Dr. Oz’s Medicare Leadership Team Takes Shape

Washington Post / By Dan Diamond
 
President-elect Donald Trump appears poised to tap a trio of health policy experts to serve as top deputies to Mehmet Oz, his pick to oversee the Centers for Medicare and Medicaid Services, according to seven people who spoke on the condition of anonymity to discuss private conversations.
 
Chris Klomp, a health-care entrepreneur, would lead the roughly $1 trillion Medicare program, which provides health coverage to about 68 million Americans. Abe Sutton, a veteran of the first Trump administration, would oversee Medicare’s innovation center, which tests new ways to deliver care to patients. Stephanie Carlton, a longtime McKinsey consultant and former GOP Senate staffer, would serve as Oz’s chief of staff, helping run the vast agency that also has responsibility for Medicaid and the Affordable Care Act.
Klomp, Sutton and Carlton did not immediately respond to requests for comment. Their proposed appointments are not finalized and are subject to further review, according to the people with knowledge of the planned selections. STAT News reported Monday night that Sutton was Trump’s pick to run the innovation center.
 
A person familiar with the Trump transition team’s plans confirmed that Klomp, Sutton and Carlton are all favored for their respective positions…

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DOL Issue[s] Opinion Letter on Whether FMLA Regulations Pertaining to Substitution of Paid Leave Apply When Employees Take Leave Under State or Local Paid Family Leave Programs

SESCO Management Consultants

While the Family and Medical Leave Act (FMLA) provides for unpaid leave for employees that work for an employer with 50 or more employees, the FMLA also allows the employee to elect, or an employer to require the employee, to “substitute” accrued employer-provided paid leave (e.g., paid vacation, paid sick leave, etc.) for any part of the unpaid FMLA period. The term “substitute” means that either the employer or employee, on their own, can decide to have employer-provided paid leave run concurrently with the unpaid FMLA leave. However, the U.S, Department of Labor (DOL) has explained that neither the employer nor the employee can require substitution, under the FMLA, of employer-provided accrued paid leave during an absence for which the employee receives compensation provided by a disability or workers’ compensation program. Likewise, where an employee, during leave covered by the FMLA, receives compensation from a state or local family or medical leave program, the DOL has now stated that the FMLA substitution provision does not apply to the portion of leave that is compensated.

• Because the substitution provision does not apply, neither the employee nor the employer may use the FMLA substitution provision to unilaterally require the concurrent use of employer-provided paid leave during the portion of the leave that is compensated by the state or local program.

• If the employee is receiving compensation through state or local paid family or medical leave that does not fully compensate the employee for their FMLA covered leave, and the employee also has available employer-provided paid leave, the employer and the employee may agree, to use the employee’s employer-provided accrued paid leave to supplement the payments under a state or local leave program.

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Mandatory OSHA Injury & Illness Reporting

Alliance Daily

Many employers with more than 10 employees are required to keep a record of serious work-related injuries and illnesses. Some health care and home care companies must electronically submit injury and illness reports to the Occupational Safety & Health Administration (OSHA) annually through OSHA’s Injury Tracking Application (ITA).  The deadline for submission of the 2024 data is March 2, 2025.

It is important to note OSHA has requirements for both recording and reporting work-related injuries and illnesses. A recordable injury or illness includes:

• Any work-related fatality.
• Any work-related injury or illness that results in loss of consciousness, days away from work, restricted work, or transfer to another job.
• Any work-related injury or illness requiring medical treatment beyond first aid.
• Any work-related diagnosed case of cancer, chronic irreversible diseases, fractured or cracked bones or teeth, and punctured eardrums.
• There are also special recording criteria for work-related cases involving: needlesticks and sharps injuries; medical removal; hearing loss; and tuberculosis.

To determine if your organization must submit a report, please review the ITA submission requirement flowchart [found on page 3 of the linked Injury Tracking Application (ITA) User Guide] Note that there may be different and/or additional state-specific reporting differences.

All employers, including those partially exempted by reason of company size or industry classification, must report to OSHA any workplace incident that results in a fatality, in-patient hospitalization, amputation, or loss of an eye (see § 1904.39). 

Additional information about OSHA’s recordkeeping and reporting requirements can be found here.

ACO Growth Inches CMS Toward Value-Based Care Goal

Modern Healthcare / By Bridget Early
 
More than half of fee-for-service Medicare enrollees are now in accountable care arrangements, putting the Centers for Medicare and Medicaid Services past midway toward its 2030 goal, according to data the agency released Wednesday.
Accountable care participation rose 4.3% to 14.8 million people from 2024 to 2025, the largest annual increase since CMS started tracking these numbers. That amounts to 53.4% of fee-for-service beneficiaries, according to the agency.
 
The CMS report illustrates the progress the agency has made promoting value-based care in traditional Medicare since announcing in 2021 that it wanted all fee-for-service enrollees in accountable care arrangements by 2030. It also shows how much is left to do to meet that target, and consummating the endeavor would require President-elect Donald Trump's administration to pick up where President Joe Biden's team leaves off.
 
“This progress demonstrates that when providers are empowered to manage costs and focus on outcomes, they can achieve high-quality outcomes and drive innovation,” Aisha Pittman, senior vice president of government affairs for the National Association of ACOs, said in a news release.
 
Tweaks to existing accountable care organizations and the creation of models such as the ACO Primary Care Flex Model support the 2030 goal, but regression in one high-profile model highlights the ongoing challenges. Congress also must decide how to handle bonus payments for providers transitioning into value-based care.
 
The CMS report covers the permanent Medicare Shared Savings Program and models from the Center for Medicare and Medicaid Innovation such as ACO Realizing Equity, Access and Community Health, or ACO REACH…

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