Health Care Policy News
Poll shows opposition to health care overhaul declining
Opposition to the landmark health care overhaul declined over the past month, to 35 percent from 41 percent, according to the latest results of a tracking poll, reported Thursday. Fifty percent of the public held a favorable view of the law, up slightly from 48percent a month ago, while 14 percent expressed no opinion about the measure, according to the poll by the Kaiser Family Foundation.
Roberts still calling for hearing on Berwick
At a hearing of the Senate Finance Committee, U.S. Senator Pat Roberts today continued his call for a public hearing on the nomination of Dr. Donald Berwick to head the Centers for Medicare and Medicaid Services (CMS) so Americans can learn about the person responsible for cutting half a trillion dollars from Medicare and controlling one third of all health care spending in America.At issue is President Obama’s recess appointment of Dr. Berwick earlier this month to avoid a public hearing on Dr. Berwick’s controversial record.Senator Roberts made the following statement at the Finance Committee hearing on nominations:
25 House Members Go To Bat For Agents On Future Health Care Role
Twenty-five members of the House have asked federal health regulators to ensure a role for licensed insurance agents in the web portal that will be used to aid consumers in comparing coverage options. The Department of Health and Human Services unveiled the web portal July 1 on a trial basis. An update with more comprehensive information is scheduled to be in place as of Oct. 1. The web portal is seen as a precursor to the health insurance exchanges that will be launched in 2014 under the Patient Protection and Affordable Care Act.
Primary care boosted in proposed Medicare pay rule
The Centers for Medicare & Medicaid Services has issued a proposed Medicare physician fee schedule rule that it says will expand preventive services for Medicare beneficiaries, improve payments for primary care services and promote access to health care. The proposed rule, announced June 25, would implement provisions in the national health reform law that will eliminate out-of-pocket costs for beneficiaries for most preventive services, including a new annual primary care visit benefit, CMS said.
Recession-Weary Workers, States Still Hope For COBRA And Medicaid Subsidies
With states facing a recession double-whammy of less revenue and more demand for health care services, Congress included extra money to Medicaid programs in the February 2009 federal stimulus package. Before the stimulus, the federal government's share of Medicaid costs was between 50 and 76 percent (depending on the per capita income of the state). The federal match increased to between 61 and 84 percent of all Medicaid spending.
Md. could save $829M under health care reform
Maryland could save about $829 million on health care costs between fiscal year 2011 and 2020 because of federal health care reform, according to a model the state released Monday. The savings, however, last only until the end of the decade, when the federal law shifts a greater share of financial responsibility for Medicaid expansion to the states. The projections are in an interim report by Maryland's Health Care Reform Coordinating Council, which Gov. Martin O'Malley created in March to study how the federal health care reform law will affect the state.
Britain Plans to Decentralize Health Care
Perhaps the only consistent thing about Britain’s socialized health care system is that it is in a perpetual state of flux, its structure constantly changing as governments search for the elusive formula that will deliver the best care for the cheapest price while costs and demand escalate. Practical details of the plan are still sketchy. But its aim is clear: to shift control of England’s $160 billion annual health budget from a centralized bureaucracy to doctors at the local level. Under the plan, $100 billion to $125 billion a year would be meted out to general practitioners, who would use the money to buy services from hospitals and other health care providers.
HHS Rule Bolsters Appeal Rights When Insurers Say No
Patients whose claims are denied by their health plans will be able to appeal those denials to an external reviewer under new regulations announced this week by the Department of Health and Human Services (HHS). "For the first time, [the law will] require consumers have access to independent third party review of claims," Phyllis Borzi, assistant secretary for the Employee Benefits Security Administration at the Department of Labor, said during a teleconference.
American Osteopathic Association Installs First Female President
Not one to back down from a challenge, Karen J. Nichols, DO, embraces her term as the first female president of the American Osteopathic Association (AOA) during a time of historic change in health care. The AOA installed her as its 114th president this afternoon during its annual business meeting in Chicago.
Rules to ease consumer appeals in health coverage
Consumers will get new and expanded rights to appeal denials of health insurance claims under federal regulations released Thursday.
The rules, part of the nation's new health law, will make it easier for consumers to dispute an insurer's decision within the plan and require coverage to continue during the appeal, said Phyllis Borzi, an assistant secretary in the Department of Labor.
Consumers will have the right to an independent, third-party review of insurers' decisions.
Although 44 states allow some form of external appeal, the level of consumer protection varies greatly, and in some states, the outside reviewer is hired by the insurer that denied the claim, Borzi said.
McDermott touts healthy return of health care's 'public option'
Could the public option be revived? Months after a Republican filibuster helped kill off a government-run health plan under the new health-care law, Seattle Congressman Jim McDermott and other U.S. House Democrats are calling anew for a Medicare-like public insurance plan that would compete with private carriers. This time, the Democrats are taking their arguments straight out of the Republican handbook, saying a public plan would lower the deficit.
AMA, state groups call for change to doctor rankings
The American Medical Association and 47 state medical groups are calling on health insurance giants to improve the accuracy of how physicians are rated for consumers enrolled in health plans. The doctor groups are concerned that patients could be choosing doctors based on the cost of the physician services and inaccurate information of the health plan, rather than the quality of care the physician provides.The call comes as more employers are turning to such ratings to control premium costs and as consumers troll the Web for information on the best physicians, analysts said.
FDA Puts Partial Hold on Avandia Safety Study
No new patients will be permitted to enroll in a safety study of the controversial diabetes drug Avandia until further notice, the U.S. Food and Drug Administration announced Wednesday. But under the partial clinical trial hold, those patients already enrolled in the TIDE (Thiazolidinedione Intervention With Vitamin D Evaluation) trial will be allowed to continue to participate, the agency said in a news release.
Tougher meaningful-use rules promised
The administration's health information technology czar on Tuesday told a House panel that providers would be held to much tougher standards in the coming years over the adoption and use of electronic health records.“We have every intent in the next rulemaking, in 2013, to require much more robust exchange as a feature of meaningful use,” David Blumenthal, HHS' national coordinator for health IT, told members of the Ways and Means Committee's health subcommittee.
Teva Pharmaceuticals to pay Texas $50 million to settle case
Texas Attorney General Greg Abbott reached a settlement with Teva Pharmaceuticals Inc. in a case involving allegations that Teva and two other companies overcharged the Texas Medicaid program.
Texas was a party to the lawsuit along with the states of Florida, California and the U.S. government. In all, Teva has agreed to pay a total of $169 million. Texas will receive $51.4 million of that amount.
Firms cancel health coverage
The relentlessly rising cost of health insurance is prompting some small Massachusetts companies to drop coverage for their workers and encourage them to sign up for state-subsidized care instead, a trend that, some analysts say, could eventually weigh heavily on the state’s already-stressed budget.
$1 billion a year riding on OK of drug Avastin
$1 billion
That's how much annual sales of Roche's Avastin might be cut if the drug's approval for treating breast cancer is withdrawn, analyst Jack Scannell of Sanford C. Bernstein predicted. Developed by the company's South San Francisco-based Genentech unit, Avastin generated $5.97 billion in sales last year. The FDA said last week that its advisers would meet Tuesday to reconsider approval of the drug, which also is used to treat brain, lung and colon tumors. Roche shares fell 4.2 percent Friday on the news.
Medicare Crackdown: "Prosecution Is Not the Solution"
The round up continued Friday night across South Florida and the nation as authorities made nearly 100 arrests relating to some $251 million in Medicare fraud. Officials say it is the largest such bust in history.
The crackdown has so far involved 33 South Floridians who produced $140 million in bogus claims. Arrests were announced in Miami by top Obama administration officials US Attorney Eric Holder and Health and Human Services Secretary Kathleen Sebelius, who spoke of tougher penalties and new ways to find the crooks.
House committee passes 'Improving Nutrition for America’s Children Act'
Everyone from to Jamie Oliver to Michelle Obama agrees that our nation's school lunch program is hungry for change. And it's no wonder such prominent figures are ready for the next course of action, given that 1 in 5 children are obese or overweight, according to the Centers for Disease Control and Prevention. On Thursday the "Improving Nutrition for America's Children Act" was passed by the House Education and Labor Committee, bringing the nation's kids one bite closer to the possibility of more nutritious meals.
Health lobbyists focus on a once-obscure group
For years, an obscure federal task force sifted through medical literature on colonoscopies, prostate-cancer screening and fluoride treatments, ferreting out the best evidence for doctors to use in caring for their patients. But now its recommendations have financial implications, raising the stakes for patients, doctors and others in the health-care industry.
