Final rule: Policy and Technical Changes to the Medicare Advantage, Medicare Prescription Drug Benefit, Programs of All-Inclusive Care for the Elderly (PACE), Medicaid Fee-For-Service, and Medicaid Managed Care Programs for Years 2020 and 2021

This final rule will revise the Medicare Advantage (MA) program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations to implement certain provisions of the Bipartisan Budget Act of 2018; improve quality and accessibility; clarify certain program integrity policies for MA, Part D, and cost plans and PACE organizations; This final rule will also revise the appeals and grievances requirements for certain Medicaid managed care and MA special needs plans for dual eligible individuals to implement certain provisions of the Bipartisan Budget Act of 2018.

Proposed rule: Joint Employer Status

This proposed rule revises and clarifies the responsibilities of employers and joint employers to employees in joint employer arrangements. This proposal would ensure employers and joint employers clearly understand their responsibilities to pay at least the federal minimum wage for all hours worked and overtime for all hours worked over 40 in a workweek.

Proposed rule: Regular Rate Under the Fair Labor Standards Act

This proposed rule clarifies when employee benefits such as tuition reimbursements, reimbursed travel expenses, and unused paid leave may be excluded from overtime pay calculations.

Proposed rule: Defining and Delimiting the Exemptions for Executive, Administrative, Professional, Outside Sales and Computer Employees

The Department of Labor has proposed an increase in the salary-level threshold for white-collar exemptions to $35,308 per year from $23,660. If finalized, the proposal will result in the reclassification by employers of more than a million currently exempt workers as nonexempt and an increase in pay for others above the new threshold.

Propose rule: Medicare and Medicaid Programs; Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans in the Federally-Facilitated Exchanges and Health Care Providers

This proposed rule is intended to move the health care ecosystem towards interoperability as envisioned in the 21st Century Cures Act and Executive Order 13813 to improve access to, and the quality of, information that Americans need to make informed health care decisions, including data about health care prices and outcomes, while minimizing reporting burdens on affected plans, health care providers, or payers.

Section IV: Section 202 Project Rental Assistance Contract (PRAC) Projects (Draft RAD Notice Rev 4)

The Consolidated Appropriations Act, 2018 authorized the conversion of properties assisted by Section 202 Project Rental Assistance Contracts (PRAC). This draft is specificly to implement the new PRAC provisions.

Final Rule: Management Standards for Hazardous Waste Pharmaceuticals and Amendment to the P075 Listing for Nicotine

The final rule, applicable to “healthcare facilities” and “reverse distributors,” establishes new sector-specific regulations for managing hazardous waste pharmaceuticals. Among other provisions, the regulations include a prohibition on disposing hazardous waste pharmaceuticals in sewer systems, a limited carve-out for hazardous waste pharmaceuticals that are also DEA controlled substances, and new management standards related to reverse distribution of prescription pharmaceuticals.

Proposed rule: Veterans Community Care Program

The Department of Veterans Affairs (VA) proposes to amend its medical regulations to implement its authority for covered veterans to receive necessary hospital care, medical services, and extended care services from non-VA entities or providers in the community.

Request for Medicare Payment Advisory Commission (MedPAC) Nominations

GAO is now accepting nominations for MedPAC appointments that will be effective May 2019. MedPAC's primary task to advise the U.S. Congress on issues affecting the Medicare program.

2020 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies

This document details what CMS is proposing to pay MA plans in 2020 and the policy changes they will need to abide by if they decide to offer an MA plan in 2020. Few highlight includes, plans will not be getting as big of a rate increase in 2020, capitated payments to MA plans will only increase 1.59% compared to the 3.4% increase they received for 2019, and plans will be able to offer new optional supplemental benefits in 2020 for enrollees that are chronically ill. These benefits no longer have to be “primarily health-related” nor uniform across populations. They can be targeted to the needs of a particular individual. CMS notes these new, expanded benefits may include: non-medical transportation, home-delivered meals (exceeding current allowable limits), food and produce.