In the past week, the Supreme Court granted certiorari in the challenge to the Affordable Care Act brought by 26 states, the National Federation of Independent Business and two individual plaintiffs from the 11th Circuit; CMS announced that it will award up to $1 billion in grants to implement ideas that can quickly deliver cost saving and quality of care benefits to the Medicare program; and members of the Supercommittee reported that it is unlikely a deal to cut $1.2 trillion will be reached by this week's deadline.
IN THE COURTS
On Monday (11/14), the Supreme Court granted certiorari in the challenge to the Affordable Care Act brought by 26 states, the National Federation of Independent Business and two individual plaintiffs from the 11th Circuit. The central issue raised by the case is whether Congress exceeded its constitutional powers when it required most individuals to carry health insurance or pay a penalty. The Court is expected to hear oral arguments in March and decide the case in June. The 26 states argue that the entire Affordable Care Act must be abandoned if the individual mandate is deemed unconstitutional.
On Friday (11/18), the Supreme Court appointed H. Bartow Farr III and Robert A. Long, two experienced D.C. litigators, to handle two of the case's key issues. Because neither of the parties in the case takes this position, the Court has asked Farr to defend the 11th Circuit Court of Appeals' decision that the individual mandate is unconstitutional and has asked Long to argue that the case is premature, a position the 4th Circuit Court of Appeals took.
On Tuesday (11/15), C-SPAN sent the Supreme Court a letter requesting that it allow the health care arguments to be televised. The Supreme Court has never televised its arguments. Sen. Charles Grassley (R-IA) also asked for the arguments to be televised.
AT THE AGENCIES
On Monday (11/14), CMS announced that it will award up to $1 billion in grants to ideas that can quickly deliver cost saving and quality of care benefits to the Medicare program. Awards will range from approximately $1 million to $30 million for a three-year period.
On Thursday (11/17), the HHS Office for the National Coordinator for Health Information Technology announced that more than 100,000 primary care providers are adopting Electronic Health Records to lower costs and improve quality of care.
On Tuesday (11/15), CMS announced that it is launching three demonstration programs this January to try to reduce overall payment errors in Medicare and Medicaid. The programs are a Recovery Audit Prepayment Review Program, which will allow Medicare recovery auditors to review claims before they are paid, a Prior Authorization for Certain Medical Equipment Program, which will require prior authorization for certain medical equipment for Medicare beneficiaries who live in the seven states with high populations of fraud and error-prone providers, and a Part A and Part B Rebilling Program, which will allow hospitals to rebill for 90 percent of the Part B payment when a Medicare contractor denies a Part A inpatient short stay claims as "not reasonable and necessary."
ON THE HILL
On Wednesday (11/16), the House of Representatives passed legislation that will provide some regulatory relief to tax-paying hospitals. The legislation repeals a 3 percent withholding law on certain payments to contractors and vendors by government agencies. The Senate passed the bill two weeks ago as well.
Nine health care organizations, most of which advocate for those with chronic illnesses, are urging the Supercommittee to oppose cuts to Medicare. The advocates penned a letter to Congressman Greg Walden (R-OR) encouraging him to maintain his opposition to spending cuts to Medicare Part D.
IN THE STATES
The National Governors Association will work with officials in Alabama, Illinois, Kentucky, Nevada, Utah and Washington to help facilitate discussion on the creation of health care exchanges in those states.
CMS approved Louisiana Gov. Bobby Jindal's "Bayou Health" plan, under which the state Medicaid program will be run through different managed care plans.
CMS officials have given themselves an extra 30 days to decide on Florida's request for a waiver from the medical loss ratio requirements of the Affordable Care Act.
Mississippi, Louisiana, Alabama, Illinois,and Kentucky are receiving more than $6 million in rural health care grants from the U.S. Department of Agriculture. The funds will go towards a range of projects including the creation of an urgent care center in Mississippi, extension of doctors' hours, telemedicine projects in Louisiana, transportation for nurses and medical students to areas without clinics and hospitals, and equipment at state schools.
To view our compilation of recent health care reform implementation news, click here.