Fall 2019 Unified Agenda of Regulatory and Deregulatory Actions

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

“The Unified Agenda provides uniform reporting of data on regulatory and deregulatory activities under development throughout the Federal Government, covering approximately 60 departments, agencies, and commissions. Each edition of the Unified Agenda includes regulatory agendas from all Federal entities that currently have regulations under development or review. Agencies of the United States Congress are not included. Fall editions of the Unified Agenda include The Regulatory Plan, which presents agency statements of regulatory priorities and additional information about the most significant regulatory activities planned for the coming year.

The activities included in individual agency agendas are primarily those currently planned to have an Advance Notice of Proposed Rulemaking (ANPRM), a Notice of Proposed Rulemaking (NPRM), or a Final Rule issued within the next 12 months. However, to keep users better informed of opportunities for participation in the rulemaking process, an agency may list in the “Long-Term Actions” section of its agenda those rules it expects will have the next regulatory action more than 12 months after publication of the agenda. When an agency subsequently schedules a regulatory action on one of these rules within a 12-month timeframe, the item will reappear in the appropriate section of the agency’s next agenda. Agencies may also report “Completed Actions, which are rulemakings that are being Withdrawn or ending their lifecycle with a regulatory action that completes the rulemaking.” The agency agendas generally do not include regulations concerning military or foreign affairs functions and regulations related solely to agency organization, management, or personnel matters.”

You can search the plan by agency as well as get more information.  The Introduction to the Fall 2019 Regulatory Plan is an interesting 3-page read. You can view the 13-page Department of Health and Human Services Statement of Regulatory Priorities for Fiscal Year 2020 that provides more details of the three (3) broad strategies for this FY:

  • facilitating patient-centered markets
  • promoting health and protecting life
  • promoting independence

“These strategies have the potential to deliver lasting change across America’s health care system.”

With the above background information, you best sit down to view my excerpt of CMS-specific items (the entire HHS Agency Rule List – Fall 2019 is much longer, including CDC, FDA as well as other agencies within HHS):

HHS/CMS
Prerule Stage
Request for Information: Assurance of Medicaid Transportation (CMS-2481-NC)
0938-AT81

HHS/CMS
Proposed Rule Stage
Conditions for Coverage for End-Stage Renal Disease Facilities–Third Party Payments (CMS-3337-P)
0938-AT11

HHS/CMS
Proposed Rule Stage
Adoption of Standards for Health Care Attachments Transactions, Acknowledgments Transactions, Electronic Signatures, and Modification to Referral Certification and Authorization Standard (CMS-0053-P)
0938-AT38

HHS/CMS
Proposed Rule Stage
Personnel, Alternative Sanctions for Certificates of Waiver, and Histocompatibility Requirement Updates (CMS-3326-P)
0938-AT47

HHS/CMS
Proposed Rule Stage
Grandfathered Group Health Plans and Grandfathered Group Health Insurance Coverage (CMS–9923–P)
0938-AT49

HHS/CMS
Proposed Rule Stage
Medicaid Fiscal Accountability (CMS–2393–P)
0938-AT50

HHS/CMS
Proposed Rule Stage
Medicaid Premiums and Cost Sharing (CMS-2411-P)
0938-AT57

HHS/CMS
Proposed Rule Stage
Civil Money Penalties and Exclusion Authority to Enforce 1150B Requirements (CMS-3359-P)
0938-AT60

HHS/CMS
Proposed Rule Stage
Modernizing and Clarifying the Physician Self-Referral Regulations (CMS-1720-P)
0938-AT64

HHS/CMS
Proposed Rule Stage
Establishing Minimum Standards in Medicaid State Drug Utilization Review (DUR) and Supporting Value Based Payments (VBP) for Drugs Covered in Medicaid (CMS-2482-P)
0938-AT82

HHS/CMS
Proposed Rule Stage
Accrediting Organizations: Conflict of Interest and Consulting Services and Use of CMS Standards and Process (CMS-3367-P)
0938-AT84

HHS/CMS
Proposed Rule Stage
Miscellaneous Medicare Secondary Payer Clarifications and Updates (CMS-6047-P)
0938-AT85

HHS/CMS
Proposed Rule Stage
Civil Money Penalties and Medicare Secondary Payer Reporting Requirements (CMS-6061-P)
0938-AT86

HHS/CMS
Proposed Rule Stage
Medicare Coverage of Innovative Technologies (CMS-3372-P)
0938-AT88

HHS/CMS
Proposed Rule Stage
International Pricing Index Model For Medicare Part B Drugs (CMS-5528-P)
0938-AT91

HHS/CMS
Proposed Rule Stage
Preadmission Screening and Resident Review–Update (CMS-2418-P)
0938-AT95

HHS/CMS
Proposed Rule Stage
Medicaid and Children’s Health Insurance Plan (CHIP) Scorecard Initiative (CMS-2419-P)
0938-AT96

HHS/CMS
Proposed Rule Stage
Proposed Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Program for Contract Year 2021 (CMS-4190-P)
0938-AT97

HHS/CMS
Proposed Rule Stage
HHS Notice of Benefit and Payment Parameters for 2021 (CMS-9916-P)
0938-AT98

HHS/CMS
Proposed Rule Stage
Revisions to Promote Patient’s Electronic Access to Healthcare Information and Improve Interoperability for Medicare and Medicaid Participating Providers and Suppliers (CMS-9123-P)
0938-AT99

HHS/CMS
Proposed Rule Stage
Strengthening the Program Integrity of the Medicaid Eligibility Determination Process (CMS-2421-P)
0938-AU00

