Federal register

Healthcare Financial Management, Feb, 2006

... The FY07 federal medical assistance percentages and enhanced federal medical assistance percentages were published in the Nov. 30, 2005, Federal Register. They are used to determine the amount of federal matching funds for medical services under Medicaid and state children's health insurance programs.

... CMS has adopted as final (Federal Register, Dec. 13, 2005) the process described in a Dec. 13, 2002, interim final rule regarding establishing realistic anD equitable payment amounts for Medicare Part B services when existing payment amounts are inherently unrealistic Because they are either grossly excessive or grossly deficient. The rule does not apply to physician services, or those paid under a prospective payment system.

Under this final rule, a payment amount will not Be considered grossly excessive or deficient if it is determined that an overall payment adjustment of less than 15 percent is necessary to produce a realistic and equitable payment amount.

... In a final rule (Federal Register, Dec. 30, 2005), the Social Security Administration described the process for determining when and how beneficiaries can get a subsidy to help with their Medicare drug benefit premium and cost sharing. Those wanting to receive the subsidy must file an application, have a determination of eligibility made, and enroll with an authorized Medicare Part D prescription drug provider. However, Medicare beneficiaries covered by Medicaid, who are enrolled in a Medicare savings program with their state, or who receive supplemental security income, are automatically eligible for the subsidy and do not need to apply.

... CMS has published a new interim final rule (Federal Register, Dec. 23, 2005) requiring state agencies and CMS Outcome and Assessment Information Set contractors to maintain OASIS databases according to CMS's specifications, and establishing requirements for the release of individual patient data to ensure the confidentiality of this information. The final rule becomes effective June 21.

HFMA staff review the Federal Register daily for information that affects healthcare financial managers, and post links to the Federal Register on HFMA's web site (www.hfma.org/members_only/federal_register.cfm).