CMS Comments: "No Comment" on The Forthcoming Smart Act Regulations

CMS is withholding comment about The Smart Act regulations for now. See the transcript below:

"CENTERS FOR MEDICARE & MEDICAID SERVICES
Moderator: John Albert
07-25-13/1:00 p.m. ET
Confirmation # 11907630
Page 14

That’s all I have on that right now. Some of the areas sort of more high 
arching as oppose to just a single question. As we received a number of 
questions about the SMART Act and how it affects this process and what 
regulations are out there.

In terms of regulations, when CMS is doing an advance notice of proposed 
rulemaking, an ANPRM or NNPRM or final rules or even a federal registered 
notice, we’re not allowed to comment whether we are or are not doing that 
notice or the content of that until there is at least something on the unified 
regulatory agenda at which point we still can’t tell you specifics but we can 
tell you that document is in progress. The site you need to go to for that 
generally is – if I can find the right thing – is www.reginfo.gov. And what 
that – you can also find it simply by Googling the Unified Regulatory Agenda 
and then the term CMS. But what it lives on that, it won’t – and want – those 
are ones that are in our process – officially in the process.

And right now, the requirement in the SMART Act that an ANPRM be done 
with respect to civil money penalties under Section 111 is on that Regulatory 
Agenda. I believe there are at least two other MSP related regulations either –
whether it’s under something in the final rule, a pre rule or proposed rule. But 
you can check that out and that’s a site that you may want to monitor every so 
often if you have a question about whether or not we’re doing a particular 
regulation.

Similar to that, because I mentioned the SMART Act before, is a lot of the 
questions were asking specific facts about our specific actions we planned to 
take with respect to what’s in the SMART Act. As we make any changes or 
do anything related to the SMART Act, we – anytime instructions are going to 
change, we will give appropriate notice. At this point, there’s nothing that we 
have changed in our instructions that affects you at this time. So, we won’t be 
addressing any specific SMART Act questions.

Last but not least, as we have said in most of these calls, the extent we 
received questions that are related to MSP recoveries in the mailbox, those are 
outside the scope of this call. And we won’t be addressing those.

Read more about The Smart Act

Workers' Compensation: The SMART Act and Workers' Compensation

May 09, 2013

The SMART Act, which was signed into law by President Obama on January 10, 2013, amends and reforms the Medicare Secondary Payer Act to improve the reimbursement process. It is located in Title II of H.R. 1845 and ...

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It's Not "If", It's "When" - California - Workers' Compensation

Feb 01, 2013

Enactment of The SMART Act, the reality of which is that the regulations will eat up the statute, and also their lunch. I plan to write more on The SMART Act in the coming weeks. Maybe that wasn't so smart after all for the ...

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Workers' Compensation: Medicare Conditional Repayment ...

Jan 14, 2013

In additional to commenting on the new Strengthening Medicare And Repaying Taxpayers (SMART) Act, Judge Hickey will be discussing how the interaction of the workers' compensation claims process integrates with this ...

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High Disability Rates Persist in Old Age

Aging and "late life disability" is an an increasing trend. Injured workers' are surviving longer making total disability claims and Medicare involvement an increasing factor in adjudication and settlement of workers' compensation claims. Today's post was shared by The New Old Age and comes from newoldage.blogs.nytimes.com

Weird berries. Capsules of unpronounceable supplements. Yoga or tai chi. Crossword puzzles. Such amulets, we’re told, may ward off disability — which is the real fear that accompanies aging, isn’t it? Not the sheer number of years that will have passed, but the things we’ll no longer be able to do.

But our efforts to dodge disability appear to be falling short. Gerontologists once hoped for a “compression of morbidity”; the idea was that we could remain healthy and active until our bodies fail at advanced ages, and we swiftly died. But new research shows that this has not materialized for most of the elderly. The price we’re paying for extended life spans is a high rate of late-life disability.

Fast food workers strike to double current wages

Wages are a critical component of workers' compensation systems. Wages are utilized to determine rates of compensation benefits. Today's post was shared by Steven Greenhouse and comes from www.nydailynews.com

They're not lovin' it.

Hundreds of New York City fast food workers from the likes of McDonald’s, Wendy’s and KFC went on strike Monday, chanting “Hold the burgers hold the fries, make our wages super-sized!"
They shouted that they deserve the right to unionize and make $15 hourly wages instead of the minimum wage they currently earn.

"I want for us to be respected. $7.25 is not enough!" said Lisette Ortiz, 27, of Rockaway, who works at a McDonald's in downtown Brooklyn.

"I live with my dad. I would like to get my own apartment. You can't! It's impossible!"
Her comments echoed scores of mostly part-time burger flippers, pizza deliverymen and fry cooks who gathered at fast food joints in the Bronx, midtown Manhattan, and downtown Brooklyn before a rally of around 300 protesters in Union Square. They said their paychecks simply cannot sustain life in the city.

"I live with my grandma, my aunt, and cousin. I can't even afford privacy!" said Naquasia LeGrand, 22, of Canarsie, Brooklyn.
"I'm a cashier, I cook, prep, clean — I do it all. It's just not enough, $7.25, not when milk and eggs are going up!”

She said she relies on $113 a month in welfare, in addition to the $225 she makes from working 38 hours a week at two KFCs.

Councilman Jumaane Williams led a rowdy crowd of 60 that barged into the rear entrance of a Wendy's in downtown Brooklyn. Protesters chanted to the workers inside, "We can't survive on $7.25!" and "Come on out, we got your...

