POLICY BRIEFINGS


Loan Applications for CO-Ops


The Center for Consumer Information and Insurance Oversight said that the agency is taking 51 applications, due October 17, for $600 million in start-up and solvency loans to create private, non-profit CO-OP insurance plans in each state and the District of Columbia.  The PPACA provides $3.8 billion to promote integrated models of care which should enhance competition under state health insurance exchanges.


House E&C Health Subcommittee Passes GME and Biodefense Bills


By voice vote the Health Subcommittee of the House Energy and Commerce Committee passed H.R. 1852, legislation to reauthorize through 2016 the children’s hospital graduate medical education (GME) program, and H.R. 2405, legislation reauthorizing parts of the Project BioShield Act of 2004 and the Pandemic and All-Hazards Preparedness Act of 2006 which provides for responses, including public health preparedness, to potential chemical, biological, radioactive and nuclear attacks.  Also, the subcommittee approved H.R. 1254, which would add certain synthetic drugs that imitate the hallucinogenic or stimulant properties of drugs like marijuana, cocaine or methamphetamines as Schedule I controlled substances.


Final Rules Increase Hospice and Inpatient Rehab Payments


CMS issued a final rule increasing Medicare payments to hospices by 2.5% for FY 2012.  The rule also modifies a current policy whereby any hospice physician would be allowed to perform a required face-to-face encounter with the hospice patient, “regardless of whether that same physician recertifies the patient’s terminal illness and composes the recertification narrative….”  CMS also issued a final rule under which inpatient rehabilitation facility (IRF) payment rates will be increased by 2.2% in FY 2012, or by about $150 million over the prior year.


Members Object to Proposed CMS IPPS Payment Offsets


Letters from 219 House members and 45 senators to CMS call for a reconsideration of the documentation and coding offsets included as part of the proposed FY 2012 inpatient prospective payment system (IPPS) rule.  They asked that CMS ensure that the correct methodology is used before any changes go into effect and that the proposed rule take into consideration any changes in the severity of patient conditions that may have occurred.


Final Rule Reduces SNF Payments


CMS issued a final rule reducing Medicare skilled nursing facility prospective payments in FY 2012 by $3.87 billion, or about 11.1%.


Nursing Grant Awards


HHS announced the awarding of several hundred grants, totaling $71.3 million, to expand nursing education, training and diversity.


Senate Judiciary Committee Passes Bill to Ban Designer Drugs


The Senate Judiciary Committee has approved by voice vote three bipartisan bills (S. 409, S. 605 and S. 839) which would block the use of certain chemicals in such synthetic drugs, making their possession and sale illegal as Schedule I controlled drugs.  Among the banned substances are those contained in drugs such as synthetic “K2” and “Spice” marijuana products and those in the 2C family which were invented for scientific research but never intended for use by humans.


Senate HELP Committee Hearing on FDA User Fees


At a Senate HELP Committee hearing, the FDA Commissioner Margaret Hamburg testified that user fees paid by the drug and medical device industries provide a stable source of funding to support the FDA’s activities to ensure the continued safety of drugs and devices.  The current legislative authority for the medical device user fee program, the Medical Device User Fee Amendments of 2007 (MDUFA), expires in September 2012 and for the Prescription Drug User Fee Act (PDUFA), reauthorized in 2007 by the FDA Amendments Act, also will expire in September 2012.  She said the FDA intends to submit its final recommendations on user fees to Congress in January 2012.  However, Senator Richard Burr said he would delay the passage of any reauthorization legislation unless the agency speeds up its approval of medical devices and incorporate a “least burdensome” approach.  In related news, the Institute of Medicine recommended that Congress create a new, more extensive regulatory process for moderate-risk medical devices such as powered wheelchairs, infusion pumps and blood pressure cuffs.  The FDA said it will review the recommendations, but that they will not necessarily be adopted.  Also of note, in the House Oversight and Government Reform Subcommittee on Government Organization, Efficiency, and Financial Management hearing on DME, CMS testified that the agency will be implementing in the next six to eight months a new methodology, with help from the private sector, for determining the extent of fraud within the durable medical equipment and home health areas.  HHS has reported that improper Medicare payments totaled $48 billion in FY 2010.



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