Ryan Medicare Reform Redo

In a surprising bipartisan development, House Budget Committee Chair Paul Ryan and Senator Ron Wyden released a “white paper” proposal that would give Medicare beneficiaries “premium support” subsidies to purchase a private health plan through a new insurance exchange.  Subsidies would vary based on the cost of the health plan with lower-income beneficiaries receiving a full subsidy and higher-income beneficiaries receiving less.  The plan would not apply to those now age 55 or older, but beginning in 2022 both new and current enrollees would be able to choose between traditional Medicare and the private health plans.  The authors said they would introduce legislation only after the presidential election next year.  The White House press spokesman said the proposal “would undermine, rather than strengthen, Medicare.”

HHS Partnership for Patients Grants

HHS announced that 26 “hospital engagement networks” will receive a total of $218 million as part of the HHS Partnership for Patients initiative which intends to reduce hospital readmissions and preventable medical errors.  The networks will be required to conduct intensive training programs to: teach and support hospitals in improving patient safety; provide technical assistance to hospitals; and implement a system to track hospital progress toward meeting quality improvement goals.

Medicare Secondary Payer Guidance

CMS issued guidance relating to the Medicare Secondary Payer (MSP) system under which beneficiaries with claims of less than $25,000 will be able to obtain conditional payments before settlement of lawsuits involving physical trauma injuries where treatment has been completed.

Medicare Fraud Prevention

CMS announced that all Medicare Part D and Medicare Advantage prescription drug plans will now have the ability to withhold pharmacy payments for suspicious claims, until an investigation has determined that such a claim is not fraudulent, as part of an effort to reduce fraud and abuse.

Recently Introduced Health Legislation

S. 1982 (DIRECT CAREGIVERS), to amend the Older Americans Act of 1965 to develop and test an expanded and advanced role for direct care workers who provide long-term services and supports to older individuals in efforts to coordinate care and improve the efficiency of service delivery; CASEY; to the Committee on Health, Education, Labor, and Pensions, Dec. 13.

S. 1985 (FEDERAL BUDGET), to allow a bipartisan group of members of Congress to propose and have an up-or-down vote on a balanced deficit reduction bill pursuant to this act, such as proposed by the National Commission on Fiscal Responsibility and Reform report, reducing the deficit by a goal of $4 trillion over 10 years; LIEBERMAN; to the Committee on Homeland Security and Governmental Affairs, Dec. 14.

H.R. 3633 (MEDICARE), to amend Title XVIII of the Social Security Act to repeal the reduction in Medicare disproportionate share hospital (DSH) payments made by Section 3133 of the PPACA; BUERKLE; to the Committee on Ways and Means, Dec. 12.

H.R. 3654 (911 CALL CENTERS), to adopt technology allowing 911 call centers to receive and respond to emergency text messages, and for other purposes; HOCHUL; jointly, to the committees on Energy and Commerce and Transportation and Infrastructure, Dec. 13.

H. RES. 4894 (CANCER SURVIVORS), expressing support for designation of the first Tuesday in June as National Cancer Survivor Beauty and Support Day; to the Committee on Oversight and Government Reform, Dec. 13.

S. 1995 (MEDICAL DEVICES), to enhance Food and Drug Administration oversight of medical device recalls, to provide for the conditional clearance of certain medical devices, and for other purposes; GRASSLEY; to the Committee on Health, Education, Labor, and Pensions, Dec. 14.

H.R. 3667 (MEDICARE), to provide for a Medicare primary care graduate medical education pilot project in order to improve access to the primary care workforce; MCMORRIS RODGERS; jointly, to the committees on Ways and Means and Energy and Commerce, Dec. 14.

H.R. 3668 (DRUGS), to prevent trafficking in counterfeit drugs; MEEHAN; to the Committee on the Judiciary, Dec. 14.

H.R. 3669 (FEDERAL BUDGET), to improve the accuracy and transparency of the Federal budget process; RENACCI; jointly, to the committees on the Budget, Rules, Oversight and Government Reform, and Ways and Means, Dec. 14.

H.R. 3671 (APPROPRIATIONS), making consolidated appropriations for the fiscal year ending Sept. 30, 2012, and for other purposes; ROGERS of Kentucky; jointly, to the committees on Appropriations and the Budget, Dec. 14.

H. CON. RES. 94 (APPROPRIATIONS), directing the clerk of the House of Representatives to make corrections in the enrollment of H.R. 3672; ROGERS of Kentucky; jointly, to the committees on Appropriations and House Administration, Dec. 14.

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