Health Bills Passed

The House passed H.R. 307, the Pandemic and All-Hazards Preparedness Reauthorization Act (PAHPA) of 2013, which now moves to the Senate. Also, by unanimous consent, the House Energy and Commerce Committee passed three bills which will next be taken up on the House floor: H.R. 297, the Children’s Hospital GME Support Reauthorization Act, which reauthorizes the funding for five years of training programs for pediatric care physicians; H.R. 225, the National Pediatric Research Network Act of 2013, which would authorize NIH to establish a national pediatric research network dedicated to finding treatments and cures for pediatric diseases and conditions; and H.R. 235, which streamlines the certification requirements for U.S. veterans with military emergency medical training to become civilian EMTs and which authorizes a five-year grant program for states that demonstrate an EMT shortage.

Senate Lame Ducks

Senators having sway over key health and budget issues who have announced that they will make the current Congress their last include: Sen. Tom Harkin (D-IA), Chairman of the Senate HELP Committee; Sen. Jay Rockefeller (D-WV), Chairman of the Senate Finance Health Care Subcommittee; and Sen. Saxby Chambliss (R-GA) who has proved an important voice for long-term deficit reduction as a member of the so-called “Gang of Eight”. Of note, Senator Harkin also said his Senate HELP Committee will hold a hearing “30 Million New Patients and 11 Months to Go: Who Will Provide Their Primary Care?” on Tuesday at 10:00 a.m. in 430 Dirksen Bldg.

Republicans Continue to Target PPACA Provisions

Senators Lamar Alexander (R-TN) and Orrin Hatch (R-UT) introduced S. 40, legislation that would repeal the Patient Protection and Affordable Care Act’s (PPACA) individual mandate. Senator Hatch said the bill eliminates the individual mandate “so we can instead find ways of providing people with health care, but in a manner that doesn’t run counter to our constitutional framework of limited government.” In the House, Rep. Phil Roe (R-TN-01) and several Democrats support legislation (H.R. 351) which would repeal the Independent Payment Advisory Board (IPAB) while Rep. Erik Paulsen (R-MN-03) is seeking to repeal the PPACA’s 2.3% excise tax on medical devices. House leaders would likely require that consideration of the two latter bills be accompanied by cost offsets which could again scuttle such legislation in the Senate. Federal costs under the PPACA could also be pushed off by extending the various effective dates of the act, an idea that may be pursued by Rep. Michael Burgess (R-TX-26).

PPACA Subsidy Thresholds Clarified

HHS released the federal poverty guidelines which will be used under the PPACA to determine the income levels for households with between 100-400% of the FPL which are eligible for premium subsidies (refundable tax credits) under the law. The FPL for one person is $11,490 and $23,550 for a family of four.

Notification of Availability of Exchange Coverage Delayed

The Departments of Labor, Health and Human Services and Treasury announced that the PPACA mandate that all employers subject to the Fair Labor Standards Act notify new and current employees of coverage available under health insurance exchanges has been delayed from March 1, 2013 until regulations outlining the notification requirements are issued (probably in late summer or this fall).

New Benefit Required Under PPACA

The U.S. Preventive Services Task Force (USPSTF) announced a final recommendation that health care providers screen all women of childbearing age (14-46) for possible domestic abuse to determine if they are victims of intimate partner violence which often goes undetected. If present, providers could recommend counseling, home visits or referrals to community services. This so-called “Grade B” ruling means that the screening will be defined as a “preventive service” under the PPACA and covered without cost-sharing. In a non-final draft recommendation the Task Force said more evidence would be needed for the panel to make a final recommendation that providers intervene to prevent child maltreatment among children who show no signs of abuse. The draft recommendation is open for public comment until February 18, 2013.

House Chairs Question CMS Ability to Provide Accurate Plan Data

House Ways and Means Chairman Dave Camp (R-MI-04) and Subcommittee Chairman Kevin Brady (R-TX-08) alerted Department of Health and Human Services (HHS) Secretary Kathleen Sebelius of their concern that, according to the Government Accountability Office (GAO), the Centers for Medicare and Medicaid Services (CMS) failed at times to provide accurate data about the availability of Medicare Advantage cost plans under the agency’s online plan finder. They asked HHS to respond by February 8 as to whether and how the systems involved need to be improved to provide Medicare beneficiaries with accurate information. They intimated that if CMS cannot provide accurate plan information now, it does not bode well for the ability of HHS to provide accurate plan information under the health exchanges required under the PPACA.

NAIC Names Ben Nelson CEO

The National Association of Insurance Commissioners (NAIC) named former Nebraska Senator Ben Nelson as their new CEO. He said the association’s focus will be retaining state insurance authority as the PPACA and its health insurance exchanges are implemented.

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