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MACRA (Medicare Access & CHIP Reauthorization Act of 2015)

Everything you need to know about MACRA, MIPS, APM’s etc: click below: 

http://www.aafp.org/practice-management/payment/medicare-payment/faq.html#prep

 

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Check out the latest AAFP Government Relations Update- Friday september-9

 

 

May 10, 2016 Legislative Update by:

PETERS, CANNATA & MOODY PLC

The legislature worked through Friday night to process more than 250 bills and end the 2016 legislative session at 5:45 on Saturday morning. The final hours of the session had both congeniality and tension. A small number of bills failed, while some bills failed only to be revived on a second vote. Many others passed without discussion or controversy.

In the 117 days of this legislative session, 1,361 bills, memorials, and resolutions were introduced. Thirty-four memorials and resolutions were transmitted to the Arizona Secretary of State with legislative statements of support for a variety of causes. The legislature passed 387 of the introduced bills, and thus far Governor Ducey has signed 115 into law. The Governor has almost two weeks to act on the remaining legislation on his desk. Only three have been vetoed.

Though the legislature adjourned, they will not be absent from the Capitol. Eight study committees were established this year, creating official mechanisms for ongoing study and debate on topics ranging from transportation funding needs to cosmetic lasers (more information is included in this report). In addition, state agencies and the Auditor General were tasked

with evaluating potential changes to government processes.

As the session ends, many lawmakers are shifting to campaigns for renewed terms in the legislature next year. But an unusually high number are leaving the Capitol – many after years of public service there. Fifteen lawmakers have reached the maximum years allowed by the state’s term limits, opted to retire, or started a run for another public office. The legislature will lose up to 150 years of experience from their departure. Among those departing are Representative Debbie McCune-Davis (D-Phoenix), who has served 30 years in the legislature. Her deep knowledge of key policy areas will be missed by everyone at the Capitol.

With the loss of experience, however, comes the opportunity to inform a new body of legislators eager to serve and better understand the information we are ready to share as the 2016 campaign season moves toward the 2017 legislative session.

KidsCare Restored in Arizona

In a surprising shift at the legislature, a bipartisan coalition in both the House and the Senate overruled legislative leaders and forced a vote to restore the state’s KidsCare health insurance program. The Governor, who had remained quiet on the topic as public support and legislative focus on the topic increased throughout the session, signed the bill the same day it arrived on his desk. The proposal, SB 1457, also expands access to empowerment scholarship account funds for students with disabilities that are found to need education beyond the age of 18.

© 2016 Peters, Cannata & Moody PLC. All rights reserved. MONDAY, MAY 9, 2016

PETERS, CANNATA & MOODY PLC

The sudden success in reinstating the health insurance program was heralded by legislators, AzAFP, and other advocacy groups who have long argued that Arizona should no longer be the only state rejecting federal dollars for insurance to children of the working poor.

Medical Compacts Reach Governor’s Desk

Despite an unpredictable and contentious path through the legislative process, four proposals to establish or expand medical compacts in the state are now on the Governor’s desk for consideration. HB 2502 (medical licensure compact, HB 2503 (psychologists licensure compact), HB 2504 (physical therapy licensure compact), and HB 2362 (nurse licensure compact) were all approved in the final days of the legislative session.

The House adopted the amendments from the Senate, which place strict limitations on the medical compacts to ensure state autonomy and transparency are emphasized.

Legislature Directs Further Study on Key Issues

Every year, the legislature considers bills that seek to start a conversation about a particular topic through a study committee established in state law. This session was no exception – the legislature approved the creation of eight new study committees:

  •   HB 2035 establishes a Study Committee on Cosmetic Lasers to review regulations for laser certification, and monitoring and opportunities for cosmetic laser businesses. The report is due January 1, 2017.

  •   HB 2666 creates a Workforce Data Task Force within the newly created Office of Economic Opportunity, to oversee workforce system evaluation data sharing and methodologies used for data collection, retention, distribution and storage. An initial report is due November 1, 2016, and the Task Force continues until 2024.

  •   HB 2677 establishes a Peace Officer Employment Study Committee, charged with researching and reporting on peace officer staffing levels and recruitment and retention policies and practices, and on the impact these have on the rate of attrition and public safety. The Committee is required to report its recommendations by December 31, 2016, and would be removed from statute on October 1, 2017.

  •   HB 2701, the budget bill for criminal justice issues, creates the Study Committee on Incompetent, Non-restorable and Dangerous Defendants Committee to evaluate and recommend a program to provide long-term service to individuals found to be incompetent and non-restorable who are charged with crimes involving violent or dangerous behavior. The report is due by December 15, 2016; the committee is repealed on January 1, 2017.

