Summer begins. Reform continues. Reminder: for those of you commenting on the ACO regs, today's the deadline. Expect CMS to modify the draft rules. Lots of blowback coming in the comments.
IN CONGRESS
Seven members of the Senate Finance Committee have requested that CMS withdraw the accountable care organization proposed rule. The seven members are Sens. Tom Coburn (R-OK), Jon Kyl (R-AZ), Mike Crapo (R-ID), Mike Enzi (R-WY), John Cornyn (R-TX), Pat Roberts (R-KS), and Richard Burr (R-NC). The request comes as an increasing number of hospitals and clinics express that the quality instead of quantity model is unworkable. They say the proposed regulation is too stringent and costly for them to consider participating.
On Monday (5/23), Sen. Jon Kyl (R-Ariz.) introduced legislation that would repeal several provisions of the Affordable Care Act, including the employer mandate and its tax on health care plans. The National Federation of Independent Business (NFIB) supported Sen. Kyl's bill. The NIFB, along with the Chamber of Commerce and several other groups are campaigning to repeal an $87 billion tax on insurance plans beginning next year.
On Tuesday (5/24), the House debated a bill that would eliminate automatic funding for medical training. Under the Affordable Care Act, the program is funded automatically. Republicans are trying to change this so that the program is instead discretionary, and would have to be authorized each year. Democrats dismissed the bill as Republicans' latest attempt to defund the Affordable Care Act.
On Wednesday (5/25), the House approved an amendment from Rep. Virginia Foxx (R-N.C.) that would prevent a federal health care education fund from being used for abortion or providing training for abortion procedures. The amendment was attached to H.R. 1216, which scales back federal funding for a graduate-level medical training program created in the Affordable Care Act.
AT THE AGENCIES
CMS awarded three states millions of dollars to build health insurance exchanges. Indiana received $6.8 million, Washington $23 million, and Rhode Island $5.2 million.
On Wednesday (5/25), the Wall Street Journal published an article by Cass Sunstein, head of the Office of Information and Regulatory Affairs. In the article, "21st-Century Regulation: An Update on the President's Reforms," Sunstein reminds his readers that earlier this year President Obama outlined a plan to create a “simpler, smarter and more cost-effective approach to regulation.” President Obama called for a government-wide review of regulations already on the books so the Administration could evaluate the extent to which regulations were “out-of-date, unnecessary, excessively burdensome or in conflict with other rules.” Sunstein reported that the results of the evaluation were in, and 30 agencies were laying out regulatory reforms to save money and eliminate unjustified regulations. On Thursday (5/26), the Office of Management and Budget posted on the White House website the preliminary regulatory review plans of 30 agencies for which specific regulations will be modified or eliminated.
CMS released a fact sheet on accountable care organizations specifically for rural providers. The factsheet provides four provisions intended to increase rural participation in the Medicare Shared Savings Program: 1) ACOs in rural communities would be eligible for an exemption from the 2 percent net savings threshold; 2) A lower confidence interval would be used to set the minimum savings rate for smaller ACOs; 3) Certain critical access hospitals would be eligible to form their own ACOs; 4) The proposal features incentives for including federally qualified health centers and rural health clinics in the accountable care organization.
IN THE COURTS
On Wednesday (5/25), three appeals judges were chosen to hear the multi-state challenge to the Affordable Care Act. Unlike the judges who heard the appeals arguments in Richmond earlier in May, the 11th Circuit panel will include judges appointed by both Republican and Democratic presidents. The judges who will hear the appeal on June 8th are: Chief Judge Joel Dubina, a George H.W. Bush appointee; Judge Frank Hull, a Bill Clinton appointee; and Judge Stanley Marcus, a Clinton Republican appointee. The 11th Circuit Court of Appeals announced last week that it will make available for sale audio recordings of next month's argument in the multi-state challenge to the Affordable Care Act.
A section of the Patient Protection and Affordable Care Act that makes it easier for coal miners to receive benefits for black lung disease survived an employer's constitutional challenge. A little-known section of the Affordable Care Act establishes a presumption that a mine worker with fifteen years of service who contracted a lung disease contracted it on the job, and further made it retroactive to claims filed after January 1, 2005.
IN THE STATES
On Thursday (5/26), Vermont Governor Peter Shumlin signed into law a bill establishing a single-payer health care plan for the state, making Vermont the first state with a single-payer plan.
Some sources have attributed Democrat Kathy Hochul's defeat of Republican Jane Corwin in the New York Special Election last week to their Medicare plans. Corwin (R) endorsed the GOP plan to alter Medicare. Hochul (D) defended a social safety net. Rep. Paul Ryan acknowledged that Democrats’ "demagoguery" of his budget, which Corwin said she would have supported, played a role in Republicans' defeat.
On Wednesday (5/25), House members approved an amendment allowing Texas to join a multistate health care compact.
In March, Florida Governor Rick Scott said he would accept a $35.7 million federal "Money Follows the Person" health grant, however the Florida legislature did not give the Agency for Health Care Administration the authority to spend this money. The grant was for five years, however it is not clear whether Florida will be able to accept the money if the legislature changes its mind later.
On Thursday (5/26), Maryland Governor Martin O'Malley signed executive orders to establish the creation of an Office of Health Care Reform, expand the Health Care Reform Coordinating Council, and enhance the role of the Maryland Health Quality and Cost Council.
As always, please feel free to contact us with any questions.
To view our compilation of recent health care reform implementation news, click here.