HHS withdraws three proposed rules, including drug payment model

The Centers for Medicare & Medicaid Services today officially withdrew its proposal to test new models for how Medicare Part B pays for prescription drugs provided in physician offices and hospital outpatient departments. AHA had expressed concerns with the proposed rule and its inclusion of hospitals, which have little control over which drugs physicians prescribe in hospital-based settings. In addition, the Department of Health and Human Services today withdrew a proposed rule that would require health plans that control their own business activities to demonstrate compliance with standards and operating rules for three types of health care electronic transactions under the Health Insurance Portability and Accountability Act. Hospitals can still ask health plans to demonstrate their compliance to the standards by undertaking voluntary certification through the CAQH CORE alliance. CMS also today withdrew a proposed rule that would revise certain conditions of participation for health care providers, conditions for coverage for suppliers, and requirements for long-term care facilities. Specifically, the rule would have revised certain definitions and patients’ rights provisions to ensure they are consistent with the Supreme Court decision in United States v. Windsor, which held that Section 3 of the Defense of Marriage Act was unconstitutional. CMS believes that a subsequent Supreme Court decision on same-sex marriage, Obergefell v. Hodges, “has addressed many of the concerns raised” in the original rule.