HHS/CMS
Proposed Rule Stage
Comprehensive Care for Joint Replacement Model Three Year Extension and Modifications to Episode Definition and Pricing (CMS-5529-P)
0938-AU01

HHS/CMS
Proposed Rule Stage
Organ Procurement Organizations (OPOs) (CMS-3380-P)
0938-AU02

HHS/CMS
Proposed Rule Stage
Medicaid Payments to States for Ineligible Beneficiaries (CMS-6083-P)
0938-AU03

HHS/CMS
Proposed Rule Stage
Transparency in Coverage (CMS-9915-P)
0938-AU04

HHS/CMS
Proposed Rule Stage
FY 2021 Inpatient Rehabilitation Facility (IRF) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1729-P)
0938-AU05

HHS/CMS
Proposed Rule Stage
CY 2021 Home Health Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1730-P)
0938-AU06

HHS/CMS
Proposed Rule Stage
FY 2021 Inpatient Psychiatric Facilities Prospective Payment System Rate and Quality Reporting Updates (CMS-1731-P)
0938-AU07

HHS/CMS
Proposed Rule Stage
CY 2021 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System and Quality Incentive Program (CMS-1732-P)
0938-AU08

HHS/CMS
Proposed Rule Stage
FY 2021 Hospice Wage Index, Payment Rate Update, and Quality Reporting Requirements (CMS-1733-P)
0938-AU09

HHS/CMS
Proposed Rule Stage
CY 2021 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B (CMS-1734-P)
0938-AU10

HHS/CMS
Proposed Rule Stage
Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals; the Long-Term Care Hospital Prospective Payment System; and FY 2021 Rates (CMS-1735-P)
0938-AU11

HHS/CMS
Proposed Rule Stage
CY 2021 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates (CMS-1736-P)
0938-AU12

HHS/CMS
Proposed Rule Stage
FY 2021 Skilled Nursing Facility (SNFs) Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1737-P)
0938-AU13

HHS/CMS
Proposed Rule Stage
Payment Policies for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) (CMS-1738-P)
0938-AU17

HHS/CMS
Proposed Rule Stage
HHS Notice of Benefit and Payment Parameters for 2022 (CMS-9914-P)
0938-AU18

HHS/CMS
Proposed Rule Stage
Administrative Simplification: Modifications to NCPDP Retail Pharmacy Standards (CMS-0056-P)
0938-AU19

HHS/CMS
Proposed Rule Stage
Medicaid Eligibility Determination and Mechanized Claims Processing and Retrieval Systems (CMS-2433-P)
0938-AU20

HHS/CMS
Final Rule Stage
Eligibility Notices, Fair Hearing and Appeal Processes for Medicaid, and Other Provisions Related to Eligibility and Enrollment for Medicaid and CHIP (CMS-2334-F3)
0938-AS55

HHS/CMS
Final Rule Stage
Covered Outpatient Drug; Further Delay of Inclusion of Territories In Definitions of State and United States (CMS-2345-IFC3)
0938-AT09

HHS/CMS
Final Rule Stage
Medicaid and CHIP Managed Care (CMS-2408-F)
0938-AT40

HHS/CMS
Final Rule Stage
Methods for Assuring Access to Covered Medicaid Services–Rescission (CMS-2406-F)
0938-AT41

HHS/CMS
Final Rule Stage
Administrative Simplification: Update of Retail Pharmacy Standards (CMS-0055-F)
0938-AT52

HHS/CMS
Final Rule Stage
Exchange Program Integrity (CMS-9922-F)
0938-AT53

HHS/CMS
Final Rule Stage
Policy and Technical Changes to the Medicare Advantage and the Medicare Prescription Drug Benefit Programs for Contract Year 2020; Risk Adjustment Data Validation (CMS-4185-F2)
0938-AT59

HHS/CMS
Final Rule Stage
CY 2020 Home Health Prospective Payment System Rate Update and Quality Reporting Requirements (CMS-1711-F)
0938-AT68

HHS/CMS
Final Rule Stage
CY 2020 Changes to the End-Stage Renal Disease (ESRD) Prospective Payment System, Quality Incentive Program, Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) (CMS-1713-F)
0938-AT70

HHS/CMS
Final Rule Stage
CY 2020 Revisions to Payment Policies Under the Physician Fee Schedule and Other Revisions to Medicare Part B (CMS-1715-F)
0938-AT72

HHS/CMS
Final Rule Stage
CY 2020 Hospital Outpatient PPS Policy Changes and Payment Rates and Ambulatory Surgical Center Payment System Policy Changes and Payment Rates (CMS-1717-F)
0938-AT74

HHS/CMS
Final Rule Stage
CY 2020 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts (CMS-8071-N)
0938-AT76

HHS/CMS
Final Rule Stage
CY 2020 Part A Premiums for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement (CMS-8072-N)
0938-AT77

HHS/CMS
Final Rule Stage
CY 2020 Part B Monthly Actuarial Rates, Monthly Premium Rates, and Annual Deductible (CMS-8073-N)
0938-AT78

HHS/CMS
Final Rule Stage
CY 2021 Inpatient Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts (CMS-8074-N)
0938-AU14

HHS/CMS
Final Rule Stage
CY 2021 Part A Premiums for the Uninsured Aged and for Certain Disabled Individuals Who Have Exhausted Other Entitlement (CMS-8075-N)
0938-AU15

HHS/CMS
Final Rule Stage
CY 2021 Part B Monthly Actuarial Rates, Monthly Premium Rates, and Annual Deductible (CMS-8076-N)
0938-AU16

We’ll all want to keep our eyes on these Pre-Rules, Proposed Rules and Final Rules.  It looks to be a very busy FY.