On the Hill, supporters and opponents of the Independent Payment Advisory Board gear up for this week’s debate; CMS is busy issuing proposed rules and reading comments in response to them; and in the states, officials are not implementing insurance exchanges quickly enough to be on track for the 2014 deadline.
IN THE COURTS
On Tuesday (7/5), a federal district court for the Northern District of Ohio ruled that it was bound by the 6th Circuit’s recent holding in Thomas More “that the minimum coverage provision of the Patient Protection and Affordable Care Act is a valid exercise of legislative power by Congress under the Commerce Clause.” The losing party in that case, the Thomas More Law Center, is expected to appeal that decision to the Supreme Court.
In hopes that Supreme Court Justice Kagan will recuse herself from any cases related to the Affordable Care Act, 49 Republicans sent a letter asking the House Judiciary Committee to explore her alleged prior role in devising a legal defense of the Affordable Care Act while she was President Obama’s solicitor general.
AT THE AGENCIES
CMS issued a proposed rule to update the Outpatient Prospective Payment System for calendar year 2012. The rule seeks to strengthen the Value-Based Purchasing Program and the Hospital Outpatient Quality Reporting Program, change the Medicare Electronic Health Record Incentive Program and implement certain Affordable Care Act provisions.
On Tuesday (7/5), CMS proposed a 3.35 percent decrease in Medicare payments to home health agencies beginning in 2012. These cuts would produce savings of $640 million compared to 2011.
On Wednesday (7/6), in an effort to avert payment cuts, the American Hospital Association released data that shows hospitals create more than $2 trillion in economic activity, employing more than 5.4 million and spending roughly $342 billion on purchases from other businesses.
CMS Administrator Donald Berwick was appointed to his position last July during recess. His recess appointment expires in December unless he is confirmed by the Senate. Given strong Republican opposition, however, it is widely believed that Berwick will not be confirmed. Supporters of the reform law are concerned about Berwick's departure because he was the "intellectual architect" of many of the provisions within it.
CMS is accepting comments on its proposed rule titled "Proposed Changes to the 2011 Electronic Prescribing Incentive Program" until July 25th.
On Friday (7/8), CMS announced that over 2,000 hospitals and 2,500 other organizations have signed up to be part of a voluntary Medicare initiative aimed at reducing medical errors. Though HHS is spending $1 billion to implement the initiative, officials say it has the potential to save 60,000 lives and $35 billion in costs.
A new report from the Center for American Progress highlights the less-talked-about exchanges that come from the Affordable Care Act, small-business exchanges. Under the law, states have the opportunity to offer affordable health care to small businesses whose health care premiums have increased 113 percent over the past decade.
IN THE STATES
The Hill reports this week that states are moving too slowly to set up health insurance exchanges before the 2014 deadline. Governors in 10 states have signed laws establishing insurance exchanges. Under the Affordable Care Act, the federal government has authority to set up exchanges for states that do not do so themselves.
Gov. Nikki Haley decided that South Carolina will not pursue any more grant money for an insurance exchange from the Affordable Care Act.
Last week we reported that Iowa and North Dakota are waiting to hear from HHS whether they may implement the PPACA requirement that insurance companies spend 80 percent of premiums on customers' claims more gradually than is required by the law. This week, there is news that Kentucky is awaiting a response as well.
On Thursday (7/7), Kentucky awarded three managed care companies three-year Medicaid contracts. Beginning this October, most Medicaid recipients in Kentucky will choose from WellCare Health Plans Inc., Coventry Health Care Inc., and Centene Corp. for their care. This expansion of managed care is projected to save Kentucky $375 million and help the state balance its budget.
On Wednesday (7/6), a coalition of Ohio conservatives submitted to Ohio’s secretary of state a petition with 550,000 signatures to let Ohioans vote on an amendment to the state constitution, which would prevent Ohioans from being forced to buy health insurance or face penalties.
THIS WEEK
This week is likely to be consumed by fierce debate on the IPAB (Independent Payment Advisory Board), a commission created by the Affordable Care Act, which will have the authority to make decisions to reduce Medicare’s growth rate.
On Tuesday (7/12) at 10:00 a.m., the House Budget Committee will hold a hearing titled "Medicare's Future: An Examination of the Independent Payment Advisory Board." HHS Secretary Sebelius is among the witnesses scheduled.
On Tuesday (7/12) at 12:30 p.m., the Heritage Foundation will hold a panel discussion to suggest an alternative to the Independent Payment Advisory Board.
On Wednesday (7/13) at 9:00 a.m., the House Energy and Commerce Subcommittee on Health will hold a hearing titled "IPAB: The Controversial Consequences for Medicare and Seniors." Sec. Sebelius will be one of the panelists.
On Wednesday (7/13) at 10:00 a.m., the House Budget Committee will hold a hearing titled "Medicare and Social Security: The Fiscal Facts." The chief actuaries from CMS and the Social Security Administration will testify.
As always, please feel free to contact us with any questions.
To view our compilation of recent health care reform implementation news, click here.