POLICY BRIEFINGS


President Obama Says SOTU Got PPACA Reasoning Wrong


In a published interview, the President unveiled his views on the Supreme Court's decision upholding the constitutionality of the PPACA.  He was quoted as stating "It was interesting to see them, or Justice Roberts in particular, take the approach that this was constitutional under the taxing power….The truth is that if you look at the precedents dating back to the 1930s, this was clearly constitutional under the Commerce Clause."


Medicare Home Health Care Coverage Decision


It was reported that HHS has proposed a settlement in a class-action lawsuit brought by the Center for Medicare Advocacy which alleges that CMS illegally denied thousands of chronically ill Medicare beneficiaries' essential therapies and medical services under the "demonstrable improvements in functioning" coverage criteria.  The change proposed by HHS would provide for skilled nursing and therapy services when they are needed to "maintain the patient's current condition or prevent or slow further deterioration."  CMS has not released a cost estimate of the proposed change.


House Oversight Committee Issues Subpoena


Last week the House Oversight and Government Affairs Committee sent a subpoena to HHS to compel the agency to provide certain previously requested documents related to the 10-year $8.3 billion Medicare Advantage Quality Bonus Payment Demonstration.  Republicans maintain the program is but an election year ploy to cover up cuts under the PPACA to the Medicare Advantage program.


OIG Doc Watch


The HHS Office of Inspector General's 2013 work plan includes several initiatives to review possible improper physician payments, including  place-of-service errors and the error rate for "incident-to" services performed by non-physicians.  In addition, meaningful use payments for EHRs will come under scrutiny by the OIG.


Draft Bill to Improve Drug Distribution Security


IThe Senate HELP Committee and House Energy and Commerce Committee released draft legislation designed to help improve pharmaceutical drug distribution security. The bipartisan "track and trace" bill would set standards for tracking prescription drugs to prevent counterfeit or adulterated products to be introduced into the supply chain.



October 29, 2012: | Page 1 Page 2

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