Republicans Demand Hearing On CMS Head Berwick, Block Other Nominees
Senate Republicans are still angry over President Obama's recess appointment of Dr. Donald Berwick to head the Center for Medicare and Medicaid Services. Politico: "Republicans on the Finance Committee, which has jurisdiction over the post, say that not holding a hearing with Berwick would 'result in circumventing the open public review that should take place for a nomination of such importance' and 'casts a shadow over his legitimacy and authority to serve as administrator during a critical time for CMS.'
Health Experts Who May Decide Whether You Live Or Die
During the run-up to the passage of health reform, President Obama caught flack for saying doctors should be overruled when they recommend treatments that are more expensive than equally effective alternatives. In one speech, he questioned whether it made sense to get your tonsils out if a pill to relieve the pain would suffice. "The doctor may look at the reimbursement system and say to himself, 'You know what? I make a lot more money if I take this kid's tonsils out,'" Obama mused.
White House Unveils Free Preventative Services
Treatments for the prevention of alcohol abuse, depression and obesity are among the services that will be free to consumers with new insurance plans starting in September. As part of the new health law, the Obama administration on Wednesday released rules specifying which preventive health services insurers must provide to consumers at no additional cost. Democrats hope the change will be one of the most popular early pieces of the sweeping legislation. "Services like these will go a long way in preventing chronic illness," First Lady Michelle Obama said Wednesday.
F.D.A. Panel Votes to Restrict Avandia
A federal medical advisory panel recommended Wednesday that Avandia, a controversial diabetes drug, should either be withdrawn from the market or have sales severely restricted because it increases the risks of heart attacks. The panel’s votes, taken after two days of intensive scientific discussions, were a blow to GlaxoSmithKline, which makes Avandia. The company argued that Avandia is a safe and needed option in treating diabetes.
U.S. Eases Funds to Adopt Electronic Medical Records
The Obama administration on Tuesday loosened the rules for hospitals and doctors to qualify for federal funding to replace paper medical records with electronic files for patients. Under legislation passed last year, the Department of Health and Human Services set aside $27 billion to help health-care providers convert patients' health records into electronic documents. Only 20% of doctors and 10% of hospitals use basic electronic medical records. The others rely on paper systems that are inefficient and subject to damage, according to the department.
White House Unveils Plan to Fight AIDS
The Obama administration on Tuesday committed itself to cutting the nation's stubborn HIV infection rate by 25% over the next five years. The goal is part of a new national HIV and AIDS strategy released by the White House. It seeks to stem the spread of the virus and extend effective AIDS drugs to more of the estimated 1.1 million Americans living with the disease. The strategy calls for an intensified effort to target HIV prevention to communities hardest hit by HIV. The vast majority of new infections are now in African-Americans, and officials suggested demographic shifts have been moving more quickly than public health efforts.
Doctors Threaten to Pull Out of Texas Medicaid
Cuts to the reimbursements given to doctors who treat patients covered by the state's low-income health care program are raising fears that already declining physician participation will fall even further, according to a published report.The health care and insurance industries fear that a 1 percent cut in Medicaid fees scheduled to take effect Sept. 1 will be the first in a series of cuts as state agencies are asked to trim their two-year budgets by 10 percent to help cover an expected $18 billion revenue shortfall, The Dallas Morning News reported Sunday.
HHS Proposes Patient Privacy Rules
The Department of Health and Human Services has announced new rules that expand patients' rights to make decisions regarding their health records, including giving patients the ability to restrict the use of information for marketing purposes, and granting them greater control over the sale of their health information. The proposed rules are seen as a crucial step as the Obama administration promotes the adoption of electronic health information exchange, and has set the goal of providing every citizen with an electronic medical record (EMR) by 2014.
FDA to consider fate of diabetes drug Avandia
A large clinical trial of Avandia, sponsored by its maker, "was inadequately designed and conducted to provide any reassurance" that the controversial diabetes drug does not increase cardiovascular risk, a Food and Drug Administration scientist wrote in a memo released Friday. The lengthy memo by Thomas Marciniak, a medical team leader in the Division of Cardiovascular and Renal Products, is part of a 765-page briefing document prepared by FDA scientists in advance of next week's advisory committee meeting on Avandia's fate
Move To Have Businesses Manage Medicaid Is Triggering Concern
Since Congress passed the health overhaul, businesses that manage Medicaid "are rushing to get a foothold in states that outsource Medicaid. … But the experience in some states suggests pitfalls ahead. A recent report found that 2.7 million children on Medicaid in nine states, most of them states that outsource Medicaid, are not receiving required screenings and immunizations.
Second Round of $250 Medicare Checks Sent
Seniors who have recently reached the coverage gap in their Medicare prescription drug plan will soon receive $250 checks from the federal government. Over 300,000 one-time payments are in the mail, the Obama administration announced today. The first round of approximately 80,000 checks was mailed to retirees in June. “Seventy percent of our first round of these $250 rebate checks were cashed within a week of eligible Medicarerecipients receiving them,” says U.S. Department of Health and Human Services Secretary Kathleen Sebelius. “So, we know that folks really need some help.”
Obama Fills Medicare and Medicaid Post Without Senate Approval
President Obama on Wednesday bypassed Congress and appointed Dr. Donald Berwick to head Medicare and Medicaid-- filling the job while Congress is in recess to get around Republican opposition that threatened to derail Berwick's confirmation. Berwick's supporters say he is the right man in the right place at the right time. Obama said in a written statement Wednesday that the recess appointment would allow Berwick and two other "extremely qualified candidates" to get to work "right away."
Missouri Lt. Gov. Kinder files challenge against health-care overhaul
Missouri Lt. Gov. Peter Kinder has filed a legal challenge against the recently enacted federal health care overhaul. Kinder v. Geithner was filed Wednesday in federal court in Cape Girardeau. The defendants named in the suit are Treasury Secretary Timothy Geithner, Health and Human Services Secretary Kathleen Sebelius, Labor Secretary Hilda Solis and U.S. Attorney General Eric Holder. Kinder filed the suit as a private citizen and in his official capacity as lieutenant governor, spokesman Gary McElyea said. All legal fees will be paid for with private donations, he said.
CMS proposes 2.15% outpatient update
Hospital outpatient departments will see a 2.15% increase in their Medicare payments under a proposed CMS rule that will set payment rates for outpatient services and ambulatory surgical centers in 2011. The update reflects an inflationary increase of 2.4% minus a 0.25 percentage point reduction required under the new reform law. Overall, the agency estimates that more than 4,000 hospitals and other facilities will get paid a total of $40 billion next year under the outpatient prospective payment system, whereas 5,000 ambulatory surgery centers will receive approximately $4 billion.
Massachusetts: Health payment overhaul shelved
he state’s ambitious, first-in-the-nation plan to transform how hospitals and doctors are paid is on hold, at least for this year, largely because of disagreements among key officials, legislators, and providers over how best to control health care spending.Senate President Therese Murray, a leading advocate of payment changes, said in an interview that she will not file legislation to change the system this year, as originally planned, because of the logistical and political complexity of changing a system that has been in place for decades.
'Game Changer' Rule Looms For Health Insurers
One number in the health-care overhaul law could dramatically alter the health-insurance landscape. How federal regulators interpret a metric known as a medical-loss ratio could affect players from industry giant UnitedHealth Group Inc. down to specialized companies such as American National Insurance Co. Plans could be forced to pay out millions in rebates, while others may be driven out of the market.
Health overhaul may mean longer ER waits, crowding
Emergency rooms, the only choice for patients who can't find care elsewhere, may grow even more crowded with longer wait times under the nation's new health law. That might come as a surprise to those who thought getting 32 million more people covered by health insurance would ease ER crowding. It would seem these patients would be able to get routine health care by visiting a doctor's office, as most of the insured do. But it's not that simple. Consider:_There's already a shortage of front-line family physicians in some places and experts think that will get worse.
HHS Secretary Sebelius Announces New Pre-Existing Condition Insurance Plan
The U.S. Department of Health and Human Services (HHS) announced today the establishment of a new Pre-existing Condition Insurance Plan (PCIP) that will offer coverage to uninsured Americans who have been unable to obtain health coverage because of a pre-existing health condition. The Pre-Existing Condition Insurance Plan, which will be administered either by a state or by the Department of Health and Human Services, will provide a new health coverage option for Americans who have been uninsured for at least six months,
Judge to Rule on Health Reform Claim Within Month
A federal judge is considering whether to throw out Virginia’s lawsuit challenging the health- care overhaul signed by President Barack Obama after hearing arguments over whether the state has jurisdiction to sue. U.S. District Judge Henry Hudson today in Richmond said he would decide within 30 days on the federal government’s request to dismiss the case. Virginia claims that a requirement for people buy health insurance exceeds Congress’s powers under the Constitution, while the U.S. counters that provision is allowed under its commerce powers because of the $43 billion in unpaid medical bills absorbed by the market each year.
