Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Congress Eager to Pass FY 2013 CR

The House and Senate return Tuesday and their first major order of business is expected to be the consideration of a bipartisan-bicameral continuing resolution providing FY 2013 appropriations through next March. House Republican budget hawks have backed off their opposition to the measure even though the CR does not follow the House budget resolution which would trim the Budget Control Act’s $1.047 billion cap on discretionary spending. Although Congress is expected this year to trim or delay the BCA’s across-the-board spending sequestration, this task will be pushed back into the lame-duck session after the November elections. This task was supposed to be made easier when Congress passed the Sequestration Transparency Act which required the Administration by September 7th to provide members with all the details regarding which programs would be cut and by how much. After missing the Friday deadline, Republican leaders expressed their displeasure that the White House pushed the deadline back a week. Under the sequestration rules, Medicare cuts would be limited to 2% and Social Security cash benefits and Medicaid would be exempt from the mandated reductions.

Democrats Praise Obamacare at Convention

party’s nomination for a second term, President Obama reinforced his campaign statements in support of the PPACA by saying he would oppose Republicans’ call for repeal. He said the Republican health plan amounted to “If you can’t afford health insurance, hope that you don’t get sick.” The President also took off after the Republican platform which calls for Medicare reform using a “premium support” approach, but also said “we will reform and strengthen Medicare for the long haul, but we’ll do it by reducing the cost of health care, not by asking seniors to pay thousands of dollars more.” In addition, the President indicated he would like to reach a deficit reduction agreement with Congress that stresses the “principles” of the Bowles-Simpson Deficit Reduction Commission. These two comments would seem to show a willingness by the President to agree to Medicare payment reductions as part of a deficit reduction deal in his second term. Vice President Joe Biden coined the Republican Medicare plan as “vouchercare” and other Democrat convention speakers highlighted the benefits of the PPACA as did the party platform. The party document stated that “Over the determined opposition of Republicans, we enacted landmark reforms that are already helping millions of Americans, and more benefits will come soon….” However, the platform also conceded that “No law is perfect and Democrats stand willing to work with anyone to improve the law where necessary, but we are committed to moving forward….” The platform indicated that Democrats would seek to expand primary care and community health centers, eliminate health disparities and fight HIV/AIDS

PPACA Hearings

This Tuesday the House Ways and Means Subcommittee on Oversight has scheduled a hearing to review the IRS’s progress in implementing the PPACA’s provisions and the effect of the law on other revenue collection aspects of the agency. This Wednesday the House Ways and Means Subcommittee on Health has scheduled a hearing focusing on the lack of final regulations relating to the establishment of state health insurance exchanges. Also on the same day the Senate Special Committee on Aging will hold a discussion of the PPACA’s requirement for the public disclosures of payments between physicians and pharmaceutical, medical device and biologics companies

MedPAC on MD and Outpatient Therapy Payments

At a recent MedPAC meeting, Commission Chairman Herb Kuhn recommended that the geographic adjustment component of the Medicare physician payment system be simplified by eliminating the Geographic Practice Cost Indices (GPCI) in favor of specific separate targeted payment adjusters to achieve new goals, such as increasing access for beneficiaries. Others suggested that payments be adjusted more in rural communities to maintain physician access in such areas. Congress mandated that MedPAC study whether to continue geographic adjustments and report by mid-June, 2013. The commissioners also discussed whether the current Medicare caps on physical, occupational and speech therapy payments should be replaced by alternatives, such as an episode-based payment system or one based on prior authorization. MedPAC will also report to Congress in 2013 on their recommendations on this issue.

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