Health Care Reform Update – Week of August 5th, 2013

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Office of Personnel Management Addresses Premiums for Congressional Staffers On August 1st, the U.S. Office of Personnel Management (OPM) announced it will release proposed regulations within the next week to allow the federal government to contribute to the health care premiums of members of Congress and their staffs. Earlier in the week, President Obama said he was working with Congress to address the issue, which had prompted concerns about a brain drain from Capitol Hill. Senator Tom Coburn (R-OK) said he intended to place a hold on Katherine Archuleta, the nominee to be the chief at OPM, until the issue was resolved.

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House Energy and Commerce Committee Unanimously Approves SGR Bill On July 31st, by a unanimous 51-0 vote, the House Energy and Commerce passed legislation that would repeal the sustainable growth rate (SGR) Medicare physician payment method and shift payment to quality-based measures.

Implementation of the Affordable Care Act

On July 29th, CMS issued a release that indicates the ACA and its gradual closure of the donut hole coverage gap has saved 6.6 million Americans over $7 million, an average savings of $1,061 per beneficiary.

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On July 29th, the White House issued a blog post noting nationwide health care costs grew just 1.1% from May 2012 – May 2013. The 1.1% growth is the slowest in 50 years.

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On July 30th, House Republicans released a playbook for the August recess that encourages members to hold “emergency town halls” in response to ACA implementation.August 5, 2013

On July 30th, the CMS released an application that allows organizations to become “Champions for Coverage” under the ACA.

On July 30th, CMS released an application for community health centers and other health providers that want to become certified application counselor organizations and help people searching for insurance coverage on the ACA exchanges.

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On July 30th, the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JTC) issued an estimate that the employer mandate delay of the ACA will cost about $12 billion.

On July 31st, HHS issued a request for information from stakeholders regarding section 1557 of the ACA, which prohibits discrimination based on race, color, national origin, sex, age, or disability in health care programs.

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On July 31st, the Kaiser Family Foundation (KFF) released a report and interactive map on how insurance coverage would be expanded as a result of the ACA.

On July 31st, House Speaker John Boehner (R-OH) said he is still unsure if House Republicans will use the threat of a government shutdown in an effort to defund the ACA.

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On July 30th, EHealthInsurance reached a deal to sell its products on the ACA insurance exchanges. EHealth CEO Gary Lauer says his company’s involvement on the exchanges will lead to increased enrollment and improved competition in the insurance marketplace.

On August 1st, California announced six insurers that will offer coverage on the state’s Small Business Health Options Program (SHOP). A summary of the Covered California plan indicates the premium prices and coverage options for hypothetical business operations.

On August 1st, 38 Republican Senators sent a letter to White House Counsel Kathryn Ruemmler with a request for information on the government agencies involved in ACA implementation.

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On August 1st, the House Ways and Means Committee held a hearing on the role of the IRS in ACA implementation. Gary Cohen of the CMS Center for Consumer Information and Insurance Oversight (CCIIO) and Daniel Werfel of the IRS testified before the committee.

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On August 1st, the House Energy and Commerce Committee conducted a hearing with CMS Administrator Marilyn Tavenner to discuss the current state of ACA implementation.

On August 2nd, the House voted, 232-185, to prohibit the IRS from being involved in enforcement of the ACA. The vote was the 40th time the House has attempted to repeal components of the ACA.

Other HHS and Federal Regulatory InitiativesAugust 5, 2013

On July 30th, the Department of Justice (DOJ) announced Wyeth Pharmaceuticals agreed to pay over $490 million to resolve criminal and liability issues arising from the company’s unlawful marketing of Rapamune, a drug only approved by the Food and Drug Administration (FDA) for kidney transplants.

On July 31st, CMS issued final payment rules to increase payments to skilled nursing facilities by 1.3%, at a cost of $470 million, and increase payments to inpatient rehabilitation facilities by 2.3%, a $170 million cost.

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On August 1st, the FDA released 2014 user fee rates for biosimilars, brand name prescription drugs, generic prescription drugs, and medical devices.

On August 2nd, the FDA issued a rule addressing ‘gluten-free’ food labeling. The rule states foods that claim to be gluten-free but contain more than 20 parts per million of gluten will be considered misbranded products.

On August 2nd, CMS released a final rule relating to payments for acute care and long-term care hospitals in 2014. The rule increases payment to the nation’s 3,400 acute care hospitals by $1.2billion. Payment to 440 long-term care facilities is set to increase $72 million.

Other Congressional and State Initiatives

On July 31st, Rep. Daniel Lipinski (D-IL) introduced legislation to require hospitals to publicly disclose the prices charged for the most common medical procedures.

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On August 1st, Democratic Senators sent a letter to President Obama urging the White House to establish set targets for Medicare and Medicaid cost savings.

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On August 1st, Senators Mark Warner (D-VA) and Johnny Isakson (R-GA) introduced The Care Planning Act of 2013, a bill to improve palliative care and provide seriously ill patients with greater control of their own care.

On August 2nd, Michigan and Illinois announced a partnership to share Medicaid information systems, a plan expected to save millions of dollars for both states.

On August 2nd, Senators Mike Crapo (R-ID), Ben Cardin (D-MD), and Angus King (I-ME) introduced a bill, S. 1422, to require the CBO to more completely address the cost-savings of preventive healthcare.

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Other Health Care News

On July 29th, doctors from the National Cancer Institute published a report suggesting the word ‘cancer’ is overused. The report argues the overuse of the term leads to unnecessary and potentially harmful treatment in many patients.August 5, 2013

On July 29th, Gallup released a poll indicating Americans have exercised less each month in 2013 than during the same months in 2012. About half of Americans say they exercise at least 30 minutes three or more days each week.

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On August 2nd, the Institute of Medicine released a report on the efforts needed to tackle obesity in the United States.

Hearings and Mark-Ups Scheduled

The Senate and the House of Representatives are in recess until the week of September 9th.

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David Shirbroun also contributed to this article.

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