Insurers’ Group Skips Endorsement of Medicare Nominee
Dr. Donald M. Berwick’s nomination to head Medicare and Medicaid received a lift on Tuesday when a diverse collection of about 90 employer groups, patient advocates, medical societies and others wrote to Senator Max Baucus, the Montana Democrat who helped oversee the creation of the new health care law, in favor of his selection. Among those signing the letter were the National Business Group on Health, the American Academy of Family Physicians, the A.F.L.-C.I.O. and Families USA.
WellPoint Scales Back Rate Increases Sought in California
WellPoint Inc., backing off a plan to increase health-insurance prices by as much as 39% for individuals in California, has re-filed rates with the state insurance commissioner that it said would bring it a $100 million loss in that market. Late Wednesday, WellPoint's Anthem Blue Cross unit submitted rates to the California Insurance Department that would increase prices for individual policyholders by an average of 14%, down from the 25% average it had previously sought.
Insurance Pools Readied in Some States
The Obama administration is poised to award contracts worth hundreds of millions of dollars to about 20 states to run new insurance pools for people with serious medical problems. In another 20 states, where local officials chose not to participate, the federal government will run the pools through a private nonprofit entity. Applications will be available to the public in many states on Thursday, and coverage could start as early as August, said Richard A. Popper, deputy director of the new federal Office of Consumer Information and Insurance Oversight.
Congress grants Medicare reprieve
Physicians got a reprieve from a 21 percent cut in their Medicare reimbursement this week when Congress voted to repeal it and even gave them a 2.2 percent pay raise. But it's only a six-month fix. Congress will have to deal with it again in November. And doctors say it's that instability and uncertainty, along with a payment rate that was until now at the 2001 level, that's forcing some of them to stop taking Medicare patients, or limit the number they take, resulting in access problems for seniors.
Obama proposes interim health protections
The Obama administration issued a series of proposed regulations Tuesday that would provide interim protections for Americans until the healthcare insurance market is more fully overhauled in 2014.President Obama, meeting at the White House with people who had been denied care, also challenged Republicans who have been trying to repeal the healthcare law. "They want to go back to the system we had before," Obama said from the East Room of the White House, where he signed the healthcare law 90 days ago. "I refuse to go back."
Aetna Finds Flaw in Rate Request
Aetna Inc. withdrew its request to raise prices for individual policyholders in California by an average of 19% after discovering in its rate filing with state regulators, according to the California Department of Insurance. California Insurance Commissioner Steve Poizner, a Republican candidate for governor, on Thursday said Aetna's withdrawal was voluntary. The errors include incorrectly calculating the annual cost of monthly premiums and incorrectly compounding the increases year over year, a spokesman for the department said. The increase, filed in March and scheduled to go into effect July 1, would have hit 65,000 policyholders.
Obama Unveils Health 'Bill of Rights', Says No Going Back
President Barack Obama unveiled a package of consumer benefits Tuesday to build support for his health care overhaul within a divided nation and warned Republicans about trying to repeal his landmark law. "We're not going back," said a defiant president. Obama also sparred with the insurance industry—but this time he sounded a conciliatory note, praising insurers for meeting some requirements of the law ahead of schedule.
Individuals see health insurance costs jump-report
U.S. health insurers are raising prices by an average of 20 percent for working age adults who buy their own policies, according to a survey released by a nonprofit healthcare group on Monday. Such premium cost increases affected more than three-quarters of the 14 million U.S. adults who buy their own health plans and caused some to either seek a cheaper option with fewer benefits or switch insurers altogether, the Kaiser Family Foundation study showed.
High court allows trial on drug safety to proceed
A lawsuit brought by a breast cancer patient against a major drug company will go forward after the Supreme Court refused to intervene in the dispute. The justices without comment Monday turned aside an appeal from Wyeth Pharmaceuticals, maker of drugs for hormone replacement therapy. An Arkansas jury had awarded $2.75 million in compensatory damages to Donna Scroggin, who claimed she developed the cancer from drugs made by Wyeth and Upjohn Corp. Both companies are now owned by Pfizer Inc. The Little Rock resident argued the medicines Prempro and Premarin lacked adequate safety warnings about the increased risks for developing breast cancer.
Senate Passes Plan to Stop Medicare Pay Cuts to Doctors
With lawmakers worried that older Americans relying on Medicare could begin losing access to health care, the Senate on Friday approved a six-month plan to prevent a steep cut in doctors’ fees paid by the federal health program. The $6.4 billion measure would reverse a 21 percent cut in physician payments that was to kick in Friday, raising the possibility that some doctors might begin to turn away those covered by Medicare. The legislation, known on Capitol Hill as the doc fix, was approved without a roll-call vote after leaders of both parties agreed to pull it out of a stalled package of tax changes and safety-net spending.
Drug Rebate Is Mailed Out
Some participants in Medicare Part D prescription-drug plans should be on the lookout for a check in the mail. The U.S. Department of Health and Human Services started sending out $250 rebate checks late last week. The one-time rebate, which is part of the health-care reform bill signed into law by President Obama earlier this year, applies to Part D participants who fall into the drug-coverage gap commonly known as the "doughnut hole." The rebate is meant to help alleviate the costs people incur during the gap. The doughnut hole kicks in after a person's annual prescription-drug cost -- covered at 75% -- reaches a set dollar amount. For 2010, it's typically $2,830.
State will give health plan rate changes extra scrutiny
Future rate changes by major health plans for individual customers will undergo an additional level of actuarial analysis before regulatory approval by the California Department of Insurance, state insurance commissioner Steve Poizner announced Thursday. Top health insurers in the individual market include Anthem Blue Cross, Aetna, Health Net and Blue Shield of California. These plans cover roughly 90 percent of the business.
Pain drugs abuse requires urgent action: CDC
Emergency room visits tied to the abuse of prescription painkillers have jumped 111 percent over a five-year period, an alarming increase that threatens the American public health system, U.S. government researchers said on Thursday.Emergency department visits involving the nonmedical use of pain drugs such as oxycodone rose to 305,885 in 2008, from 144,644 in 2004, according to a study by the Substance Abuse and Mental Health Services Administration and the Centers for Disease Control and Prevention.
U.S. sets rules for employer healthcare plans
The Obama administration on Monday announced new rules it said would protect Americans who want to keep their current health insurance but critics say the changes could end up causing millions to lose their coverage.Part of President Barack Obama's healthcare overhaul, the new regulations are meant to discourage companies from making major changes in health insurance benefits. Health Secretary Kathleen Sebelius said the new rules "make good on the president's promise that Americans can keep their health plan and doctor they like under the new law."
Doctors' group wants more accuracy from insurers
One in five medical claims is processed inaccurately by commercial health insurers, often leaving physicians shortchanged, according to the nation's largest doctor's group. The American Medical Association released its third annual report card on insurers Monday. In past years, Medicare performed well in how quickly and accurately it paid doctors, but the AMA did not release Medicare's data Monday to keep the focus on commercial insurers. Those private insurance companies matched their payments to what they agreed to pay doctors about 80 percent of the time.
FDA to monitor genetic testing
Indicating they plan to closely monitor the sale of genetic tests directly to consumers, federal regulators Friday told five companies involved in the business — including two in the Bay Area — their products are medical devices that require the government's approval. Among the companies the Food and Drug Administration notified were Navigenics of Foster City and Mountain View-based 23andMe. In letters to the companies, the FDA said neither had "submitted information on the analytical or clinical validity" of their tests, which the companies promote as helping consumers understand their genetic predispositions so they can better manage their health.
GOP, Lawmakers Clash On Stimulus
Washington Republicans and state GOP governors are clashing over the extension of last year's economic stimulus program, officials say. Nearly all Republican congressional lawmakers opposed the massive stimulus bill last year, and this year Senate Republicans oppose the extension unless its $24 billion cost is fully offset with spending cuts, The Hill newspaper reported. But California Gov. Arnold Schwarzenegger and other Republican governors want the extension, saying the new federal Medicaid funding is needed to help close state deficits, the report said. The Medicaid funding was part of last year's bill.
Healthcare industry fights for White House role in innovation
Healthcare industry leaders are pressing the White House to get more involved with promoting healthcare innovation, saying the United States leads the world but faces growing challenges. In separate events Wednesday and Thursday, former House Majority Leader Dick Gephardt (D-Mo.) and Stephen Ubl, the head of the medical device trade group AdvaMed, called on the Obama administration to task a federal office with promoting U.S. innovation.
Health reform has liability insurers looking at tort alternatives
Tort reform advocates say the medical liability system is in need of serious repair, and the federal health reform law -- while not perfect -- offers some tools to help get the job started. That was the message delivered in May to medical liability insurers attending the annual meeting of the Physician Insurers Assn. of America, a trade group for physician-owned medical liability companies. The health reform law, enacted in March, designated $50 million in incentive payments to encourage states to test alternatives to damage caps and other more traditional tort reform. The provisions expanded on a separate $25 million patient safety and liability demonstration program approved by the Obama administration in 2009.
