Heart of Health Policy

What You Should Know: Proposed Inpatient Prospective Payment Rule
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The Centers for Medicare and Medicaid Services (CMS) has released the FY 2022 proposed Inpatient Prospective Payment (IPPS) rule. The ACC Advocacy Team is currently reviewing the rule in depth, but in the meantime, highlights from the proposed rule include:

  • Creation of a "New COVID-19 Treatments Add-on Payment" (NCTAP) for eligible discharges during the public health emergency (PHE).
  • Adoption of the COVID-19 Vaccination Coverage Among Health Care Personnel (HCP) measure, beginning with a shortened reporting period from Oct. 1 through Dec. 31, affecting the CY 2021 reporting period/FY 2023 payment determination and for subsequent years.
  • Proposed updates to the Promoting Interoperability Program, including a 180 continuous day period starting in FY 2024 and new attestations on the Health Information Exchange (HIE) bi-directional exchange measure and four of the existing Public Health and Clinical Data Exchange Objective measures.
  • An announcement to move fully to digital quality measurement in CMS quality reporting and value-based purchasing programs by 2025 – CMS seeks information on the move to digital quality measures (dQMs) including feedback on definitions and standards for digital quality measurement.
  • Review of MS-DRG assignments, including LAAC and surgical ablation, among others.
  • Establishment of new technology add-on payments (NTAP) for the Caption Guidance system, among others.
  • A one-year extension of NTAP for 14 technologies for which the new technology add-on payment would otherwise be discontinued beginning FY 2022, including Eluvia.
  • New requirements and revisions of existing requirements for the Hospital Value-Based Purchasing Program.
  • Repeal of the collection of market-based rate information on the Medicare cost report and the market-based MS-DRG relative weight methodology, as finalized in the FY 2021 IPPS/Long Term Care Home Prospective Payment System (LTCH PPS) final rule.
CMMI Aligning Payor Efforts to Encourage Value-Based Care

The Center for Medicare and Medicaid Innovation (CMMI) recently announced that the agency is revisiting programs and aligning payor efforts to further move the needle on the transition to value-based care. These statements come after CMMI pressed pause on various models for review, such as the Direct Contracting Model, and the Primary Care First Serious Illness Population Model, to evaluate ways to reduce overlap between various models and to condense trial programs. Read more >>>

FDA Announces Commitment to Prohibit Menthol Cigarettes and Flavored Cigars

The U.S. Food and Drug Administration (FDA) on April 29 announced that it is initiating rulemaking to prohibit menthol cigarettes and flavored cigars, including menthol-flavored cigars, to reduce disease and death from using combustible tobacco products as well as address health disparities. Read more >>>

FDA Approves Dapagliflozin to Treat CKD

The U.S. Food and Drug Administration (FDA) on May 3 approved dapagliflozin (Farxiga) oral tablets to reduce the risk of kidney function decline, kidney failure, cardiovascular death and hospitalization for heart failure in adults with chronic kidney disease (CKD) who are at risk of disease progression. This announcement comes after the FDA approved dapagliflozin oral tablets in 2020 for adults with heart failure with reduced ejection fraction to reduce the risk of cardiovascular death and hospitalization for heart failure. Read more >>>

Keywords: ACC Publications, Cardiology Magazine, Inpatients, Prospective Payment System

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