House W&Ms Committee Votes to Repeal 1099 Reporting

Last week the House Ways and Means Committee passed two legislative versions repealing the PPACA’s IRS Form 1099 reporting requirements.  The first, H.R. 705, would pay for the $19.2 billion cost of the legislation by tightening the PPACA’s provision for recapturing the overpayment of federal subsidies under health insurance exchanges.  Democrats opposed the payfor in the first bill, but allowed a voice vote to occur on the second bill, H.R. 4, Lungren legislation which does not contain any cost offset.  The bill could be brought to the House floor in March or later this spring.

House Judiciary Passes Med-Mal Legislation

Last week on an 18-15 vote, the House Judiciary Committee passed medical malpractice reform legislation, H.R. 5 (the Help Efficient, Accessible, Low-cost, Timely Healthcare Act) which would place a $250,000 cap on noneconomic damages and allocate damages based on fault.  The committee chairman said the bill would reach the House floor in the next several weeks.

ACO Rules

With accountable care organizations (ACOs) due to start up under the PPACA next January, CMS has sent to OMB proposed rules for their establishment.  With considerable differences among insurers, providers and others as to the scope and operations of ACOs, Senators Mark and Tom Udall and six others wrote the Department of Justice and the Federal Trade Commission requesting that they coordinate their antitrust guidance for ACOs.

HHS Grants

HHS announced that grants for seven cooperative agreements totaling $241 million were awarded to “early innovator” states to help design and implement information technology infrastructure needed to operate health insurance exchanges.  The program is designed to create various health insurance exchange models that other states can use.

Hearings on PPACA and President's Budget

Last week the National Academy for State Health Policy issued a briefing paper on PPACA requirements for state health insurance exchanges.  A major issue for states is whether to establish separate exchanges for individuals and families and separate exchanges for small businesses.  The exchanges have to provide minimum coverage according to the PPACA beginning in 2014.  In this connection, at last week’s House Energy and Commerce Subcommittee on Health hearing on the PPACA, the Chairman, Cliff Stearns, said the PPACA has resulted in “lost coverage, higher premiums, and higher costs.  And when the damaging effects of the Administration’s health care plan got so bad that people were starting to notice, then it was time for waivers….”  However, Rep. Henry Waxman stuck up for the Administration waiver process maintaining that HHS did not act with bias in granting the waivers for union and other mini-med plans effective during the period before the exchange rules take effect.  Last week the Administration went further and granted waivers to health insurers covering 900 plans in four states, exempting them from the minimum $750,000 essential benefits requirement.  At a Ways and Means Committee hearing, Chairman Dave Camp grilled HHS Secretary Kathleen Sebelius on the President’s budget proposals, stating that the PPACA “is a mess, and so is the budget that is meant to finance its implementation….”  He also said the Medicare physician payment two year extension is “absent of any policy details….”  He also called attention to the lack of long-term reform proposals for Medicare under the budget.

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