federal register • 01 november 2021

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CMS has published in the federal register:

  • A Notice of Agency Information Collection Activities:
    1. Survey Report Form for Clinical Laboratory Improvement Amendments (CLIA) and Supporting Regulations
    2. ICF/IID Survey Report Form and Supporting Regulations
  • A Notice of Agency Information Collection Activities:
    1. Data Use Agreement (DUA) Form, Research Identifiable Files Request Packet
    2. Contract Year 2023 Plan Benefit Package (PBP) Software and Formulary Submission

federal register • 13 august 2021

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CMS has published in the federal register:

  • Final Rules for the Medicare Program:
    1. Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2022 Rates;
    2. Quality Programs and Medicare Promoting Interoperability Program Requirements for Eligible Hospitals and Critical Access Hospitals;
    3. Changes to Medicaid Provider Enrollment; and
    4. Changes to the Medicare Shared Savings Program
  • A Notice of Agency Information Collection Activities:
    1. Request for Certification as Supplier of Portable X-Ray Services under the Medicare/Medicaid Program
    2. Request for Certification in the Medicare/Medicaid Program for Provides of Outpatient Physical Therapy and/or Speech-Language Pathology

federal register • 04 august 2021

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CMS has published in the federal register:

  • Final Rules for the Medicare Program:
    1. FY 2022 Hospice Wage Index and Payment Rate Update,
    2. Hospice Conditions of Participation Updates,
    3. Hospice and Home Health Quality Reporting Program Requirements
  • Final Rules for the Medicare Program: FY 2022 Inpatient Psychiatric Facilities Prospective Payment System and Quality Reporting Updates for Fiscal Year Beginning October 1, 2021 (FY 2022)
  • Final Rules for the Medicare Program:
    1. Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2022 and Updates to the IRF Quality Reporting Program;
    2. Payment for Complex Rehabilitative Wheelchairs and Related Accessories (Including Seating Systems) and Seat and Back Cushions Furnished in Connection with Such Wheelchairs
  • Final Rules for the Medicare Program:
    1. Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities;
    2. Updates to the Quality Reporting Program and Value-Based Purchasing Program for Federal Fiscal Year 2022; and
    3. Technical Correction to Long-Term Care Facilities Physical Environment Requirements
  • Proposed Rules for the Medicare Program:
    1. Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs;
    2. Price Transparency of Hospital Standard Charges;
    3. Radiation Oncology Model;
    4. Request for Information on Rural Emergency Hospitals

federal register • 23 july 2021

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CMS has published in the federal register:

  • Proposed Rules for the Medicare Program: CY 2022 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment Policies; Medicare Shared Savings Program Requirements; Provider Enrollment Regulation Updates; Provider and Supplier Prepayment and Post-Payment Medical Review Requirements
  • A Notice of Agency Information Collection Activities
  • A Notice of a Funding Opportunity: Reduction of Issuer Burden Through Technology Grant
  • A Notice of a Meeting for the Medicare Program: Advisory Panel on Hospital Outpatient Payment

federal register • 17 march 2021

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CMS has published in the federal register:

  • Interim Final Rules for the Medicare Program: Coverage of Innovative Technology and Definition of Reasonable and Necessary; Delay of Effective Date; Public Comment Period
  • A Notice of Agency Information Collection Activities: Medicaid Eligibility and Enrollment (EE) Implementation Advanced Planning Document (IAPD) Template
  • A Notice for the Medicare and Medicaid Programs: Quarterly Listing of Program Issuances—October Through December 2020
  • A Notice of Meetings: Advisory Panel on Outreach and Education

don’t blame incentives

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Psychology which explains everything
explains nothing
and we are still in doubt.

—Marianne Moore, Marriage

I was tempted to title this post “against incentives”. But really my objection isn’t to “incentives” per se. To be “against incentives” makes about as much sense as being “against breathing” or “against food” or “against gravity”. What I’m against is the mindless talk about “incentives” which is now ubiquitous. “Incentives” explain all social, economic, and political behavior — or are the only explanation that is needed. And a reference to “incentives” is all that is required to define the purpose and the goals of public policy. The problems that public policy are concealed by the all-purpose veil of “good incentives”. The causes of those problems remain unidentified and unaddressed once it is “understood” that they are the result of “bad incentives”. Human agency itself is tossed away, as, oddly enough, is the very notion of freedom. All behavior becomes nothing more than an unthinking, involuntary response to incentives. No one chooses how they behave. They just respond to incentives. Some people choose well. Many poorly. The difference between “good choosers” and “bad chooser” simply reflects their ability to compute the incentives.

the market isn’t the solution

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“Government isn’t the solution to our problems. Government is the problem.”

— Ronald Reagan,
January 20, 1985,
First Inaugural Address

It is tempting to parody Ronald Reagan in light of the events of the past 12 months (and longer) and say: The market isn’t the solution to our problems. It is the problem.” Tempting, but just as illogical and fallacious as Regan’s statement was and remains. Government isn’t the problem because it isn’t the solution to our problems. Indeed, few critical thinkers would ever have claimed that government was the solution to our problems. Government policy and government action to enforce those policies can contribute to the solution of our problems. Government policy may be a necessary part of the solution to our problems, but it is not — by itself — sufficient to solve those problems.

It’s the same with markets. The market is the context, the setting, the ecosystem within which our problems emerge and within which our problems must be solved. If there is any lesson that should be taken from the failure of the Soviet experiment (1919 to 1981) it is that it isn’t possible to simply abolish the market. This is the (sole) truth that should be taken from so-called public choice theory. But the “market” does not exist as some pure, pristine Platonic Form that is corrupted by fallible and flawed human actors. The market is itself created — at least in part and, in some cases, in substantial part — by government policy. With no offence intended to proponents of deregulation, the market doesn’t just emerge from the unconstrained actions of market participants. Or rather, the market that would emerge from the unconstrained actions of market participants would resemble Thomas Hobbes’ description of the State of Nature: “a War of every man against every man” in which life is “solitary, poore, nasty, brutish, and short”.