CMS Issues RFI on PPACA Basic Health Plan

CMS announced it is seeking information on factors that states will face in deciding whether or not to formulate their basic health plan options for individuals with incomes between 133-200% of the federal poverty level.  The factors include: whether to offer a basic plan; how the basic plan could be made more or less attractive to states; costs associated with their decisions; the standards for the basic plan; the contracting process for the basic plan; and how such plans should coordinate with other health programs.

Fourth Circuit Avoids Decision on Individual Mandate

The U.S. Court of Appeals for the Fourth Circuit held that the State of Virginia lacks the standing to challenge the PPACA’s individual mandate.  The court said that the mandate did not apply to the state itself and the state, therefore, could not demonstrate that it would suffer an injury in fact should the mandate be upheld.  The court also said a state cannot bring an action solely to defend the constitutional rights of its citizens, such as in the Virginia law saving individuals from the individual mandate.  In another case against the individual mandate, Liberty University Inc. v. Geithner, the court said that the tax anti-injunction act (AIA) stripped it of jurisdiction to hear a challenge to the constitutionality of the mandate.

House Ways and Means Hearing on Hospital/Insurer Prices

At a House Ways and Means Health Subcommittee hearing last week, witnesses said that the consolidation among hospitals and health insurers has led to higher prices, up to 50% in some cases.  Chairman Wally Herger said that research has shown that such consolidation does not lead to greater efficiencies and improved quality and that the hearing is a starting point for further assessment of the consolidation issue.

Senate HELP Passes Reauthorization of Pediatric Training

By voice vote the Senate HELP Committee passed S. 958, legislation reauthorizing the children’s hospital graduate medical education (GME) program for five years at the current level of $330 million annually.  There was bipartisan support for the bill which goes against the President’s recommendation to defund the program.

HHS Guidance on Fair Visitation Rights for Patients

HHS issued guidance giving hospitalized Medicare and Medicaid patients the right to see visitors of their choosing, including same-sex partners.  CMS alerted state survey agencies of the policy with respect to their role to conduct on-site inspections.

Grants to Community Health Centers

HHS announced $700 million in grants under the $11 billion PPACA program designed to construct, expand and upgrade community health centers.

Recently Introduced Health Legislation

H.R. 2841 (MEDICAID), to require the secretary of health and human services to approve waivers under Medicaid that are related to state provider taxes that exempt certain retirement communities, Sept. 2.

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