HHS giving states funds to probe health insurers’ rate hike requests
Insurance regulators across the nation may now access a grant to help them more closely scrutinize requested premium rate hikes by health insurers. The U.S. Department of Health and Human Services announced the initial availability of $51 million in Health Insurance Premium Review Grants, made possible by the Patient Protection and Affordable Care Act. The distribution is the first round of grants in what will be a $250 million grant program the HHS says will create and strengthen insurance rate review.
Beneficiary Information About the $250 Part D Rebate
The Centers for Medicare & Medicaid Services (CMS) posted at www.medicare.gov (under "What's New") "Closing the Prescription Drug Coverage Gap" brochure that describes details about the tax-free, one-time check for $250 for people who enter the Part D donut hole and are not eligible for Medicare Extra Help. The first checks are being mailed June 10 and checks will be mailed monthly after people have entered the coverage gap. To help fight fraud and protect beneficiaries from potential scams, Medicare is reminding seniors there are no forms to fill out to receive this benefit. Medicare will automatically send a check. The envelope will have the US Department of Health and Human Services symbol on it and will say "Medicare Part D." Beneficiaries don’t need to provide any personal information.
Medicare Provides Assistance to Help Low-Income Beneficiaries Get Big Savings on Prescription Drug Costs.
Medicare beneficiaries who qualify for "Extra Help" may be eligible to pay no more than $2.50 for generic drugs and $6.30 for each brand name drug thanks to changes to Medicare's Low-Income Subsidy Program for Part D prescription drug costs (also known as LIS or "Extra Help") that take effect this year. These changes make it easier than ever for people on Medicare with limited incomes to save on their drug costs. The Centers for Medicare & Medicaid Services estimates that "Extra Help" can save eligible Medicare beneficiaries as much as $3,900 per year.
FDA Needs Food Safety Overhaul: Report
The U.S. Food and Drug Administration (FDA) isn't equipped to handle problems with the food supply and is in need of a major revamping, a government panel of experts reported Tuesday. To come up to speed, the FDA needs to squarely focus its efforts on identifying and addressing high-risk areas and on preventing foodborne illness in the first place, stated the report, issued today by the Institute of Medicine (IOM) and the National Research Council at the request of Congress.
Desperately seeking COBRA subsidy
If you lose your job after June 1, you'll see more than just your paycheck disappear. You also won't get the 65% federal subsidy to cover your COBRA health insurance premium. That's because House Democrats last week opted not to extend the subsidy in order to bring down the cost of a jobs and tax bill winding its way through Congress. Continuing the provision through Dec. 31 would run $7.8 billion.
State aid to Medicaid drops 2.7%; fed spending jumps 17%
State financing for Medicaid declined an estimated 2.7% in fiscal 2010 as federal spending for the safety net insurer increased 17.2%, according to the latest survey by the National Association of State Budget Officers and National Governors Association.The lopsided growth, the result of $87 billion in federal Medicaid relief for states under the 2009 economic stimulus bill, is expected to reverse sharply in fiscal 2011 as the aid runs out, the survey suggests.
State, insurer reach rate settlement
The state Division of Insurance has reached a settlement with Neighborhood Health Plan, allowing the Boston insurer to boost its base premium rates by 7.7 percent for small businesses and individuals. Neighborhood Health was one of six insurers challenging the Patrick administration’s denial of proposed double-digit rate hikes that would have taken effect April 1. The settlement, disclosed yesterday, halts Neighborhood Health’s administrative appeal and removes it from participation in the insurers’ lawsuit filed in Suffolk Superior Court.
Judge clears way for L.A. to begin marijuana dispensary crackdown
Medical marijuana patients and dozens of dispensaries lost an eleventh-hour bid Friday to stop a city ordinance from going into effect next week, but a judge indicated that both groups may have a legitimate basis for an injunction at a later date. Los Angeles County Superior Court Judge James C. Chalfant cleared the way for the ordinance to take effect Monday by denying more than a dozen requests for a temporary restraining order to bar the city from enforcing the law, which would force more than 400 shops to shutter their doors.
Doctors' group turns up heat on Medicare payments
The American Medical Association turned up the heat on the U.S. Congress on Thursday for failing to stop a 21 percent Medicare pay cut for doctors treating elderly patients. The doctors group said it launched a multimillion dollar ad campaign criticizing the U.S. Senate for going on a week-long Memorial Day break before acting on a bill that would have postponed the pay cut that went into effect on June 1.
Health care costs continue to increase for PPO plans
Medical spending for an American family of four covered by an employer-sponsored PPO plan rose, in cash terms, faster than ever, according to a survey. However, by percentage, those costs are going up at a consistent rate, with physician services becoming less of a contributing factor. These were among the findings of the 2010 Milliman Medical Index, an annual report published by the market research firm Milliman. The report found that for the third year in a row, the annual rate of health care cost increase has been 8% or less. However, the dollar increase of $1,303 (difference between 2010 cost of $18,074 and 2009 cost of $16,771) was the highest since Milliman started publishing the index 10 years ago.
What Is An ACO And How Can It Help?
Now that health insurance reforms have been voted in, attention is quickly turning to measures to improve the quality of care and bend the ever-escalating cost curve. Many health policy experts believe that developing a more efficient, less fragmented primary-care-based delivery system is part of the solution. In fact, the recently passed reform legislation offers that “Accountable Care Organizations” (ACOs) may well be a key to containing the rising cost of health care while achieving improved quality.
US Supreme Court To Consider Tax Rule On Medical Residents
)--The U.S. Supreme Court agreed Tuesday to hear a challenge by medical colleges and teaching hospitals of a Treasury Department regulation requiring payment of Social Security taxes on behalf of medical residents. Under a 2005 Treasury Department rule, medical residents and other "full-time employees" do not qualify for the general student exemption from Social Security taxes. At stake is the tax treatment of medical residents nationwide, of which there are currently about 100,000, and $700 million in annual revenue to the federal government, according to court papers.
Poll: Plurality say GOP should not push to repeal any part of healthcare reform
A plurality of Americans said they would prefer Republicans to leave the new healthcare law alone and not repeal any parts of it, a new poll found Tuesday.
Given the option to name the sections of the healthcare law they would most like to see the GOP repeal, 42 percent said they would leave the bill alone and repeal no parts, a new "60 Minutes"/Vanity Fair poll found. But if there is one section voters would like to see stricken from the healthcare law, it seems to be the individual mandate — the requirement that all Americans buy health insurance, or face stiff penalties.
US lawmaker presses J&J on recall, expands probe
The head of the U.S. House Oversight and Government Reform Committee expanded his investigation of Johnson & Johnson on Tuesday, saying another 2008 recall casts doubt on the drugmaker's pledge of protecting consumers. Chairman Edolphus Towns, in a letter to the drugmaker, asked the company for all records related to the 2008 recall of some adult versions of its Motrin pain reliever, including the identities of employees involved, as well as outside contractors and subcontractors who worked for J&J. The letter follows a May 27 hearing on the latest J&J recall of more than 40 liquid children's medications, including Children's Tylenol.
New law offers temporary aid to small firms seeking health insurance for workers
If you own a small business and are struggling to pay for employees' health insurance, the new health-care law could provide quick financial help. The smallest businesses could get temporary tax credits that effectively pay for up to 35 percent of their premium contributions. Slightly larger businesses could get smaller credits.But the tax credit comes with several strings, and not everyone thinks it will do enough. Blake Anderson, owner of a small construction company in Durham, N.C., is one of the optimists. When he started Innovative Renovation three years ago, he explored buying coverage for himself, his business partner and the seven workers he had at the time.
Medicare: Congressional Tax Committees Release Bill with SGR Fix
Congressional leaders on the House Ways and Means and Senate Finance committees have released the purported “tax extenders” bill (HR 4213), which among other things would raise doctors’ Medicare reimbursements 1% to 2% through 2013.
Obamacare taking on water
As they followed one another off the political cliff in voting for the health-care overhaul, Democratic senators and representatives comforted themselves with their own self-created myth that, although ObamaCare was horribly unpopular as a bill, it would prove to be quite fetching as a law. Furthermore, this transformation, this change they could believe in, would take place sooner rather than later — as voters would reward rather than punish them for passing ObamaCare in clear and open defiance of popular will.
10 Things You Can Do to Improve America's Health Care System
Key things you should know about the new health care law and ways you can bring true reform to the industry.
