The U.S. Court of Appeals for the District of Columbia Circuit gave PPACA a mixed reception during oral arguments, the White House began downsizing the office charged with implementing the CLASS Act, and a Senate subcommittee approved a $70.18 billion budget for fiscal year 2012.
IN THE COURTS
On Friday (9/23) during oral arguments, two of three judges of the U.S. Court of Appeals for the District of Columbia Circuit said a ruling upholding the Affordable Care Act could leave the government with unprecedented power over its citizens. The judges suggested, however, that the challenge to PPACA may be premature because no tax or penalty has yet been paid.
AT THE AGENCIES
The White House requested that Senate Democrats not provide any funding for the CLASS program. HHS is either downsizing or closing the office charged with implementing this program. On Thursday (9/22), more than a dozen members of Congress sent a letter to Sec. Sebelius seeking more information on HHS's plans for the CLASS Act and CLASS office.
HHS will award $109 million in PPACA grants to 28 states and the District of Columbia to help counter large premium increases from health insurers.
On Tuesday (9/20), the Senate Labor, Health and Human Services, and Education, and Related Agencies Appropriations Subcommittee approved a $70.18 billion budget for HHS for fiscal year 2012.
On Tuesday (9/20), pursuant to Section 6411 of PPACA, CMS released a final rule on Medicaid recovery audit contractors. The rule directs states to coordinate with other contractors, entities auditing Medicaid providers, and state and federal law enforcement agencies.
To date, CMS has spent more than $653 million on electronic health records. The programs were founded as part of the American Recovery and Reinvestment Act, not the Patient Protection and Affordable Care Act. The programs have registered 90,650 organizations, 13,099 of which joined during the month of August.
CMS took the bold step of launching a new accountable care organization records database that will house personally identifiable information about patients, their history, health professionals, and more. The program is called Shared Savings Program and Pioneer ACO Program, it is optional, and all information logged with the program will be available to HHS and CMS for their appropriate internal use and external dissemination.
On Monday (9/19), President Obama announced a new deficit reduction plan, which proposes to save $248 billion in Medicare spending and $72 billion in Medicaid spending. According to The Washington Post, the proposal differs most from the White House's April deficit-reduction proposal in "greater cost sharing in Medicare, fewer cuts to Medicaid, and a big hit to the Prevention and Public Health Fund."
MedPAC recently evaluated the payment adjustments for rural health care providers, as required by PPACA. Though draft recommendations have not yet been made, according to Becker's Hospital Review, a MedPAC presentation suggests: 1) principles for evaluating rural payment adjustments should focus on targeting providers that are the sole source of care in their area; 2) adjustments must be made for critical access hospitals, low-volume adjusters and telehealth; and 3) as critical access hospitals raise charges, outpatient co-insurance goes up, which costs Medicare a lot of money.
Letters of intent for Model 1 of the Bundled Payment Initiative were supposed to be due on September 22 and applications due October 21. CMS extended the deadlines to October 6 for the letters of intent and November 18 for reports.
Under new rules proposed Monday (9/19), states will be able to get federal help establishing insurance exchanges, without having a government takeover of them, under an exchange partnership option. Under this model, HHS and the state will be responsible for different functions of the exchange.
On Friday (9/16), CMS issued a guide to assist health care providers transition to new ICD-10 code sets for electronic health transactions. Providers have until October 1, 2013, to adopt these new code sets.
On Friday (9/16), CMS published the final rule on the Medicaid Recovery Audit Contractors program, which the administration estimates will save $2.1 billion over five years.
IN THE STATES
HHS rejected Delaware's request to exempt two state health insurers from the medical loss ratio requirements.
In response to Kansas Gov. Sam Brownback’’s decision to reject the $31.5 million federal “early innovator grant” for health reform, a woman from Wichita submitted a petition last week with over 3,000 signatures protesting the rejection.
On Tuesday (9/20), Idaho Gov. Butch Otter announced that his office will seek $30.9 million in federal funds under the Affordable Care Act to build a state-run health insurance exchange.
THIRD PARTIES
Two surveys released Wednesday (9/21), one from the government and the other from Gallup, found that significantly fewer young adults are going without coverage. The Gallup survey found that adults 18-25 without coverage dropped from 28 percent last autumn to 24.2 percent this summer.
THIS WEEK
On Wednesday (9/28) from 12:00 - 1:00 p.m., The Heritage Foundation previewed the likely blockbuster cases for the Supreme Court's 2011 Term.
To view our compilation of recent health care reform implementation news, click here.