Medicaid/SCHIP Eligibility Limits Passed

Last week the House Energy and Commerce Health Subcommittee passed H.R. 1683 (14-9), legislation that would allow states to ignore the maintenance of effort provisions (MOE) placed on their Medicaid and SCHIP eligibility requirements under the PPACA and the 2009 economic stimulus laws.  The MOE provisions for Medicaid would expire anyway once the PPACA insurance exchange requirements come into effect in 2014.  CBO estimated the bill would provide state savings of about $2.8 billion in 2012-2016 while leaving about 300,000 uninsured in 2013.

HEALTH Act Passed

The House Energy and Commerce Committee also passed H.R. 5 (30-20), the Help Efficient, Accessible, Low-cost, Timely Healthcare Act, which would provide a three-year statute of limitations for malpractice claims beginning when an injury is discovered; cap noneconomic damages at $250,000; restrict punitive damages; limit attorney contingency fees; and create a safe harbor from punitive damages for manufacturers and distributors of FDA approved medical products.  CBO estimated that the bill would reduce the federal deficit by about $40 billion over 2011-2021.  The bill was previously passed by the House Judiciary Committee and is headed to the House floor after a resolution of competing versions by the House Rules Committee.

Single Payer Promoted

Senator Bernie Sanders and Rep. Jim McDermott introduced legislation that would undo the PPACA and instead mandate that all states establish single payer systems beginning in 2013.  The legislation would eliminate Medicare, Medicaid, Tricare and the FEHBP and allow states to provide benefits greater than federal minimums.  Benefits would be paid for through a new income tax, an employer payroll tax, a surcharge on high-income individuals and a tax on securities and financial transactions.

PPACA Biologics Pathway User Fees

The FDA has issued a proposal describing the principles it will use to develop a biosimilars user fee program and the related structure and performance goals as mandated under the PPACA’s “Biologics Price Competition and Innovation Act.”  Comments are due by June 9.

New Federal Research and Development Center

CMS has requested public comment on its plan to sponsor a new “Federal Research and Development Center” operated by a private contractor which would assist CMS in updating its processes, systems and operations.  Comments are due by July 5th.

New Dual-Eligible Initiatives

HHS announced two new initiatives to help states coordinate care for their dual Medicare/Medicaid populations.  A new data alignment initiative would enable state Medicaid programs to gain faster access to treatment information.  HHS also is seeking ways to identify and address conflicting requirements between Medicaid and Medicare that can impede coordination of care for dual eligible beneficiaries.  Comments are due in 60 days.

Hearing on Alternatives to Medicare MD Payment System

Bipartisanship broke out in the House Ways and Means Health Subcommittee during hearings on measures to replace the current SGR, sustainable growth rate, Medicare physician payment formula.  Rep. Pete Stark complimented Chairman Wally Herger on the subcommittee’s bipartisan efforts to work together to find a suitable alternative to the SGR.  Witnesses suggested various replacements, including “Alternative Quality Contracts” setting per-patient global budgets over five years; fixed capitation payments; and payments to “community health teams” such as in Vermont.  The House-passed FY 2012 budget contemplates a change to the current system that would mandate a cut of about 30% in payments next year.

December 31, 1969: | Page 1 Page 2 Page 3 Page 4



 -  2018