ACA Small Employer Legislation Sent to the President

Last week, the Senate passed a bill to change the definition of a small employer under the Affordable Care Act (ACA) from 100 employees or less to 50 employees or less with bipartisan support. The legislation will allow states to decide whether or not to expand the small group market beginning in 2016. The bill will also put $205 million into the Medicare Improvement Fund that was cut under the 2010 health care law. The Protecting Affordable Coverage for Employees (PACE) Act (H.R. 1624) was introduced by Rep. Brett Guthrie (R-Ky.) and Rep. Tony Cárdenas (D-Calif.). The bill had the support of mid-sized businesses, which were concerned that if included in the small-group market they would be forced to seek new coverage, resulting in disruption in the market and higher premiums. The House had previously approved the measure by voice vote. President Obama is expected to sign the bill into law.

Policymakers Urge CMS Not to Cut Reimbursement for Colorectal Cancer Screening

Bipartisan members of both the House of Representatives and the Senate have written to the Centers for Medicare and Medicaid Services (CMS) in opposition to proposed cuts to Medicare reimbursement rates for colorectal cancer screening. The agency proposed cuts of 10 to 20 percent for colonoscopy services. The U.S. Department of Health and Human Services’ (HHS) goal is to achieve an 80 percent screening rate for the recommended population by 2018. While rates of colorectal cancer are improving among the Medicare population, lawmakers expressed concerns that such a rate change could hamper the progress being made in colorectal cancer prevention and detection efforts.

GAO Report Outlines Impact of Value-Based Purchasing

The Government Accountability Office (GAO) has released a report that reviews the impact of value-based purchasing programs. The GAO finds that such programs negatively impact safety-net hospitals. While the gap has narrowed over time, safety-net hospitals generally received smaller bonuses or larger penalties than hospitals overall. Additionally, the report shows that small urban hospitals perform better than hospitals overall. There was only one noticeable change in hospital performance on quality measures. Hospitals improved on readmissions, which the GAO interpreted as an indication that financial penalties can promote enhanced quality in some circumstances. Hospitals attested to the fact that the Hospital Value Based Purchasing Program only helped to reinforce their already ongoing efforts to improve quality, but did not shift their focus, and also argued that the most common barrier to improving quality was difficulties with information technology systems.

Study Finds Rise in Part D Premiums

Over 80 percent of Medicare Part D beneficiaries will see an eight percent rise on average in their premiums next year, according to a new report by Avalere. For the first time in the program’s history, the average premium will be more than $40. The study also reveals that fewer plans will be offered in the coming year – 886 plans down from 1,001. The study examined seniors enrolled in the 10 most popular Part D plans. Avalere also finds that while 81 percent of Medicare Advantage enrollees will have access to a $0 premium plan, compared to 78 percent in 2015, the drug benefits available to Medicare Advantage enrollees may become less generous. Additionally, the average Medicare Advantage premium will drop 1 percent in 2016 to $32.60.

Upcoming Congressional Meetings and Hearings

House Agriculture Committee: hearing titled “2015 Dietary Guidelines for Americans;” 9:00 a.m., 1300 Longworth Bldg., Oct. 7

House Veterans’ Affairs Committee: hearing titled “A Call for System-Wide Change: Evaluating the Independent Assessment of the Veterans Health Administration;” 10:30 a.m., 334 Cannon Bldg., Oct. 7

Senate Appropriations Labor, Health and Human Services, Education and Related Agencies Subcommittee: hearing on the National Institutes of Health; 10:00 a.m., 124 Dirksen Bldg., Oct. 7

Energy and Commerce Health Subcommittee: hearing titled “Examining Legislative Proposals to Combat our Nation’s Drug Abuse Crisis;” 10:15 a.m., 2322 Rayburn Bldg.; Oct. 8

House Veterans’ Affairs Health Subcommittee: hearing titled “Evaluating VA Primary Care Delivery, Workload, and Cost;” 10:00 a.m., 334 Cannon Bldg., Oct. 22

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