PPACA Supreme Court Requests

The Department of Justice has urged the U.S. Supreme Court to delay its decision on whether to review issues raised by the state of Virginia in its suit challenging the individual mandate.  On the other hand, The Virginia AG, Kenneth Cuccinelli asked the court to review the Fourth Circuit decision holding that the state of Virginia does not have standing to challenge the provision on behalf of its citizens.  The DOJ argued that the Supreme Court should first take up the issues in the Florida case under which the Eleventh Circuit held for the state plaintiffs and against the constitutionality of the individual mandate.


Senator John Thune introduction legislation, S. 720, to repeal the PPACA long-term care CLASS Act following the HHS policy announced that it will abandon the current implementation of the program.  CBO revealed that the HHS policy has induced CBO to change their PPACA budget baseline to exclude the $83 billion in net deficit reduction that would have resulted from CLASS Act implementation.  As a result, CBO said the Thune bill would have “no budgetary effect”.

House Republicans Say IRS Erred in Subsidy Regs

Twenty-four House Republicans sent the IRS Commissioner a letter saying they object to the IRS regulations allowing for PPACA individual subsidies to persons enrolled in exchanges operated by the federal government.  They cited the law which states that the tax credits would go to individuals who are enrolled only in “an exchange established by the state.”

Final Medicare MD Payment Rules

CMS released the final CY 2012 Physician Fee Schedule rule which states that Medicare rates will be cut by 27.4% next year unless Congress intervenes to change the result.  HHS Secretary Kathleen Sebelius said that “the pattern of threatened SGR cuts and last-minute Congressional rescues is in itself not a sustainable solution and must be remedied.”  The rule also: finalized PPACA quality and cost measures to be used in establishing a new value-based modifier that would adjust physician payments based on the level of quality and efficient care; implemented the third of a four-year transition to new practice expense RVUs; updated the Physician Quality Reporting System, the e-Prescribing Incentive Program, and the Electronic Health Records Incentive Program; and finalized an expansion of physician coding which will focus on determining whether codes billed in each specialty that result in the highest Medicare expenditures under the fee schedule are overvalued.  Comments on the following are due by year-end--the interim final work, practice expense, and malpractice RVUs; certain other 2012 Healthcare Common Procedure Coding System codes; and the physician self-referral designated health services codes.

Health Care Disparities

HHS released final PPACA standards to measure health care disparities based on race, ethnicity, sex, primary language and disability status.  The final data standards apply to the collection of data in HHS-sponsored population surveys where person-level data are collected either via self-report or from a respondent who serves as a knowledgeable household representative.

FDA Issues

In a “Can’t Wait [for Congress]” initiative, the President announced that he will sign an Executive Order which will direct the FDA to broaden reporting of potential shortages of certain prescription drugs and to expedite regulatory reviews that can help prevent or respond to such shortages.  The FDA Commissioner also said that the agency is requesting drug manufacturers to report promptly regarding the potential discontinuation of drugs, including drugs for which reporting is not required.

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