POLICY BRIEFINGS


GOP Governors Ask for Meeting with the President


The Public Policy Committee of the Republican Governors Association sent a letter to President Obama requesting a meeting in an attempt to gain more flexibility over HHS decisions regarding the expansion of Medicaid under the PPACA. Other issues of concern to the governors include the rules for establishing state-run health insurance exchanges.


House Small Business Committee Explains PPACA Provisions


The House Small Business Committee released documents which the committee says gives small businesses the tools to better understand their responsibilities under the PPAWCA, as well as information on the “consequences for small business”.


CBO Defends PPACA Cost Assumptions


The CBO responded to a request by House Government Reform Chairman Darrell Issa for the reason the agency assumed that federal subsidies would be available to individuals who elect to be covered under the default federal health insurance exchange beginning in 2014. Several legal authorities have offered their opinion that the plain language of the PPACA cannot be read to authorize subsidies beyond state-run exchanges. The Executive Director said the CBO assumed the individual subsidies would be available in all states, even under the federal exchange, because the possibility that such subsidies would only be available in states that created their own exchanges did not arise in the agency’s discussions with congressional staff during the law’s consideration.


IRS Releases Final Tax Rules on Medical Devices and Health Insurance


The Internal Revenue Service issued final regulations defining the details of the 2.3% excise tax on medical devices imposed by the PPACA. The tax applies to the sale of certain medical devices beginning in 2013. The rule exempts eyeglasses, contact lenses and hearing aids. Another PPACA final rule released by the IRS implements and provides guidance on the “fees” imposed on health insurers in connection with certain health insurance policies as well as on the the plan sponsors of certain self-insured group health plans. The final regulations apply to policy and plan years ending on or after October 1, 2012 and before October 1, 2019.


MedPAC Releases Recommendations on Provider Payments


The Medicare Payment Advisory Commission released FY 2014 payment rate recommendations under which inpatient and outpatient hospitals would receive a 1% increase (the .8% difference between the 1% and the 1.8% statutory update is intended to recover past overpayments). The Commission also appears ready to recommend in January that that ambulatory surgical centers (ASCs) be given a .5% payment increase in FY 2014. In addition, MedPAC said that inpatient rehabilitation facilities, long-term care hospitals and hospice facilities should not receive payment updates in FY 2014. Of note, MedPAC also discussed whether to reiterate their previous recommendation to Congress that the sustainable growth rate (SGR) be eliminated in determining future Medicare physician payments.


Supreme Court to Hear Pay-for-Delay Case


The Supreme Court has accepted for review a federal appeals court decision involving a “reverse payment” deal between a branded and generic drug-maker. If a ruling results from the court’s review, the decision would resolve a split in circuit courts as to whether or not such pay-for-delay deals are anti-competitive and presumptively illegal.


Health-Related Hearings This Week


House Energy and Commerce Health Subcommittee will hold a hearing titled “State of Uncertainty: Implementation of PPACA’s Exchanges and Medicaid Expansion”;
Dec. 13, 10:00 a.m., 2123 Rayburn Bldg.

Senate Finance Committee will hold a hearing titled “Improving Care for Dually-Eligible Beneficiaries: A Progress Update”. Dec. 13, 10:00 a.m., 215 Dirksen Bldg.


Health Legislation Recently Introduced


H.R. 6633 (HUMAN CLONING), to amend Title 18, U.S. Code, to prohibit human cloning; HARRIS; to the Committee on the Judiciary, Nov. 30.

H.R. 6626 (HEALTH INFORMATION TECHNOLOGY), to foster further innovation and entrepreneurship in the health information technology sector; HONDA; jointly, to the committees on Energy and Commerce, Ways and Means and Small Business, Dec. 3.

S. 3659 (MEDICARE), to repeal certain changes to contracts with Medicare quality improvement organizations, and for other purposes; CONRAD; to the Committee on Finance, Dec. 5.

H.R. 6635 (TRICARE), to direct the secretary of defense to submit a report to Congress on the future availability of TRICARE Prime throughout the United States and to ensure that certain TRICARE beneficiaries retain access to a primary care provider, and for other purposes; WALDEN; to the Committee on Armed Services, Dec. 5.

H.R. 6638 (PHARMACIES), to amend Chapter V of the Federal Food, Drug, and Cosmetic Act to enhance requirements for pharmacies that compound 13.



December 10, 2012: | Page 1 Page 2

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