House Energy and Commerce Advances Health Bills

The House Energy and Commerce Committee approved by voice vote, for consideration in the House, the following reauthorization bills: H.R. 594, for muscular dystrophy research and assistance programs; H.R. 669, for sudden infant death; and H.R. 4290, for emergency medical services for children (EMSC). The committee also voice voted H.R. 4771, legislation reclassifying certain anabolic steroids; and H.R. 4250, legislation intended to streamline FDA approval of sunscreen products. This week the Senate HELP Committee will take up legislation to reauthorize the following programs: S. 531, for physical activity guidelines; S. 2405 and S. 2406, for trauma care programs; and S. 2539, for traumatic brain injury research. The committee will also consider legislation relating to muscular dystrophy (S. 315) and EMSC (S. 2154).

House Republicans Remain Skeptical of PPACA Implementation

At a House Energy and Commerce Health Subcommittee hearing, Chairman Joe Pitts (R-PA) said that the Administration is “taking a ‘shovel the money out the door first, verify later’ approach when it comes to exchange subsidies….” and that it is “simply unacceptable that CMS [Centers for Medicare and Medicaid Services] does not yet have the internal controls necessary to validate Social Security numbers, citizenship, national status, income and employer-sponsored coverage.” Rep. Bill Cassidy (R-LA) said this may result in tens of thousands of undocumented immigrants getting unwarranted subsidies. However, a witness from the Office of Inspector General (OIG) Office of Audit Services testified that the agency’s audits did not find conclusive evidence that subsidies or tax credits were ever granted to applicants who didn’t deserve them or that subsidies were miscalculated as a result of application errors. The OIG audit report did say, nonetheless, that there were inconsistencies when the exchanges were unable to verify self-attested applicant information with the data received through the federal data hub and other sources. The office is expected to investigate whether subsidies were paid inaccurately and report back next spring. It apparently remains to be seen whether a fully operational verification system will be in place before the next open season begins in October.

Hobby Lobby Decision Spurs New PPACA Disclosure Rule

The Departments of Labor, HHS and Treasury issued guidance which requires that employer plans subject to the Employee Retirement Income Security Act of 1974 (ERISA) send out notices to employees if plan coverage is changed mid-year to eliminate PPACA women’s preventive services relating to contraceptive coverage which is allowed in accordance with the recent decision by the Supreme Court in the Hobby Lobby Stores, Inc. case. The decision allows non-publicly traded for-profit corporations to disregard the PPACA’s preventive health services related to birth control for women.

Medicare FFS Under Fire at Senate Finance Committee Hearing

At a Senate Finance Committee hearing, Ranking Republican Orrin Hatch (R-UT) stated that the Medicare Payment Advisory Commission (MedPAC) “has long said that fee-for-service Medicare creates silos—incentivizing providers to deliver more care, not necessarily higher quality, coordinated care.” Chairman Ron Wyden (D-OR) said the way health care is now delivered has to change and that managing chronic illness represents “the biggest challenge” facing Medicare and the entire U.S. health-care system. The witness from Emory Healthcare appeared to agree, stating that the current fee-for-service model makes it more profitable to prescribe and complete procedures than to coordinate care, the extra costs of which are not reimbursed under Medicare. Senator Hatch also called into question whether Accountable Care Organizations (ACOs) created under the PPACA are actually improving the quality of care and saving money through coordinated care. Of note, a Government Accountability Office (GAO) report released last week found that payments to physicians under Medicaid fee-for-service and managed care for services such as office visits and emergency care were generally lower than payments from private insurers.

December 31, 1969: | Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7



 -  2019

 +  2018