Congress Fails to Act - Medicare Payments Cut 21%
Despite ACEP's plea for Congress to reject the fundamentally flawed payment formula used to reimburse physicians for Medicare services, the U.S. Congress, once again, failed to take the necessary action to avert the 21% cut in payments beginning June 1. The House did approve a 19-month, short-term increase in physician payments on Friday afternoon by a vote of 245 to 171. This measure would provide physicians treating Medicare beneficiaries with a 2.2% update for the remainder of this year and a 1% update in 2011. However, Congress did not alter the underlying payment formula and reimbursement is projected to be cut by around 30% beginning in 2012.
The Senate adjourned for the congressional Memorial Day recess on Thursday night without taking action on the House bill or approving its own proposal to avert the Medicare physician payments cuts.
The Centers for Medicare & Medicaid Services (CMS) has announced that it will hold claims for 10 business days (through June 14) to give Congress time to act on the physician payment cut before it starts processing claims at the reduced amount. The Senate returns from the recess on June 7 and the House returns the following day, which gives lawmakers less than a week to resolve this issue.
ACEP will continue to work with Congress to repeal the current formula and replace it with a system that provides physicians with equitable payments based on the true cost of providing care.
Medicare Payment Extension
As a follow-up to the AOA's press conference in Washington, DC, yesterday, we are advised that U.S. House of Representatives leaders reportedly have modified the Sustainable Growth Rate (SGR) provisions of HR 4213. The new provisions provide 18 months of positive updates instead of the 3.5 years originally proposed and will include a positive payment update of 2.2% in 2010 and 1% in 2011. The formula returns to current law in 2012. The House is expected to consider the bill sometime today - although they still have vote problems. If the House approves the bill, the Senate will attempt to consider the bill this week before adjourning for the Memorial Day recess.
Obama administration asks judge to dismiss Virginia suit against health-care law
The Obama administration asked a federal judge Monday to dismiss Virginia's challenge of the health-care overhaul law, arguing that the state has no standing to sue over the law and that Congress's power to regulate interstate trade makes the measure constitutional. Virginia Attorney General Ken Cuccinelli II (R) filed suit against the act moments after President Obama signed it into law in March. His suit is separate from a broader effort filed in Florida that includes 20 states.
Budget cuts dilute children's health coverage
A federal law that President Obama signed early last year to expand health insurance to 4 million more low-income children has gotten off to a slow start because of budget problems in the states. The law makes more than $10 billion in federal aid available each year through 2013 but requires state funds as well. Faced with budget shortfalls, less than half the states have used it to expand the Children's Health Insurance Program, studies by the Kaiser Family Foundation, National Academy for State Health Policy and Georgetown University Center for Children and Families show.
House Likely To Vote On Measure That Includes COBRA Subsidy Extension And Medicare Doc 'Pay Fix'
Congressional Democrats are scurrying today to advance a $192 billion catch-all legislative package that includes "safety-net benefits for the unemployed, physician reimbursements, tax breaks for businesses and other provisions." In the House, where a vote is likely on Wednesday, leaders continued today to face concerns from budget hawks, caution within their own caucus about raising taxes on businesses and an overall sense of unease that even if they muster the needed 218 votes to pass the bill, the Senate will fall short of the requisite 60.
New Missouri law requires faster insurance payments
Missouri Governor Jay Nixon has signed into law a bill that requires health insurance companies in the state to speed up claims payments to doctors, hospitals and other health care professionals. The bill, which takes effect Jan. 1, 2011, requires insurers either to pay or deny claims within 45 days of receiving them. Plans that don't act within that time frame will pay a daily penalty to the affected physician amounting to 1% of the value of the outstanding claim.
Judge asked to dismiss Virginia's health reform challenge
President Barack Obama's administration on Monday asked a federal judge in Virginia to dismiss the state's lawsuit alleging Congress overstepped its constitutional bounds with the new health care reform law. Health and Human Services Secretary Kathleen Sebelius argued in a motion filed hours before a midnight deadline that the law is well within the scope of the Constitution's Commerce Clause.
Insurers may slash rates to hospitals
Massachusetts health insurers say they want to freeze or slash payments to some hospitals and large physician groups this year, setting up the toughest contract negotiations in memory and creating the potential for disruptions in where patients get their care. Other providers would get small increases, at most. Unlike in past years, insurers believe they have widespread backing from politicians, regulators, and employers to aggressively push back against large price increases, even if it means some unhappy providers drop out of insurers’ networks, forcing patients to find new doctors and hospitals.
NIH proposes new funding rules to prevent conflicts of interest
The National Institutes of Health proposed new guidelines Thursday to prevent financial conflicts of interest among thousands of researchers who receive federal funding, a move long sought by watchdogs of scientific research concerned about the influence of the drug industry and others. The move, which will affect more than 40,000 researchers, comes amid rising concern about the influence of the pharmaceutical industry and other private-sector interests on scientific research. In a series of high-profile cases, federally funded researchers have received upward of millions of dollars from companies with a financial interest in the outcome of their work.
FDA May Disclose More Details on Drug Safety
The nation's top drug regulator proposed on May 19 to disclose more information about safety problems with the drugs and devices it rejects. The effort is part of a broader plan to remake the public image of the Food and Drug Administration, which has come under fire for being too secretive. An agency taskforce is suggesting 21 ways the FDA could release more information to the public in areas like drug evaluation and in food manufacturing inspections, another area in which it has oversight responsibility. Agency leaders stressed that the FDA is merely considering the changes and that some would require legal changes by Congress to implement.
American College of Physicians supports SGR provision of H.R. 4213
The American College of Physicians (ACP), representing 129,000 internal medicine physician and medical student members, today said it strongly supports the proposed provision in the American Jobs and Closing Tax Loopholes Act (H.R. 4213), to provide stable and positive Medicare payment updates to physicians. The measure begins moving to a new framework that could serve as the basis for permanently replacing the flawed and unworkable sustainable growth rate (SGR) formula.
Bill would boost doc pay, hit hospitals
But the bill will face opposition from the hospital lobby on at least one measure. Under the package, a Medicare policy known as the “72-hour rule” would get refigured, amounting to about a $4.5 billion hit to the hospital sector.
The provision expands the list of services that are not eligible for reimbursement under the Medicare rule. Essentially, it bars the unbundling of payments for therapeutic services unrelated to a hospital admission if they are performed within 72 hours of an admission
Pathway Genomics’ Marketing Plan for Genetic Tests Draws More Heat
A House panel disclosed yesterday that it is investigating personal genetic tests sold over the Internet by San Diego-based Pathway and two other companies. Rep. Henry Waxman, D-Calif., sent the companies letters seeking information about the accuracy of the tests and how they are conducted. The House panel also wants to know what the firms do with the genetic material they collect from consumers. The Wall Street Journal has the story here
Insurers in the middle
Big Massachusetts health insurers have been howling for months about their run-in with state regulators and the fallout from limiting premium rates.So what is the actual financial impact of the decision by the state Division of Insurance to reject premium increases for individuals and small businesses, leaving 2009 rates in place for now? The logical places to look for a hint are the quarterly financial reports posted by insurers yesterday.
CHIP, Medicaid cuts in Arizona on hold for now
Arizona will not end its Children's Health Insurance Program and has tentatively reversed Medicaid eligibility cuts adopted in March. Arizona Gov. Jan Brewer signed legislation on May 6 reinstating CHIP and continuing Medicaid coverage for about 300,000 low-income adults, part of the state's 1.3 million program enrollees. The Legislature adopted the measure in the final days of its 2010 session, which ended April 29. The cuts -- adopted as part a fiscal 2011 budget bill -- would have saved the state about $385 million in fiscal 2011 and helped close a $1.3 billion deficit. However, they also could have led to the loss of several billion in federal health care funds.
Deficit worries make it tough for Democrats to move the 'doc fix'
House Democrats are struggling with how to prevent cuts to physician payments under Medicare. The cuts are scheduled to go into effect next month if Congress does not take any action, and lobbyists say they’ve heard lawmakers might not fix the problem for more than seven months in the tax extenders package currently under discussion.
Workplace Set to Remain Key Source of Health Coverage
The share of Americans who get health coverage through their jobs has been declining gradually for years, dropping to 63.3% of working-age adults in 2008. The question now is whether the new health law will accelerate that trend, and induce more employers and workers to turn to government coverage options. In the near term, at least for the total figures, that is unlikely. For the next decade, the overall number of Americans with workplace health benefits isn't likely to change much, government analysts suggest
GOP Launches Attacks On CMS Nominee Berwick
Republicans have begun attacking Donald Berwick, a doctor and Harvard professor nominated to head the Obama administration's Medicare and Medicaid agency, The Boston Globe reports. If confirmed, Berwick would run the Centers for Medicare and Medicaid Services, an agency with 4,500 employees and an annual budget of $780 billion. But, first, he will have to survive Republican attacks, such as Senate Minority Leader Mitch McConnell's assertion Wednesday that his is an "expert on rationing.
