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Affordable Care Act (ACA)

HR GPS: Variations Exist Across Plan Essential Health Benefits (EHBs)
The ACA requires all exchange plans to cover EHBs. A study found that 45 states consider chiropractic care an EHB, 26 include autism services, and 5 states considered weight loss programs an EHBs.
Health Affairs: Commentary: Tax Exempt Hospitals and the ACA
The Treasury and IRS have not released final rules as directed under the ACA provisions covering the expanded obligations of nonprofit hospitals that seek tax-exempt status.
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Employer Sponsored Insurance

Urban: Report: ACA Impact on Employers
Report discusses the ACA's anticipated impact on employers, particularly those with fewer than 50 employees. Broader trends within the employer health insurance market are reviewed to offer context.
WSJ: Employers Work to Avoid ACA Penalties
Employers are shifting employees to Medicaid and offering skinny plans to avoid fines under the ACA. The penalties can cost $2,000 per employee and will go into effect in 2015 after a one year delay.
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Doctors

CMS: Compliance Newsletter Highlights Common Billing Errors
Among them, the newsletter flags such RAC-identified issues hospital discharge day management services when different providers are involved and incorrect billing of ESRD codes, among other issues.
Washington Post: Family Physicians to Promote Primary Care
Because of the large increase in the number of people with insurance coverage, a coalition of family physicians is launching a 5-year, $20 million campaign to promote the value of primary care.
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Prescription Drugs

FDA: Obizur Approved for Acquired Hemophilia A
Baxter's Obizur [Antihemophilic Factor (Recombinant), Porcine Sequence] gained FDA approval for treating bleeding episodes among adults who have acquired rather than inherited hemophilia A. An agency official notes that "approval of this product provides an important therapeutic option for use in the care of patients with this rare disease." Also: FDA approval letter
Reuters: FDA Sends Warning to Hikma Pharma over Health Concerns at Portugal Manufacturing Plant
After a March health inspection of the plant, the FDA has contacted the drug manufacturer over investigations and environmental monitoring.
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Medicaid – General

Urban: Report: Louisiana's Success with Express Lane Eligibility for Medicaid
Report details Louisiana's experience with Express Lane Eligibility, a streamlined process for enrolling beneficiaries in Medicaid based on eligibility for other programs. ACA's impact also discussed.
WSJ: Employers Work to Avoid ACA Penalties
Employers are shifting employees to Medicaid and offering skinny plans to avoid fines under the ACA. The penalties can cost $2,000 per employee and will go into effect in 2015 after a one year delay.
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Health Information Technology (HIT)

Modern Healthcare: DeSalvo Leaves ONC, Joins Ebola Team
Dr. DeSalvo, HHS' National Coordinator for HIT, is departing the position and will serve as the Acting Assistant Secretary of Health for the Ebola response team.
VA: VA Explains New Telehealth Scheduling System
The VA met with Veteran Service Organizations (VSO) at the Washington VA Medical Center to demonstrate how to use the VA's telehealth services. The telehealth programs are a party of larger goals to improve access to care by helping how VA employees schedule telehealth appointments.
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Health Insurance Exchanges

Washington Post: HealthCare.com Seeks to Capitalize on HealthCare.gov Open Enrollment Period
Comparing itself to Kayak.com, healthcare.com allows consumers to choose from 93,000 plans from about 180 insurers across the country. Some advocates worry about the confusion it may create.
CMS: Slides Outline Federal Marketplace QHP Certification, Agreement Timeline
On slide 15, CMS specifies the timeline for Federally Facilitated Marketplace QHP certification, indicating that certification notices went to plans on Oct. 15 and that validation notices will be sent to issuers and states on Oct. 28. A countersigned agreement notice will be sent to issuers and states on Nov. 5, the agency says. Subsequent slides provide details on each step.
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Hospitals

CMS: October 2014 OPPS Pricer File Update Released
The agency notes that the October files are available for download on the hospital OPPS pricer code page under 4th quarter '14 files.
CMS: Transcripts Posted for Hospital Appeals Settlement, Star Ratings Calls
The newly available materials from an Oct. 8 call on the agency's offer to settle pending inpatient status denial appeals (transcript) and Oct.. 9 call on Hospital Compare Star Ratings (transcript) also are available through archived audio.
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Quality

CMS: Transcripts Posted for Hospital Appeals Settlement, Star Ratings Calls
The newly available materials from an Oct. 8 call on the agency's offer to settle pending inpatient status denial appeals (transcript) and Oct.. 9 call on Hospital Compare Star Ratings (transcript) also are available through archived audio.
NCQA: Group Says Behavioral Health, Antibiotic Use Quality Metrics Mostly Lag
While noting gains in plans' performance on HEDIS metrics, NCQA says behavioral health and antibiotic use need improvement. See the full report and additional background information. Also, CQ($)
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Legal

CMS: Transcripts Posted for Hospital Appeals Settlement, Star Ratings Calls
The newly available materials from an Oct. 8 call on the agency's offer to settle pending inpatient status denial appeals (transcript) and Oct.. 9 call on Hospital Compare Star Ratings (transcript) also are available through archived audio.
LA Times: Federal Officials Fine UCLA Health System After Banned Physician Bills Medicare
Officials fined the hospital $470,000 after it allowed an anesthesiologist who had been banned from billing Medicare and other federal programs to treat Medicare patients from April 2009 to Nov. 2013.
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Delivery Reform

JAMA: Report: An Overview of CMS' Pioneer Accountable Care Collaborative Model
Authors provide a detailed history of CMS' Pioneer ACO model including the process and priorities adopted in each year, the outcomes observed, and the relationship to other Medicare ACOs.
Brookings: Commentary: How to Use Health Care to Improve Population Health
Introducing Brooking's upcoming Population Health Forum, Mark McClellan explains how new payment approaches can integrate community health programs, health care, and social services to improve health.
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Prevention

Reuters: FDA Grants Emergency Authorization for Two Ebola Tests
FDA approved two new tests on Saturday that detect Ebola in blood or urine samples faster than previous tests: within 1 hour rather than 24-48 hours. Both products are made by BioFire Defense.
NPR: Ebola Worker Quarantined in New Jersey
After arriving in NJ from West Africa with a fever, a woman was quarantined under a newly implemented policy. She hasn't been identified and tested negative for Ebola. Also, Reu, WSJ$, NYT$, Bloomberg
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