  •   SB 1248 creates a Dog and Cat Breeder Study Committee, charged with the study of pet breeding by licensed and unlicensed breeders in this state and other states, and options to encourage spay or neuter clinics, adoption of dogs or cats and healthy breeding of dogs and cats. The Committee is required to report findings and recommendations by December 31, 2016, and would be removed from statute on October 1, 2017.

    © 2016 Peters, Cannata & Moody PLC. All rights reserved. MONDAY, MAY 9, 2016

PETERS, CANNATA & MOODY PLC

  •   SB 1350 establishes a Joint Legislative Study Committee on Transient Lodging, to evaluate existing state and local government regulations on transient lodging businesses. The report is due by December 15, 2017, and the committee is repealed in 2020.

  •   SB 1490 creates a Surface Transportation Funding Task Force, which will bring together nine individuals with the experience needed to review the state’s needs and recommend changes that will help address the long-term viability of transportation infrastructure.

  •   SB 1525 establishes a Continuing Educational Task Force to study course offerings and other critical information. The report is due December 15, 2016, and the task force is repealed in 2019.

    The legislature also requested additional study and oversight of the Department of Child Corrections. HB 2705, a part of the budget, requires the Department of Child Safety and the Arizona Early Childhood Development and Health board to report on their collaborative efforts to address child welfare issues by February 1, 2017. The bill also requires the Arizona Auditor General to report on specific areas of Department of Child Safety responsibilities and outlines annual updates on any plans to close facilities with the Arizona Training Program.

    HB 2704, the health budget bill, requires several reports. It requires AHCCCS and the Arizona Department of Health Services to submit a joint report on hospital charge master transparency by January 1, 2017, requires AHCCCS to report on the receipt of credits for funding the state share of medical assistance expenditures that qualify for federal financial participation by December 31, 2016 and June 30, 2017, and requires AHCCCS to report on the use of emergency departments for non-emergency purposes by AHCCCS enrollees by December 1, 2016. The bill also requires AHCCCS to report by January 2, 2017 on the availability of inpatient psychiatric treatment for children, adults, and adolescents that receive RBHA services, and by December 1, 2016 requires AHCCCS to report on Medicaid payments for health care services for Native American populations. An AHCCCS report on the technological feasibility and costs of applying a 340B drug pricing program to licensed hospitals and facilities is due by November 1, 2016.

    Thirteen additional bills required further study on a specific topic:

 HB 2033 creates a Post-9/11 Veteran Education Relief Advisory Committee to establish and oversee a newly created fund to provide assistance for tuition to state universities for veterans.

  •   HB 2388 establishes an Achieving a Better Life Experience Act (ABLE) Oversight Committee in the Arizona Department of Economic Security, tasked with responsibilities associated with the newly created ABLE program.

  •   HB 2442 requires the Arizona Health Care Cost Containment System to do a network adequacy study on Regional Behavioral Health Associations that provide behavioral health services to children enrolled in the Comprehensive Medical and Dental Care Program by July 1, 2017.

  •   HB 2613 requires the Arizona Department of Administration to conduct a cost/benefit study regarding the transfer of all non-health related boards and occupational licenses to a new licensing and regulatory division within their agency. The report must be completed by September 1, 2016.

© 2016 Peters, Cannata & Moody PLC. All rights reserved. MONDAY, MAY 9, 2016

PETERS, CANNATA & MOODY PLC

  •   HB 2620 requires the State Board of Education and the Arizona Department of Education to jointly develop and implement a transition plan for moving the state employees that investigate teacher complaints from SBE to ADE by August 1, 2016. (The employee transition was also required in the bill.)

  •   HB 2695 appropriates money for a feasibility study to replace the tax accounting system at the Arizona Department of Revenue.

  •   SB 1060 requires the Arizona Auditor General to complete a performance audit of the Arizona Power Authority.

  •   SB 1399 requires the State Land Commissioner and the Director of the Department of Water Resources to develop a plan to construct a potential new water storage facility on state trust land.

  •   SB 1421 requires each board, commission, council, or advisory committee to report compensations and reimbursements paid in fiscal year 2016, and requires the Department of Administration to provide the data in a report by December 15, 2016.

  •   SB 1428 requires the Public Safety Pension Retirement System to study methods for structured risk pooling and local board consolidations. The report is due by July 1, 2017.