Small business lobby to go to court on health law
Attorneys general and governors for 20 states won't be alone in their legal challenge to President Barack Obama's health care overhaul. The nation's most influential small business lobby is going to court with them. The National Federation of Independent Business will join the argument that Americans cannot be required under the Constitution to obtain insurance coverage, the group's president, Dan Danner, said Friday. "This law is the first time the federal government has required individuals to purchase something simply because they are alive," said Danner
Without reimbursement stability, physicians may drop Medicare beneficiaries
What is it going to take for Congress to stop playing games with physicians who treat Medicare patients and develop an effective solution to the fee cuts that are scheduled every year and require last-minute, short-term, emergency solutions? Will the likelihood of physicians stopping their care of Medicare beneficiaries be enough to jolt Congress into action?
Lawmakers investigating home healthcare companies
Shares of the companies -- Amedisys Inc, Gentiva Health Services Inc, LHC Group Inc, Almost Family -- fell on the news. In a bi-partisan letter to the companies released on Thursday, lawmakers said when Medicare changed its payment rules to provide additional reimbursement to patients when they had six, 14 and 20 therapy visits, "the home health industry apparently changed their utilization patterns as a result of these payment policy changes."
Consumer Gene Tests Need U.S. Approval, Official Says
Gene tests used to reveal a person’s risk for disease must be cleared by the government if they are to be sold directly to consumers, U.S. regulators said for the first time. Gene-testing products sold online or in retail stores that tell individual customers how their genes affect their risk of various diseases require agency review, Alberto Gutierrez, director of the Food and Drug Administration office that regulates diagnostic tests, said today in an interview. No such test has been approved or rejected by the FDA in the more than two years they have been on the market, he said
Changes to Medicare Supplement (Medigap) in 2010
Medicare has several gaps and doesn't pay for all of your health care costs. If you have Medicare you may want to buy Medicare supplemental insurance, also called Medigap insurance. This health insurance helps pay for some of your Medicare costs, such as deductibles, coinsurance, and copayments, and for some care Medicare doesn't cover. Medigap insurance is sold by private insurance companies. By law, companies must offer standardized Medigap insurance plans. Each plan has a different set of benefits.
CBO: Health Care Bill Will Cost $115 Billion More Than Previously Assessed
The director of the Congressional Budget Office said Tuesday that the health care reform legislation would cost, over the next ten years, $115 billion more than previously thought, bringing the total cost to more than $1 trillion. The revised figure is due to estimated costs to federal agencies to implement the new health care reform bill – such as administrative expenses for the Internal Revenue Services and the Department of Health and Human Services -- and the costs for a "variety of grant and other program spending for which specified funding levels for one or more years are provided in the act."
World health gains show goals work
Health targets trumpeted by international bodies are often dismissed as little more than empty promises, but data from the World Health Organization on Monday show they really can focus minds and deliver results. Efforts to improve child health, reduce maternal deaths, fight malaria and bring the AIDS epidemic under control in some of the world's poorest nations have led to "striking improvements," according to a WHO report -- and experts say the Millennium Development Goals (MDGs) that galvanized political determination are largely responsible.
AIMS Error Snags Attending In Costly Med Mal Case
In an example of unintended consequences from the use of electronic medical records, an attending anesthesiologist at a Florida medical school was sued for medical malpractice even though he was not involved in a patient’s surgery.Due to human error, the clinician’s name was entered into the hospital’s anesthesia information management system (AIMS). He was deposed and spent $10,000 in legal fees before eventually being dropped from the suit. He still must report the suit when applying for future medical licenses and hospital privileges.
Consumer-directed health plans grew 27% in 2009
More people in 2009 than in 2008 signed up for high-deductible health insurance combined with some form of health savings or reimbursement account, and much of this growth is due to the increasing number of small businesses offering employees this option. This is according to an analysis of Mercer's National Survey of Employer-Sponsored Health Plans released April 14 by the American Assn. of Preferred Provider Organizations.
Obama: Health bill benefits beginning
The most critical and controversial parts of the recently passed health care reform bill won’t take effect for more than three and half years, but President Barack Obama wants Americans to know that the historic legislation is already spurring positive changes in the insurance business. “While it will take some time to fully implement this law, reform is already delivering real benefits to millions of Americans,” Obama said in his weekly radio and video address out Saturday morning. “Already, we are seeing a health care system that holds insurance companies more accountable and gives consumers more control.”
House to Examine Medicines Recall
The House Committee on Oversight and Government Reform is opening an investigation into conflicting accounts of what prompted a Johnson & Johnson unit's recent recall of children's over-the-counter medicines, as well as how the company handled consumer complaints about foreign matter in the bottles. The committee will seek a chronology of events leading up to the recent recall, a spokesman for Rep. Darrell Issa, the ranking Republican on the committee, said Wednesday. It will also seek copies of investigation reports by the Food and Drug Administration and J&J's McNeil Consumer Healthcare unit, the spokesman said.
How The Individual Health Insurance Mandate Will Work
A simple rule lies at the heart of the Patient Protection and Affordable Care Act: Starting in 2014, almost every American will need to carry health insurance or pay a fine. That rule is known as the individual mandate. The mandate requires all citizens and legal immigrants to have "qualifying" health coverage. People eligible for employer coverage can satisfy the requirement by enrolling in their employer’s plan. Employer plans will need to meet certain standards—covering preventive care and disallowing lifetime limits—but will not need to have all of the minimum benefits that will be required of plans sold to individuals and small businesses.
Lawmakers to mull bills aimed at boosting price transparency
A House panel plans to take up a trio of bills aimed at increasing transparency and clarity in healthcare pricing, tackling an issue that has bedeviled the industry for decades and handcuffed efforts to turn everyday people into better purchasers of care. “In order for people to make informed decisions and to be their own true consumer advocate in the purchase of healthcare, they have to be able to go somewhere to get valid information about cost, price and quality, too,” said Rep. Michael Burgess (R-Texas).
Children's Tylenol Recall: FDA Report Rips Quality Control at Plant
Raw materials used to make children's liquid cold medications subject to an April 30 recall were contaminated with bacteria, according to a U.S. Food and Drug Administration report released Tuesday. The recall affected 43 different Johnson & Johnson products sold under the brand names of Tylenol, Motrin, Zyrtec and Benadryl. Preliminary tests have only narrowed down the possible bacterial contaminant to a category of microorganism described as "gram negative," a broad group that includes many germs potentially harmful to humans.
Strong opinions on health reform but few facts
Americans have negative opinions about the U.S. healthcare system despite good personal experiences and they admit they are not especially well-informed, according to a survey released on Tuesday. They are also afraid of healthcare reform and would rather stick with a flawed system than change to something new, the poll by the Deloitte Center for Health Solutions found.
Infusion pumps targeted for tighter FDA scrutiny
The Food and Drug Administration is dramatically changing its approach to regulating medical devices, announcing in April that it will impose stricter safety standards for infusion pumps as a class rather than dealing with problems on a case-by-case basis. The change comes after 710 deaths associated with malfunctioning infusion pumps used in homes and hospitals during the last five years. The agency has received 56,000 adverse-event reports regarding the devices during that time period and issued 87 recalls -- 14 of those in the FDA's highest-risk class I category.
High-Risk Insurance Pools Divide the States
A temporary insurance program that is part of the national health overhaul is exposing one of the thorniest aspects of the new law—much of its success rides on how individual states implement it. On Friday, the Department of Health and Human Services and individual states said 12 states chose not to administer a new high-risk pool program that begins in July, while 21 states and the District of Columbia will run their own. The pools are designed as a short-term way to provide insurance for people with pre-existing health conditions who have been turned down by insurers.
Healthcare stocks slide after WellPoint cancels rate increase
Healthcare stocks dropped Friday as Wall Street feared more bad news ahead for the nation's large insurance companies after giant insurer WellPoint Inc. abruptly canceled a massive rate increase in California. Investors worried that Indianapolis-based WellPoint's decision to abandon plans for rate hikes as high as 39% amid pressure from state officials could be a sign of things to come elsewhere
Lawmakers vow to monitor insurers
Two Democrats on Friday said they would use their posts on congressional oversight committees to ensure that insurance companies do not take shortcuts when they begin to comply with tighter industry restrictions and chided several insurers that they say already have. Rep. Jan Schakowsky (D-Ill.), a member of the House Energy and Commerce Committee, lashed out about reports of WellPoint and other insurers attempting to skirt some of the provisions, including shifting services to show a more favorable medical-loss ratio and dropping seriously ill patients.