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Holes in the Safety Net — Legal Immigrants' Access to Health Insurance

Immigrant workers are entitled to workers' compensation benefits in most jurisdictions even if they are in the US without status. Ongoing Congressional changes to the nation's immigration system will have significant impact on the delivery of healthcare to immigrant workers.Today's post was shared by NEJM and comes from www.nejm.org

While Congress debates whether publicly supported health care should be available to undocumented immigrants who may be placed on a path to citizenship under immigration reform, the health care needs of already legal immigrants continues to be overlooked.

More than 12 million immigrants are lawfully present in the United States. They serve in the military, pay taxes, and contribute to the economy. Yet like undocumented immigrants, whose health care vulnerabilities are outlined in the Perspective article by Sommers, legal immigrants face substantial barriers to obtaining insurance coverage (see graph Health Insurance, According to Citizenship Status, 2009.). As a result, some — such as Antonio Torres, an uninsured Arizona farmworker who was in a coma after a car accident — have been forcefully transferred to their native country when their treating hospitals were unable to find facilities willing to provide them with long-term care.1

HHS Inspector General Scrutinizes Medicare Observation Care Policy

Medical treatment costs paid in workers' compensation claims continue to exceed 50% of the losses paid. The Federal government is attempting rein in medical costs generally. Those efforts will impact workers' compensation medical payments. Today's post was shared by Kaiser Health News and comes from www.kaiserhealthnews.org

Medicare patients' chances of being admitted to the hospital or kept for observation depend on what hospital they go to -- even when their symptoms are the same, notes a federal watchdog agency in a report to be released today, which also urges Medicare officials to count those observation visits toward the three-inpatient-day minimum required for nursing home coverage.

The investigation, conducted by the Department of Health and Human Services Inspector General, was based on 2012 Medicare hospital charges. Its findings, which underscore several years of complaints that the distinction between an inpatient and observation stay isn't always clear, come just days before the Centers for Medicare and Medicaid Services (CMS) is expected to issue final regulations intended to address the problem.

Those rules, proposed in April, would assume that patients who stay two nights or longer in the hospital are inpatients. Those who have shorter stays would receive observation care, an outpatient service. However, the IG report said the proposal, which has been criticized by hospital, physician and consumer groups, would not reduce the number of observation stays.

An observation patient can be treated in the emergency room or on an inpatient unit in the hospital. CMS does not require hospitals to tell patients they are receiving observation services, which the IG's analysis said can include some of the same procedures provided to admitted patients.

"Some...

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More states report Cyclospora cases; total reaches 373

Today's post was shared by CIDRAP and comes from www.cidrap.umn.edu

Arkansas, Florida, Missouri, and New York City have reported their first Cyclospora infections with possible ties to a multistate outbreak, raising the nation's total to as many as 373, according to the latest information from federal and state sources.

The US Centers for Disease Control and Prevention (CDC) in an update today said it had received reports of 353 cases as of Jul 26, but Iowa, Nebraska, and Texas have reported more cases since then.

So far 21 patients from three states have been hospitalized, but no deaths have been reported. The CDC said illness onset dates have ranged from the middle of June to early July.

No food source has been identified yet, but health officials in Iowa—the state reporting the most cases—have said they suspect imported vegetables. Cyclospora is an extremely rare parasite, and past outbreaks have been linked to imported fruit or vegetables.

The Food and Drug Administration (FDA) said in a Jul 26 notice that it, along with the CDC and state and local departments, was investigating the multistate outbreak.

So far it's not clear if cases from all of the states are part of the same outbreak. Some of the cases in Iowa and Nebraska have tentative links to foreign travel, and some of the sick patients in Illinois, Kansas, and Missouri may have become ill after travel to other states that have reported dozens of cases.

The Florida Department of Health (FDH), which reported its first cases on Jul 26, said its epidemiologists are...

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OSHA and NIOSH issue hazard alert on 1-bromopropane

The U.S. Department of Labor's Occupational Safety and Health Administration and the National Institute for Occupational Safety and Health today issued a hazard alert to urge employers that use 1-bromopropane (1-BP) to take appropriate steps to protect workers from exposure.

"The use of 1-bromopropane has increased in workplaces over the last 20 years," said Dr. David Michaels, assistant secretary of labor for occupational safety and health. "Workers exposed to this toxic chemical can suffer serious health effects, even long after exposure has ended. Hazardous exposure to 1-BP must be prevented. Employers have a responsibility to ensure the safety of their workers."

Exposure to 1-BP has been associated with damage to the nervous system among workers, and it has been shown to cause reproductive harm in animal studies. The chemical is used in degreasing operations, furniture manufacturing, and dry cleaning. The hazard alert was issued in response to information on the increased use of 1-BP as a substitute for other solvents as well as recent reports of overexposure in furniture manufacturing. 1-BP was nominated as a chemical of concern in OSHA's Web Forum to Identify Hazardous Chemicals.

Workers can be exposed to 1-BP by breathing in vapors or spray mists and by absorption through the skin. The most effective way to protect workers from exposure is to eliminate the use of 1-BP, substituting the chemical with a less toxic substance or less hazardous material. Replacement chemicals also may have associated hazards that need to be considered and controlled.

Engineering controls to reduce worker exposure to 1-BP include isolation of workplace operations and the installation of proper ventilation systems. Other controls, such as a reduction in the time a worker is exposed to the chemical, should also be considered

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