MedPAC and MACPAC Reports

The June report issued by the Medicare Payment Advisory Commission recommended to Congress a possible restructuring of Medicare that would include combining the Part A and B deductibles; replace coinsurance with copays that vary by type of service and provider; levy a surcharge on Medigap coverage; and place a cap on out-of-pocket beneficiary spending.  A similar semiannual report issued by the Medicaid and CHIP Payment and Access Commission recommended that states and the federal government have mechanisms in place to track the access Medicaid and SCHIP beneficiaries have to high-quality health care and assess the impact of program purchasing strategies.  The report also addressed value/cost issues and described innovations such as: risk-based managed care to improve access and quality and moderate costs; patient-centered medical homes; the coordination of primary care through case management programs; and bundling, global and other payment incentives to improve quality and reduce costs.

Medicare Secondary-Payer Rules

CMS released an advance notice of proposed rulemaking containing seven options under which Medicare would not pursue reimbursements from beneficiaries who receive awards from automobile and liability insurance and workers compensation programs.  Comments are due by August 14th.

Recently Introduced Health Legislation

H.R. 5937 (BREAST CANCER), to amend the Public Health Service Act to raise awareness of, and to educate breast cancer patients anticipating surgery regarding the availability and coverage of breast reconstruction, prostheses, and other options; LANCE; to the Committee on Energy and Commerce, June 8.

H.R. 5942 (MEDICARE), to repeal certain changes to contracts with Medicare quality improvement organizations, and for other purposes; PRICE of Georgia; jointly, to the committees on Ways and Means and Energy and Commerce, June 8.

H.R. 5943 (MEDICARE), to amend Title XVIII of the Social Security Act to provide for an extension of the Medicare-dependent hospital (MDH) program and the increased payments under the Medicare low-volume hospital program, and for other purposes; REED; to the Committee on Ways and Means, June 8.

S. 3289 (MEDICAID), to expand the Medicaid home and community-based services waiver to include young people in need of services that would otherwise be required to be provided through a psychiatric residential treatment facility, and to change references in federal law from “mental retardation” to “an intellectual disability”; KERRY; to the Committee on Finance, June 13.

S. 3295 (APPROPRIATIONS), making appropriations for the departments of Labor, Health and Human Services, and Education, and related agencies for the fiscal year ending Sept. 30, 2013, and for other purposes; HARKIN; from the Committee on Appropriations; placed on the calendar, June 14.

S. 3901 (APPROPRIATIONS), making appropriations for financial services and general government for the fiscal year ending Sept. 30, 2013, and for other purposes; DURBIN; from the Committee on Appropriations; placed on the calendar, June 14.

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