Pozen, AstraZeneca Win FDA Approval of Arthritis Drug
Pozen Inc. and AstraZeneca Plc won U.S. clearance to sell an arthritis drug that combines a painkiller with an ulcer medication. The Food and Drug Administration approved the medicine, called Vimovo, for use in arthritis patients who are at risk of developing gastric ulcers, the agency said today in an e-mail. Pozen’s shares rose 21 percent, or $2.30, to $13.15 in extended trading on the Nasdaq Stock Market before being halted.
Medicare Fraud Penalties Tougher Under Proposed Bill
Saying that criminal penalties for Medicare fraud must be updated, two Florida lawmakers introduced a bill April 13 that would double fines, increase background checks and even study how biometric technology could help ensure the appropriate use of program services. U.S. Reps. Ileana Ros-Lehtinen (R, Fla.) and Ron Klein (D, Fla.) said the Medicare Fraud Enforcement and Prevention Act is "a tough new bipartisan bill" that will help crack down on Medicare fraud, protecting seniors and taxpayers alike.
Schwarzenegger backs health overhaul
Gov. Arnold Schwarzenegger pledged California's full support Thursday for national health care reform, throwing the weight of one of the nation's most prominent Republicans behind the overhaul. Mr. Schwarzenegger said he long has supported the concept of universal health coverage, and in 2007 he proposed a $14.7 billion overhaul of the health care market in California.
Insurers agree to limit health care cancellations
Several health insurers said Wednesday they plan an early start on a slice of health care reform by pledging to limit the circumstances in which they cancel coverage when a customer gets sick. UnitedHealth Group Inc., Humana Inc. and Blue Shield of California all said they will drop, or rescind, coverage only in cases where a patient has committed fraud or intentional misrepresentation. The health care reform legislation passed last month by Congress limits rescission to cases of fraud. But that provision won't take effect until Sept. 23.
Drug Giant AstraZeneca to Pay $520 Million to Settle Fraud Case
Pharmaceutical giant AstraZeneca will pay $520 million in fines to settle charges by the federal government that it illegally marketed the anti-psychotic drug Seroquel to children and elderly patients for uses not approved by the Food and Drug Administration. AstraZeneca, one of the country's biggest drug firms, allegedly pulled in hundreds of millions of taxpayer dollars through Medicare and Medicaid kickbacks and scams. Seroquel is used to treat schizophreniain patients older than 13, and bipolar disorder in patients older than 10.
Seniors aren't flocking to quality health plans
Millions of seniors signed up for popular Medicare Advantage insurance plans don't get the best quality, an independent study found. How the private plans score on a quality rating system set up by the government is about to have a direct impact on insurers' finances — not to mention seniors' benefits and premiums. President Barack Obama's health care law ties what the plans get paid by the government to the quality they provide, for the first time. There seems to be plenty of room for improvement.
Majority of Americans 'confused' about health care law
Majorities of Americans described themselves as "confused" about the new health care bill and acknowledge they don't have enough information about it to grasp how it will affect their lives, according to a new poll conducted by the Kaiser Family Foundation. The numbers -- fifty-five percent of those tested expressed confusion about the law while 56 percent didn't know what impact it would have on them -- suggest that President Obama and his administration have their work cut out for them in the runup to the midterm elections.
Not-for-profits still face challenging outlook, Moody's says
Moody's Investors Service raised credit ratings for 15 not-for-profit hospitals and health systems and lowered ratings for eight, the first quarter since the end of 2005 when not-for-profit healthcare borrowers saw upgrades outpace downgrades. Analysts cautioned the favorable ratio is unlikely to continue as the weak economy, upcoming Medicare payment cuts and health reform strain operations. Hospital executives report revenue and volume growth continue to flag but further efforts to curb expenses may be limited, Moody's noted.
FDA Issues Warning Against Faulty Defibrillators
A U.S. government agency on Tuesday warned that 280,000 external defibrillators may malfunction when used to assist people in sudden cardiac arrest and urged health care facilities to seek out alternative or replacement devices.External defibrillators use an electric shock to restore a normal heartbeat to a patient in cardiac arrest.
Some families will face wait to cover young adults
President Barack Obama's health care overhaul was supposed to take care of a major worry for parents of 20-year-olds making the transition to work: keeping the kids insured. But what sounds like a simple solution—starting this year, letting young adults stay on their parents' health plan until they turn 26—involves a surprising amount of fine print. As a consequence, some families may have to wait until 2011 to get their kids covered, particularly if the parents are working for a large employer, benefits experts and government officials say.
Federal Officials Confirm A Shift In Medicaid Drug Rebates
The federal agency that oversees Medicaid confirmed Thursday that some money states receive as rebates from drugmakers will now be redirected to the federal government to help pay for the new health overhaul. However, federal officials said that states’ losses would be offset by other changes in Medicaid, the federal-state health care program for low-income people. The health law increases the rebates that drugmakers must offer state Medicaid programs from 15.1 percent to 23.1 percent for most brand name drugs, and by smaller amounts for other drugs and generics.
Medicare pay cut stopped again; doctors decry lack of permanent fix
Congress may have stemmed most of the damage from the latest 21% Medicare payment reduction by reversing the cut before any physicians actually could feel it. Still, physician organizations say the harm caused by lawmakers once again bringing doctors to the brink before pulling them back is another major reason why the next solution must be a permanent one. Legislation to reverse the cut and postpone it until June 1 was signed into law by President Obama late on April 15. The cut technically had gone into effect April 1 as lawmakers fought over how to pay for the bill, which also extends various unemployment and health assistance programs.
U.S. budget office: 4 million likely to pay health fine
About four 4 million people in the United States could be fined for failing to buy health insurance when the health overhaul law is fully in force in 2016, the Congressional Budget Office forecast on Thursday. Most individuals must buy health insurance under the landmark legislation passed by Congress last month, or face fines that will be phased in. By 2016, those without coverage may be fined up to 2.5 percent of their income. The majority of the 21 million expected to lack insurance in 2016 will likely avoid penalties, the CBO, a nonpartisan arbiter of budget issues, said in an analysis of the overhaul, a cornerstone of President Barack Obama's domestic agenda.
Merck Revenue Cut by $170 Million From Health Law
Merck & Co. said the U.S. health- care overhaul will cut $170 million from revenue this year because of changes including increased Medicaid rebates. The law will reduce the company’s revenue by $35 million in the first quarter. For 2011, the changes will trim $300 million to $350 million from sales, Merck said today in a statement. The health-care law won’t affect the forecast of annual earnings growth in the high single-digits through 2013, Merck said, without providing specific numbers. Drugmakers Eli Lilly & Co., Abbott Laboratories, and Johnson & Johnson have also projected reduced sales because of the overhaul.
Public Opinion Varies on HealthCare Reform Act, But Agrees On Several Issues
Public opinion appears to be across the board when it comes to U.S. President Obama’s recently passed health care reform bill, The Affordable Care Act. However, individuals from different political parties surprisingly agree on several issues, according to a survey conducted by the Center for Health Policy and Professionalism Research at Indiana University. According to the survey, opinion varies widely with regard to the current legislation; 21 percent are completely satisfied; 28 percent want changes made in the law; 39 percent want the law repealed and to start the health care reform process from scratch; while 13 percent do not want any government health care reform.
FDA Pushes Oversight Of Devices
With hospitals discharging patients after ever-shorter stays, more people are recovering and continuing post-operative care, or treating chronic conditions, with sophisticated medical equipment at home. The Food and Drug Administration is raising a red flag, calling for greater oversight of devices such as dialysis machines, ventilators, infusion pumps and IV machines—which are increasingly operated by patients, family members and other minimally trained caregivers
U.S. reforms to hurt non-profit hospitals: Moody's
The healthcare overhaul will ultimately hurt the credit profiles of not-for-profit hospitals, despite some positive effects, Moody's Investors Service said in a report on Wednesday. Legislation signed into law by President Barack Obama last month overhauls the $2.5 trillion U.S. healthcare industry and extends coverage to 32 million uninsured Americans. The wave of newly insured will benefit not-for-profit hospitals in the short-term, along with other reforms such as reimbursement protections this year and a 10 percent Medicare bonus payment for primary care physicians and general surgeons in 2011, Moody's said
Obama Health Team Turns to Carrying Out Law
The success of the new health care law depends to a large degree on a handful of Obama administration officials, who are scrambling to make the transition from waging political war on Capitol Hill to managing one of the most profound changes in social policy in generations. For these officials, the task of carrying out the law may be as much of a challenge as getting it enacted.
