrollee, will continue to drive Medicare and Medicaid spending growth as aging baby boomers enter Medicare and the Patient Protection and Affordable Care Act extends Medicaid coverage to more uninsured Americans, according to a new report from the Urban Institute.
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CMS RELEASES 2013 PAYMENT RULE FOR MEDICARE ADVANTAGE AND PRESCRIPTION DRUG PLANS – AFFECTS LONG TERM CARE |
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 The U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services (CMS) released the 2013 Final Rule and Rate Announcement/Final Call Letter for Medicare Advantage (MA, Part C) and Medicare Prescription Drug (Part D) plans per ACA (Sections 1101, 2602, 3301, 6005, 6405, 10328). Comments are due June 11, 2012. Highlights include:
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MEDPAC PROMOTES MORE FLEXIBLE PAYMENT SYSTEMS FOR FEE-FOR-SERVICE |
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 The Medicare Payment Advisory Commission (MedPAC) has found through an analysis of pilot projects what is already widely known - that the current fee-for-service model does not promote the teamwork and flexibility needed to coordinate care to improve patient outcomes.
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LAWMAKERS REQUEST MORE OVERSIGHT OF MEDICARE FROM CMS ON FRAUD AND ABUSE |
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 Senate Finance Committee members Orrin Hatch (R-UT) and Tom Coburn (R-OK) and House Ways and Means members Wally Herger (R-CA) and Charles Boustany (R-LA) sent a letter to acting CMS administrator, Marilyn Tavenner, requesting information on how CMS identifies “nominee owners” and “shell companies”. The letter cited a recent case in which an individual fraudulently billed over $20 million from Medicare.
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EARLY MARKET REFORM BY STATES ALREADY IN ACTION WITH OR WITHOUT PASSAGE OF ACCOUNTABLE CARE ACT |
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 Researchers found that between January 1, 2010, and January 1, 2012, 23 states and the District of Columbia had taken new legislative or regulatory action on at least one of more reforms, and an additional 26 states had taken other action to promote compliance with the reforms.
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CBO: MOST DEMONSTRATION PROJECTS DON’T CURB MEDICARE COSTS |
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 After reviewing the outcomes of 10 major Medicare demonstrations, the Congressional Budget Office has found most produced little or no savings to the federal health insurance program. The CBO reviewed six disease management and care coordination demos, and four-value based payment demos.
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CMS ANNOUNCES ADVANCE PRACTICE NURSING PROJECT |
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 Hospitals can apply through May 21 to partner with nursing schools and community-based care settings to train additional advance practice nursing students under the Graduate Nurse Education Demonstration, CMS announced.
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Healthcare Reform 
HHS posted and seeks comments on its updated National Action Plan that addresses health care associated infections:
