At a House Budget Committee hearing, HHS Secretary Kathleen Sebelius defended the Independent Payment Advisory Board created under the PPACA when asked by Chairman Paul Ryan how medical care for beneficiaries could avoid being disrupted when the IPAB suggests various Medicare spending reductions.  The Secretary said that the IPAB cannot eliminate benefits, increase premiums or shift costs.  At another hearing held by the House Energy and Commerce Health Subcommittee, both Chairman Joe Pitts and Ranking Member Frank Pallone expressed their reservations with the IPAB.  A Democrat on the House Budget Committee, Rep. Allyson Schwartz, testified that the IPAB should be repealed.  Legislation to repeal the board has been introduced in both the House and Senate (S. 668 and H.R. 452).  House leaders have suggested that a repeal of the IPAB may be the only other part of the PPACA that can be passed in this congress.

Minimum Standards for Health Insurance Exchanges

HHS issued a proposed rule including standards that state health insurance exchanges must meet to be certified by HHS under the PPACA.  HHS said the proposal gives states flexibility to design exchanges and to form multi-state exchanges and to partner with HHS.  States can be given full approval by 2013 or conditional approval subject to meeting all requirements by the 2014 effective date.  Exchanges would have to offer benefit packages meeting the PPACA minimum “essential health benefits” rule which is first being considered by the Institute of Medicine.  Senators Orrin Hatch and Mike Enzi have written the IOM urging the agency to avoid recommending a “one size fits all” benefits package and consider the impact that such mandates will have on the cost of health insurance and access to coverage.  Comments are due within 75 days on the proposal.  In related news, the NAIC approved three white papers related to state health insurance exchanges, including one on governance, another on adverse selection and a third on the role of agents and brokers.  However, the NAIC did not endorse H.R. 1206, legislation introduced by Rep. Mike Rogers that would eliminate agent and broker commissions from the definition of “expenses” in determining minimum medical loss ratios.

Hearing on Children's Hospital Training Funds

At a House Energy and Commerce Health Subcommittee hearing last week, Chairman Joe Pitts said that he opposes the Administration’s budget recommendation to eliminate payments under the children’s hospital graduate medical education program.  There appeared to be bipartisan support for H.R. 1852, legislation which would reauthorize the program through FY 2016 at $330 annually.

School-Based Health Center Grants

HHS announced that it will provide $95 million in grants to 278 school-based health centers to help them expand and provide more health services across the country.  The PPACA made $200 million available to fund capital projects at school-based health centers.

FDA Issues

FDA Guidelines on Early FDA Engagement on Drug Development
The FDA released draft guidelines to ease the development of diagnostic tests which would assist doctors in deciding on whether or not to use a particular drug and the dose to give.  The FDA said “it is the agency’s goal to help stimulate early collaborations between drug and device makers so they can develop the best medical products for treating patients….”  In related news, the FDA said that a newly proposed agency reorganization is designed to be budget neutral.

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