OMB review could lock-in ACO rule; Long-term care providers say health law doesn't help with their problems

May 20 2011

News outlets report on aspects of the health law.

Politico Pro: OMB Review May Lock CMS Into ACO Rule
If there's a fight between CMS and the Office of Management and Budget over the final shape of the accountable care organization regulations, OMB may have an ace in its pocket. It's called the mid-session review, an update of the budget projections that the administration is required to submit to Congress by July 15. If OMB includes the $510 million in savings that the proposed rule estimates will come from the first three years of the ACO program in the new baseline, it could make it very difficult for CMS to make any changes to the rule that reduce the amount of savings (Feder, 5/19).

California Healthline: Why Nursing Homes Want To Waive Goodbye to Reform Law
Few doubt that long-term care providers face considerable challenges, partly because their patients have so many health care needs. Poor, elderly patients who are eligible for both Medicaid and Medicare require particularly expensive care. ... The Patient Protection and Affordable Care Act includes a number of reforms intended to improve long-term care ... [y]et long-term care operators say that health reform has yet to make a dent in their problems. They also warn that their facilities are strapped by low Medicaid reimbursement (Diamond, 5/18).

Modern Healthcare: Report Urges Steps To Limit Enrollee 'Churn' Among Coverage Options
To minimize "churn" between various health coverage programs that begin in 2014 under federal health reform, policy experts are recommending steps to smooth enrollment for families and limit administration burdens. The Commonwealth Fund, in a report, suggests making coverage choices valid for one full year instead of requiring changes if incomes fluctuate, for instance. The New York-based foundation also recommends requiring the Internal Revenue Service to send alerts to taxpayers when income changes alter their eligibility for coverage subsidies. Putting both individuals and small businesses into a single health insurance exchange in each state could also help transition people between coverage choices, according to the group (Vesely, 5/19).