  •   SB 1457 requires the Arizona Department of Education to create an Annual Education Plan Development Council to develop and oversee the expansion of Empowerment Scholarship Account funds to students that qualify for funding through the program between the ages of 18-22.

  •   SB 1525 requires a special audit of Joint Technical Education Districts.

  •   SB 1530, a part of the budget, requires the University of Arizona to provide a study on the services of

    the Arizona Geological Survey by August 1, 2017. The bill also requires a report by the State Geologist, in cooperation with the Mining, Mineral and Natural Resources Educational Museum Advisory Council, detailing the Museum’s operations and funding needs.

    No Referrals Added to November Ballot

    Though the legislature nearly referred numerous policy questions to voters in November, the session adjourned without actually doing so. Almost 40 ballot referrals were introduced this year, and 13 received some consideration from the legislature. Two proposals on solar energy were sidelined by an agreement between Arizona Public Safety and Solar City, and this week the House overwhelmingly rejected a proposal from the Arizona Restaurant Association to increase the minimum wage. A measure to subject the Arizona Clean Elections Commission to rulemaking procedures under an executive oversight commission stalled just before the final vote on the legislature’s last night of work.

    Though the legislature did not pass any of the ballot proposals, voters will likely see questions referred through citizen initiative on the November ballot.

    © 2016 Peters, Cannata & Moody PLC. All rights reserved. MONDAY, MAY 9, 2016

PETERS, CANNATA & MOODY PLC
Governor Considers Regulatory Changes Approved by Legislature

Many bills introduced this year would have impacted regulatory authorities and processes in Arizona; in the end, six of those were approved by the legislature.

  •   HB 2337 requires each state agency to allow a regulated person to correct deficiencies in an inspection or audit if there is uncertainty about whether that individual qualifies for statutory exemptions.

  •   HB 2450 simplifies the process by which a state agency can repeal rules it determines to be unnecessary for the operation of state government, by allowing the agency to amend or repeal those rules through the expedited rule process at the Governor’s Regulatory Review Council.

  •   HB 2487 prohibits a state agency from requiring any authorization or meeting before an application can be filed with the agency, and to limit impacts to the applicant for any pre- application process required by law.

  •   HB 2613 eliminates licensing requirements for professional driving trainers, citrus, fruit and vegetable packers, and yoga instructors, and makes licensing optional for geologists, assayers, and cremationists. It also requires the Arizona Department of Administration to provide a report by September on the costs and benefits of moving all regulatory oversight of non-health regulatory boards and occupational licenses under the oversight of the Department.

  •   SB 1388 requires the Governor’s Regulatory Review Council to review each agency rule enacted under emergency rulemaking within one year after the rule is adopted.

  •   SB 1524 prohibits a local government or state agency from doing any action that increases regulatory burdens on an individual unless it is specifically authorized by state statute, unless the regulation is necessary to address a critical or urgent need. It specifically bans regulations on businesses that use a digital platform to sell goods and services directly to a customer.

    Governor Ducey signed SB 1487 into law, requiring an Attorney General investigation if a legislator believes a local government ordinance violates state law or the state constitution. The local government would be given 30 days to correct the violation; if it is not corrected, the State Treasurer is authorized to withhold revenues that would otherwise be distributed to that local government until it is resolved.

    Five additional regulatory proposals failed to make it through the legislature:

  •   HB 2163 would have stablished a Governor’s Statutory Review Committee to review any statute and determine whether the law should be amended or repealed; each year until 2024, the Committee would make recommendations on their findings.

  •   HB 2201 would have prohibited the state and any political subdivision in Arizona from using any personnel or financial resources to enforce any executive order or policy directive from the federal government, or any ruling from a federal court, that is not constitutional and signed into law. It passed the House 31-27 but failed in the Senate.

    © 2016 Peters, Cannata & Moody PLC. All rights reserved. MONDAY, MAY 9, 2016

PETERS, CANNATA & MOODY PLC

  •   HB 2501 would have established a six-year process that brings existing health professional regulatory boards under the operation and control of the Arizona Department of Health Services (DHS).

  •   HB 2517 prohibits requires municipalities and agencies to limit occupational regulations to only those necessary, and carefully tailored to meet public health, safety or welfare objectives. The Senate narrowed the bill; as introduced, it would have addressed all regulations.

  •   HB 2600 repeals numerous advisory and oversight boards in state government: the State Parks Board, the Citizens Transportation Oversight Committee, the Water Quality Assurance Revolving Fund Advisory Board, the State Wildland-Urban Fire Safety Committee, and the Advisory Board of Arizona State Library, Archives & Public Records.