Cover page of RRIAR v 2 8 2012 04 30a DRAFT by H9ogoZc


									    Regulation Review and Impact Analysis Report
                       v. 2.8

                                       April 30, 2012

- Table A: Listing and Status Report on Regulations Reviewed
- Table B: Summary and Analysis of Agency Notices and Regulations
- Table C: NIHB Recommendations and Evaluation of Agency’s Subsequent Actions
The purpose of the Regulation Review and Impact Analysis Report (RRIAR) is to identify and summarize key regulations issued by the Centers for
Medicare and Medicaid Services (CMS) pertaining to Medicare, Medicaid, CHIP, and health reform1 that affect (a) American Indians and Alaska Natives
and/or (b) Indian Health Service, Indian Tribe and tribal organization, and urban Indian organization providers. Furthermore, the RRIAR includes a
summary of the regulatory analyses prepared by the National Indian Health Board (NIHB)2, if any, and indicates the extent to which the recommendations
made by NIHB were incorporated into any subsequent CMS actions.
In addition to this cover page, the report consists of three tables –
    -     Table A provides a status report on the RRIAR itself, listing the regulations included in the RRIAR to date, and the components of the analysis
          provided under each. The regulations are organized in four sections: I. Medicaid; II. Medicare; III. Health Reform; and IV. Other.
    -     Table B lists key regulations issued by CMS, due dates for comments, a synopsis of the CMS action, and a summary of the analysis, if any,
          prepared by NIHB.
    -     Table C identifies the recommendations made by NIHB pertaining to each regulation, if any, and evaluates the extent to which the
          recommendations made by NIHB were incorporated into subsequent CMS actions.
Regulations with pending due dates for public comments –
    47. HSA Eligibility and IHS Beneficiaries (IRS Notice 2012-4; comments due 4/30/2012)
    1.b. Medicare and Medicaid EHR Incentive Payments Stage 2 (CMS-0044-P; comments due 5/7/2012)
    1.c. HIT Revised Standards – CMS Electronic Health Records (EHR) Program (HHS-ONC; comments due 5/7/2012)
    28.b Medicaid Eligibility under ACA Expansion (CMS-2349-Interim Final; comments due 5/7/2012) (Final rule published 3/23/2012)
    7.b. Establishment of Exchange and QHP; Eligibility Determinations (CMS-9989-Interim Final; comments due 5/11/2012)(Final rule, including
             CMS-9974-F, published 3/27/2012)
    45. Actuarial Value and Cost-Sharing: CMS Pre-rule Bulletin (Open for comments as of 2/24/2012; no due date given)
    16.b. Medicaid HCBS Waivers (CMS-2249-P2) (Not yet published; comments due approximately 5/30/2012)
    31.c Certain Preventive Services (CMS-9968-ANPRM; comments due 6/19/2012)
    52. Medicare Home Health Access (CMS-10429 and CMS-10185; comments due 6/18/2012)
Comments recently submitted by NIHB and/or TTAG –
    41. Solicitation of New Safe Harbors and Special Fraud Alerts (OIG-120-N; comments submitted 2/27/12)
    43. Medicaid Reimbursement for Outpatient Drugs (CMS-2345-P; comments submitted 4/2/2012)
Regulations under OMB (Office of Management and Budget) review –
    44. Medicaid Payment for Primary Care Services (CMS-2370-P; sent to OMB 2/1/12)
    50. Exchange Accreditation Entities (CMS-9969-P; sent to OMB 3/22/2012)
Recent (final) rules issued –
    27. Risk Adjustment Standards in ACA (CMS-9975-F; issued 3/23/2012)
    11.b Policy and Technical Changes to Medicare Advantage and Medicare PDP for CY 2013 (CMS-4157-F; issued 4/12/2012)
Contacts: Doneg McDonough (; Tyra Baer (

  “Health reform” is inclusive of (1) the Patient Protection and Affordable Care Act (Pub. L. 111-148), incorporating by reference S. 1790 as reported by the
Committee on Indian Affairs of the Senate in December 2009 (containing amendments to the Indian Health Care Improvement Act, IHCIA), and as amended by
the Health Care and Education Reconciliation Act (HCERA; Public Law 111–152) (collectively referred to as “ACA”) and (2) the American Recovery and
Reinvestment Act of 2009 (ARRA, Pub. L. 111-5)
  The analyses and recommendations may include those made by the Tribal Technical Advisory Group to CMS (TTAG).
National Indian Health Board, Regulation Review and Impact Analysis Report                            Page 2 of 2                           4/30/2012

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