Monthly Archives: June 2015

BREAKING: Supreme Court Upholds Subsidies

The Supreme Court ruling in King v. Burwell (11-114) upholds the Federal tax subsides of the Patient Protection and Affordable Care Act.  As per the Court’s ruling:

“Petitioners’ plain-meaning arguments are strong, but the Act’s context and structure compel the conclusion that Section 36B allows tax credits for insurance purchased on any Exchange created under the Act. Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid.”

CMS Extends Recovery Audit Program Contracts

On June 22, 2015, the Centers for Medicare and Medicaid Services (CMS) issued a Special Notice indicating that they intend to extend the active recovery auditing period for the existing four Medicare fee for service Recovery Audit Program contracts through July 31, 2016 in accordance with FAR 6.302-1.  The Special Notice indicates that it will “allow CMS to fulfill its congressional mandate to correct improper payments in efforts to protect the Medicare Trust Funds while the procurement process is taking place.”

Matthew Horton to Present to MD AAHAM

CMS Presolicitation Notice: Unified Program Integrity Contract (UPIC)

On June 5, 2015 CMS issued a presoliciation notice indicating that they will be issuing a Request for Proposal (RFP) to solicit services for the Unified Program Integrity Contract (UPIC).  As per the notice, “the UPIC will combine and integrate existing CMS program integrity functions carried out by multiple contractors and contracts into a single contractor to improve its capacity to swiftly anticipate and adapt to the ever changing and dynamic nature of those involved in health care fraud, waste, and abuse across the Medicare and Medicaid program integrity continuum.” The solicitation will be available on or about June 22, 2015, and will be distributed solely through the Federal Business Opportunities (FBO) website. Proposals are expected to be due 30 days from the RFP issue date.  Read our blog post for more on UPICs.