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July 26, 2019 News Headlines

Doctor CVS is in the house: How CVS’ latest moves are changing healthcare delivery

CVS is no longer just the pharmacy in your neighborhood. It increasingly serves as a primary care provider and has launched initiatives related to chronic disease care and social services.

Read our latest blog post to learn more about CVS’ evolving role in an ever-changing healthcare delivery system.

Congress poised to pass two-year budget and debt limit deal

Prior to breaking for a six-week recess, the House of Representatives passed a two-year budget deal on Thursday that lifts defense and non-defense discretionary spending caps for federal fiscal years 2020 and 2021 and suspends the nation’s debt limit through July 2021. The Senate is expected to take up and pass the package next week before adjourning for the August recess. President Trump has indicated his intent to sign the legislation into law.  

The new budget framework provides much-needed breathing room and a framework for spending levels for lawmakers as they look to fund federal agencies in the coming fiscal year beginning Oct. 1.

HANYS is disappointed that the agreement is partially offset by a two-year extension of the across-the-board sequestration cuts, which includes the 2% Medicare sequestration cut into 2029. This will result in a $640 million reduction to New York hospitals. However, the deal eliminates significant threats associated with addressing the budget and debt limit wherein hospitals and health systems risked even deeper payment cuts, such as additional site-neutral payments. Contact: Elyse Oveson

Bipartisan bill to address social determinants of health introduced in House

The Social Determinants Accelerator Act of 2019, bipartisan legislation introduced in the House of Representatives this week, seeks to improve health outcomes by addressing social determinants of health. Specifically, the bill would establish a federal grant program to empower states and local governments to tackle persistent economic and social conditions, such as limited access to healthcare providers, stable housing, reliable transportation and healthy foods, that often hinder health outcomes. A one-pager and section-by-section review of the bill is available online.

Hospitals and health systems across New York are increasingly deploying SDH strategies to help manage costs and improve health outcomes. HANYS supports the legislation and is encouraging members of the New York delegation to sign on as cosponsors. Contact: Elyse Oveson

HHS reduces Medicare appeals backlog by 19.4%

According to new court documents, the Department of Health and Human Services has reduced the Medicare appeals backlog by 19.4%.

The American Hospital Association and its plaintiff hospitals had filed suit to require HHS to take affirmative steps to reduce the existing backlog. On Nov. 1, 2018, the United States District Court for the District of Columbia ordered HHS to reduce the existing backlog of Medicare appeals by 19% by the end of FFY 2019.

From Nov. 2018 through the end of the second quarter of 2019, HHS reported a net reduction of 82,936 appeals pending at the Office of Medicare Hearings and Appeals, bringing the total number of appeals to 343,658. This puts HHS ahead of schedule. HHS is required to meet a reduction of 49% by end of FFY 2020, 75% by the end of FFY 2021 and elimination of the Medicare appeals backlog by the end of FFY 2022. Contact: Melanie Graham

Federal court upholds Trump administration rule on short-term plans

A Washington, D.C., federal court upheld the Trump administration’s regulations extending existing 90-day short-term limited duration plans to 364 days (and with renewals, up to three years). While these short-term plans often cost less, they are exempt from the ACA’s coverage requirements and can deny coverage based on pre-existing conditions. The plaintiffs failed to demonstrate that extending short-term plans would incentivize healthy individuals to leave the ACA’s existing health exchanges and drive up premiums for others. The Court also rejected arguments that the regulations would irreparably harm patient care and access to coverage. Plaintiffs have already indicated plans to appeal. The New York State Department of Financial Services has confirmed that state law prohibits STLD plans in the individual and group health insurance markets, regardless of federal regulatory changes. Contact: Cristina Batt

Innovation Spotlight – Saratoga Hospital fights sepsis mortality

Early signs of sepsis are difficult to identify and usually begin in patients before arriving at the hospital. This is especially problematic as early detection and aggressive treatment are essential to fighting sepsis mortality. To combat sepsis, Saratoga Hospital began an internal awareness campaign that has matured into a comprehensive, collaborative and structured program.

To learn more about this initiative and its results, read our full story.

This story is just one of the many initiatives profiled on HANYS' Member Innovation Spotlight website that demonstrate how New York healthcare providers are improving population health, enhancing the quality of patient care and reducing the cost of healthcare despite fiscal constraints.