Riker Danzig Health Care Update October 21, 2019
New Jersey State: Selected Adopted Legislation
- S.4089 – Proposed – This bill permits long-term care facility personnel to assist residents with mail-in ballot; exempts long-term care facility employees from three ballot limit. For the complete statute, click here.
- S. 4111 – Proposed – This bill extends the length of time of postpartum comprehensive Medicaid coverage to a 180-day period for pregnant women who are eligible, beginning on the last day of pregnancy. Currently, the comprehensive Medicaid coverage for this population is a 60-day period, beginning on the last day of the pregnancy. For the complete statute, click here.
- S. 4112 – Proposed – This bill makes it possible for general hospitals to choose the manner in which staff names are displayed on identification badges worn by student nurses, nurses, and other facility staff. The motivation behind the proposal is to enable hospitals with an avenue to protect the personal information of their staff in the event that a patient files a complaint against a particular staff member or a student nurse, or seeks to identify the staff member or nurse on social media platforms. For the complete statute, click here.
New Jersey State: Selected Proposed Regulations
- 51 N.J.R. 1359 (a) – Adopted – The new rules set forth the manner in which the New Jersey Medicaid/NJ FamilyCare programs will provide covered health services to eligible persons through the Managed Care program, by means of managed care organizations (MCOs). The new rule also affects Medicaid/NJ FamilyCare providers, including managed care entities and those providers who will continue to provide certain services on a fee-for-service basis to beneficiaries who are also enrolled in managed care. For the complete adopted rule, click here.
- 51 N.J.R. 1249(a) – Proposed – This rule amends the curriculum requirements for licensure and continuing education requirements for electrologists. Comments are due by October 5, 2019. For the complete proposed rule, click here.
- 51 N.J.R. 1312 (a) – Proposed – This establishes standards to which hospices that elect to accept and dispose of surrendered prescription medications must adhere. Comments are due by October 18, 2019. For the complete proposed rule, click here.
Federal: Selected Proposed and Enacted Legislation
- S. 2543 – Proposed – This proposed bill intends to lower prescription drug prices in the Medicare and Medicaid programs, to improve transparency related to pharmaceutical prices and transactions, to lower patients' out-of-pocket costs, and to ensure accountability to taxpayers. For the complete statute, click here.
- H.R. 3 – Proposed – This establishes a fair price negotiation program, protects the Medicare program from excessive price increases, and establishes an out-of-pocket maximum for Medicare part D enrollees, and along with other purposes. For the complete statute, click here.
- H.R. 2296 – Proposed – This is another proposal to attempt to require manufacturers to report certain drug price increases. For the complete statute, click here.
- H.R. 4223 – Proposed – This is another attempt to address balance billing. In this bill, a facility cannot balance bill a patient for covered non-emergency services if the services are provided at an in-network facility and the participant or beneficiary did not have the ability or opportunity to select to receive such services from an in-network provider. Otherwise, the bill is geared toward addressing balance billing in self-insured plans. For the complete proposed statute, click here.
Federal: Selected Adopted and Proposed Regulations
- 84 FR 47794 – Final with Comment Period – This final rule with comment period implements statutory provisions that require Medicare, Medicaid, and Children's Health Insurance Program (CHIP) providers and suppliers to disclose certain current and previous affiliations with other providers and suppliers. It also provides, among other things, the agency with additional authority to deny or revoke a provider's or supplier's Medicare enrollment in certain specified circumstances. Comments are due by November 4, 2019 and the rule becomes final on November 4, 2019. For the complete final rule with comment period, click here.
- 84 FR 50308-01 – Final Rule – This final rule provides $4 billion in state Medicaid disproportionate-share hospital (DSH) cuts for 2020 and includes further cuts totaling $8 billion through 2025. DSH funds are reserved for safety-net hospitals, which serve a large share of low-income patients, Medicaid and uninsured patients to give them more financial flexibility. These cuts were long in the making. In 2013, CMS finalized a DSH Health Reform Methodology (DHRM), to implement annual allotment reductions that would have been in place only for FY 2014 and FY 2015. Prior to the implementation of allotment reductions, legislation was signed into law delaying the start of the reductions. Subsequent legislation further delayed the start of these reductions. Under current law, annual allotment reductions start in FY 2020 and run through FY 2025. In this final rule, CMS is finalizing the DHRM as proposed, with limited exceptions. This regulation is effective on November 25, 2019. For the complete rule, click here.
- 84 FR 51732 – Final Rule – This final rule reforms Medicare regulations that are identified as unnecessary, obsolete, or excessively burdensome on health care providers and suppliers. Additionally, this rule updates fire safety standards for Medicare and Medicaid participating End-Stage Renal Disease (ESRD) facilities by adopting the 2012 edition of the Life Safety Code and the 2012 edition of the Health Care Facilities Code. Finally, this final rule updates the requirements that hospitals and Critical Access Hospitals (CAHs) must meet to participate in the Medicare and Medicaid programs. For example, the final rule updates the requirements for hospitals and CAHs to have infection prevention and control and antibiotic stewardship programs that are not only active and facility-wide, but which also demonstrate adherence to nationally recognized guidelines. This rule is effective on November 29, 2019. For the complete rule, click here.
- 84 FR 51836 – Final Rule – This final rule empowers patients to be active participants in the discharge planning process and complements efforts around interoperability, i.e., the exchange of patient information between health care settings by revising the discharge planning requirements that Hospitals (including Short-Term Acute-Care Hospitals, Long-Term Care Hospitals, Rehabilitation Hospitals, Psychiatric Hospitals, Children's Hospitals, and Cancer Hospitals), Critical Access Hospitals, and Home Health Agencies must meet to participate in the Medicare and Medicaid programs. This final rule also implements discharge planning requirements which will give patients and their families access to information that will help them to make informed decisions about their post-acute care to avoid being re-hospitalized. This rule is effective on November 29, 2019. For the complete rule, click here.
- 84 FR 46688 – Proposed – This proposed rule amends the list of bulk drug substances (active pharmaceutical ingredients) that can be used to compound drug products in accordance with certain compounding provisions of the Federal Food, Drug, and Cosmetic Act (FD&C Act). It adds five additional bulk drug substances on the list. Comments are due by December 4, 2019. For the complete proposed rule, click here.
The list above does not include every proposed or adopted legislation, litigation or guidance document that may impact the health care industry. Instead, it includes only a select few chosen by the authors, and any information in this Update is not intended to provide legal advice. If you are concerned that a proposed or adopted legislation, litigation or guidance document may impact your practice, then you should seek legal advice. We send these Updates to our clients and friends to share our insights on new developments in the law. Nothing in this Update should be relied upon as legal advice in any particular matter. © 2019 Riker Danzig Scherer Hyland & Perretti LLP.