';
CLOSE
Tags Posts tagged with "OMB"

OMB

0 1877
Photo by National Cancer Institute on Unsplash

This week, the Drug Enforcement Agency (DEA) submitted a final rule regarding virtual prescribing of controlled substances to the White House’s Office of Management and Budget (OMB). Though the final rule is not yet publicly available, the OMB registry posting, titled “Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications,” suggests an extension is coming that will go beyond the current expiration date of December 31, 2024.

Without a new rule or extension of the current flexibility beyond December 31, virtual prescribing of controlled substances without a prior in-person evaluation would no longer be allowed.

DEA received more than 38,000 public comments following its proposed rule in February 2023 for telemedicine prescribing of controlled substances. Subsequently, the telehealth flexibilities were extended to the current December 31, 2024, expiration date.

RCPA will continue to monitor progress on the final rule and communicate the details of the final rule once it is made public.

0 441

Yesterday, August 12, RCPA submitted comments to the US Office of Management and Budget (OMB) on why direct support professionals (DSP) need their own Standard Occupational Classification (SOC) code. Without one, the unique work that DSPs do will not be captured, and the historically low wages that DSPs make will remain the norm. An SOC will allow for the gathering of legitimate data around wages and for the professionalization of the DSP workforce.

In June, OMB published the Federal Register notice announcing review of the 2018 Standard Occupational Classification (SOC) Manual for possible revision in 2028 and soliciting comments. This notice started the process of reviewing and possibly changing the Standard Occupational Classification (SOC) Manual for 2028. OMB is analyzing items such as how jobs are classified, the rules for coding them, the main groups of jobs, specific jobs such as public safety tele-communicators and care workers, and adding new types of jobs to the classification system.

We hope that these efforts produce an SOC that captures the essence of the multifaceted work that a DSP does on a daily basis. If you have any questions regarding the comments, contact Carol Ferenz.

0 537

The Centers for Medicare and Medicaid Services (CMS) released and published the fiscal year (FY) 2025 inpatient rehabilitation facility prospective payment system (IRF PPS) final rule in the August 6, 2024, Federal Register. Some of the key provisions contained in the provider rule are noted below.

Payment Updates

CMS estimates aggregate payments to IRFs will increase by 2.8 percent in FY 2025, compared to the 4.0 percent payment update that CMS finalized for FY 2024. This update is the result of an annual market basket update, reduced by a productivity adjustment, budget neutrality adjustments for changes to CMG weights and labor/wage changes, and adjustments to the outlier case threshold.

As in previous years, CMS will adopt new delineations for the Core-Based Statistical Areas (CBSA) as identified by the Office of Management and Budget (OMB). [Additional and more detailed information on these new CBSAs can be found in OMB Bulletin No. 23-01] These changes will result in certain counties being reclassified from urban to rural and vice-versa, as well as some counties shifting to different CBSAs. As a result, CMS projects that approximately 10 percent of providers will have a higher wage index, but 16 percent will face a decrease in wage index values (primarily for those reclassified as urban, thus losing the rural adjustment). Thus, CMS finalized a transitional “phase-out” policy for those negatively impacted, such that IRFs set to lose their rural adjustment will retain two-thirds of the adjustment in FY 2025, one-third of the adjustment in FY 2026, and fully “lose” the rural adjustment in FY 2027. CMS estimates that 8 IRFs would be reclassified as urban and thus lose the 14.9 percent rural adjustment.

CMS increased the outlier threshold amount from $10,423 for FY 2024 to $12,043 for FY 2025 (slightly lower than the proposed rule’s projection). This change will account for an estimated 0.2 percent decrease to aggregate payments across the IRF PPS in FY 2025.

Quality Reporting Program (QRP) Updates

CMS finalized its proposal to adopt four new items as Standardized Patient Assessment Data Elements (SPADE) under the social determinants of health (SDOH) category beginning with the FY 2028 IRF QRP: one Living Situation item; two Food items; and one Utilities item. CMS notes that these new SPADES are intended to assist IRFs in “better addressing those identified needs with the patient, their caregivers, and community partners during the discharge planning process, if indicated.”

Transportation Item Modification Finalized Beginning with the FY 2028 IRF QRP (October 1, 2026 Implementation)

Consistent with the AHC HRSN Screening Tool, CMS finalized a proposal to modify the A1250. Transportation item currently collected in the IRF–PAI in two ways: (1) revise the look-back period for when the patient experienced lack of reliable transportation; and (2) simplify the response options.

  • A1250. Transportation currently collected in the IRF-PAI asks: “Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?” The response options are: (A) Yes, it has kept me from medical appointments or from getting my medications; (B) Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need; (C) No; (X) Patient unable to respond; and (Y) Patient declines to respond.
  • The finalized Transportation item asks, “In the past 12 months, has a lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living?” The final response options are: (0) Yes; (1) No; (7) Patient declines to respond; and (8) Patient unable to respond.

Finalized Proposal to Remove the Admission Class Item From the IRF-PAI Beginning October 1, 2026, with Minor Modification

  • CMS asserts that the Admission Class Item is currently not used in the calculation of quality measures already adopted in the IRF QRP. It further notes that it is not used for previously established purposes unrelated to the IRF QRP, such as payment, survey, or care planning. This removal will be effective beginning with the FY 2028 IRF QRP (beginning with patients admitted on October 1, 2026); however, IRFs will not be required to collect this item beginning with patients admitted on October 1, 2024.

For additional information, CMS published a fact sheet that provides an overview of the provisions contained in the final rule.

0 481
Image by Werner Moser from Pixabay

ANCOR has shared that the first step to revise the Standard Occupational Classification process has begun. Today the Office of Management and Budget (OMB), on behalf of the Standard Occupational Classification Policy Committee (SOCPC) — which is the committee that makes recommendations to OMB for potential revisions — announced it is beginning the review of the 2018 Standard Occupational Classification (SOC) Manual for revisions to be made for 2028, and that it is soliciting public comment.

This is an opportunity to write comments in support of revisions to the SOC, in particular for the creation of a code for direct support professionals. In its notice for comments, OMB specifically notes that it “solicits and welcomes comments related to any aspect of occupational classification, especially comments concerning . . . whether to consider the addition of new detailed occupations or occupational groups, including specifically care workers.”

The public comment period is open until August 12, 2024. ANCOR will be submitting comments and providing additional guidance and tools to submit comments in the coming weeks.

For more information, the notice is available on the Federal Register website.

0 1435

On January 26, 2024, the Centers for Medicare & Medicaid Services (CMS) forwarded the final Medicaid Access Rule (CMS-2442-F) to the Office of Management and Budget (OMB) for the last review step before Federal Register publication.

The proposed Medicaid Access Rule contained a number of policies, including the much-discussed 80/20 provision that would require 80 percent of all Medicaid payments to be spent on direct care workers and direct service professionals compensation for personal care services.

RCPA commented on these proposed regulations and will continue to monitor progress with our federal partners. The OMB is expected to issue its comments in April. If you have questions, please contact RCPA Policy Director Fady Sahhar.

0 1122

The Office of Management and Budget (OMB) has released the Unified Regulatory Agenda and Regulatory Plan, which outlines regulatory actions federal agencies are considering in the coming months. Regulations can be searched by specific agency, such as Department of Health and Human Services (HHS), which includes the Centers for Medicare and Medicaid Services (CMS), the Centers for Disease Control and Prevention (CDC), and the Substance Abuse and Mental Health Services Administration (SAMHSA).

© 2021 - Rehabilitation & Community Providers Association