Tort Reforms Enacted In Utah
Utah Gov. Gary R. Herbert signed into law a series of tort reform measures limiting noneconomic damages in medical liability cases and establishing lawsuit requirements that physicians say will add stability to the legal system and improve access to care. The legislation, signed March 23, places a $450,000 fixed cap on pain and suffering awards, eliminating annual inflation adjustments included in a prior cap that stood at $488,000. The new law, which takes effect July 1, also requires patients to secure an affidavit from a medical expert certifying a lawsuit's merits to pursue any case that a screening panel had determined had no basis
Health insurers shifting costs ahead of law: report
Some of the largest U.S. health insurers are changing their accounting practices to book administration costs as medical costs in an attempt to circumvent new industry reforms, according to a U.S. Senate panel's report released on Thursday. Under the healthcare law passed in March, insurers must adjust their spending habits to meet new requirements. For example, large group plans must spend at least 85 cents of every premium dollar paid to them on actual medical care as opposed to administrative costs, while individual and small group plans must spend 80 cents.
Massachusetts health-care reform leader could play larger role nationally
Don't be surprised if you start hearing the name Jon Kingsdale a lot in the near future. Kingsdale is the founding executive director of the Massachusetts Health Connector, the agency at the heart of the state's 2006 universal health-care law that served as the model for the national health-care legislation that President Obama signed last month. Kingsdale has been widely credited with leading the implementation of the state law -- getting people to comply with Massachusetts's mandate to obtain health insurance, and setting up the Connector, a marketplace where people without employer coverage buy insurance, just as will occur on the state-based "exchanges" envisioned by the national law.
Senate confirmation only first hurdle for CMS nominee Dr. Berwick
After a long leadership drought at the agency overseeing Medicare and Medicaid, the Obama administration has placed its faith in a pediatrician widely renowned for his contributions to health care quality research and improvement to help lead the agency through the start of a critical system overhaul. Although the nomination was not yet official at this article's deadline, a White House official confirmed March 29 that President Obama will nominate Donald M. Berwick, MD, as the next administrator of the Centers for Medicare & Medicaid Services.
Waging War on Obamacare
The cloud of Obamacare has a faint silver lining. Both the substance of the bill and the way it was passed have boosted the electoral prospects for right-leaning candidates in November. That’s a critical first step toward repealing the most consequential expansion of government’s role in our daily lives in many decades. Let’s be clear, however: To repeal or even defang Obamacare will require a combination of skill, luck, and the right political environment. And it will require conservative reformers in both parties (yes, both parties — the only bipartisanship on display this past year, it is worth recalling, has been bipartisan opposition to Obamacare). It’s doable, but it won’t be easy
Medicare Doc Payment Cut Looms With New Deadline: Tomorrow
The Wall Street Journal's Health Blog: "Congress has already missed the deadline for new legislation to block cuts of 21% in Medicare payments to doctors. The pay reduction officially took effect April 1, but the Centers for Medicare and Medicaid Services — the federal agency that oversees the giant health systems — put a hold on processing physician payments for 10 business days, effectively pushing off the bite on payments for physicians' services until April 15.
Consumer hospital prices jump again
Consumer prices for hospital services spiked for a second straight month in March, rising 1.1% after climbing 1.3% in February, the largest one-month gain in the 13 years that the Bureau of Labor Statistics has collected comparable figures. The hospital CPI rose 8.6% for the 12 months ended in March compared with 6.5% the year-ago period.Prices for hospital inpatient services continued to climb, posting a one-month increase of 1.6% last month after rising 1.2% in February and 0.8% in January. Outpatient hospital consumer prices rose at a more modest 0.6% in March after climbing 1.3% in February and falling 0.1% in January.
UnitedHealth, WellPoint Fight Obama’s Cost Mandate
A U.S. mandate forcing insurers led by UnitedHealth Group Inc. and WellPoint Inc. to spend 85 percent of revenue from premiums on medical care is the newest front in the battle between the Obama administration and companies over industry profits. In 2009, UnitedHealth spent 82.3 percent of revenue from premiums to pay customers’ medical expenses and WellPoint spent 82.6 percent, according to company filings.
Massachusetts court rejects health insurers' bid to raise premiums
A Massachusetts court Monday ruled against health insurance providers seeking to raise their premiums 8 to 32 percent in a closely watched case. Massachusetts enacted a universal healthcare plan in 2006 that includes politically controversial measures such as the individual mandate requiring all adults to purchase insurance. With opponents of the national healthcare legislation passed weeks ago promising legal action, the Massachusetts case was seen a foretaste of what could lie ahead
HHS seeks input on insurer-spending rules
HHS Secretary Kathleen Sebelius is calling on state insurance commissioners, health plans and the public to help draw up rules on insurer spending for medical care. The new healthcare reform law requires health plans to spend between 80% and 85% of premium dollars on clinical services and quality, or provide a rebate to members for the difference. Health plans must begin reporting these spending figures—called a medical loss ratio—this year.
Another Cancer Battle: Costs
Cancer patients can turn to support groups when dealing with the rigors of treatment. It's far more difficult to get help with the growing financial burdens of care. The new health-care legislation contains some provisions that aim to help cancer patients and survivors in the future, including limits on out-of-pocket costs, insurers who impose caps on benefits and premiums for patients with pre-existing conditions. But some provisions won't fully kick in for four years.
Romney Dogged by a Tale of Two Health Plans
Mitt Romney, along with some other Republicans likely to run for president in 2012, is raising money this year for congressional candidates who want to repeal President Barack Obama's sweeping health-care law. But as Mr. Romney tours to promote his new book, some people have been posing an uncomfortable question: If he opposes Mr. Obama's health-care policy, why did Mr. Romney shepherd a near-universal health-insurance system into law as governor of Massachusetts?
Changes Coming To Insurance Plans
Consumers and employers who buy health insurance are scrambling to understand what will change in their premiums and benefits once provisions of the recently passed law go into effect. Unlike state insurance laws, which mostly affect policies individually purchased or offered through small and mid-sized businesses, the new federal legislation applies more broadly to nearly all types of private plans, say insurers and employer benefit experts. That includes policies offered by large self-insured employers, through whom about half of the nation’s covered workers get their insurance.
Seniors fear hit to Medicare
Seniors aren't breaking out the champagne for President Obama's health care law, and for good reason. While Democrats hail the overhaul as their greatest health care achievement since Medicare, seniors fear it's a raid on that same giant health care program - a bedrock of retirement security - in order to pay for covering younger, uninsured workers and their families.
Oregon Bill Would Let Psychologists Prescribe
Organized medicine is asking Oregon Gov. Ted Kulongoski to veto a bill that would permit psychologists to prescribe a wide range of psychotropic drugs. The measure, passed by the House in March after Senate approval, would authorize the Oregon Medical Board to grant prescriptive authority to qualified psychologists who complete certain educational and training requirements. The medical board and Board of Psychologist Examiners also would set rules for collaboration between the prescribing psychologist and the health care professional overseeing the patients' medical care, such as ensuring necessary medical examinations.
Florida says challenge to healthcare reform widens
Five more states are joining a Florida-led group of states in a lawsuit challenging President Barack Obama's overhaul of the U.S. healthcare system, Florida's attorney general said on Wednesday. The joint lawsuit led by Florida and now grouping 18 states was filed on March 23 by mostly Republican attorney generals.
Massachusetts Insurers Close Plans, Leaving Would-Be Customers In Limbo
An ongoing showdown between Massachusetts regulators and the insurance industry resulted in insurers temporarily closing plans to new enrollees Tuesday. The Boston Globe: "The standoff between Massachusetts regulators and health insurance companies intensified yesterday, as most insurers stopped offering new coverage to small businesses and individuals, and state officials demanded that the insurers post updated rates online and resume offering policies by Friday."
Health reform final package ensures more funding for primary care
Physicians who provide primary care to patients are among those the federal government will single out for more support under the final health system reform package that is now the law of the land. On March 30, President Obama signed a package of amendments to the main health reform law, the Patient Protection and Affordable Care Act. The House and Senate on March 25 adopted the amendments to address a number of concerns House members had with the underlying Senate-authored law.
CMS sends $41.6 million to Medicare counseling programs
The CMS has announced that nearly $41.6 million has been distributed to state health insurance assistance programs to help beneficiaries get more information about their Medicare health and prescription-drug plan choices.The grants are the first of two rounds of funding to be distributed to these types of counseling programs in fiscal 2010. Approximately $1.5 million in performance grants will be distributed to the insurance assistance programs in September.
The New Health Law Will Affect States' Budgets
Last month, Arizona did something no state had ever done — or is likely to ever do in the future. As part of its effort to close a $2.6 billion budget gap, Arizona became the first state to eliminate funding for its Children's Health Insurance Program. Lawmakers decided to make deep cuts in Medicaid as well, kicking 300,000 adults off the rolls as of January.
New healthcare law is full of unknowns
About the only thing Dr. Philip Schwarzman can be sure of under the national healthcare overhaul is that he is adding his daughters, ages 23 and 25, to his health plan immediately. Much less clear to Schwarzman is how the sweeping law will affect the emergency department at Providence St. Joseph Medical Center in Burbank, where he is medical director. "It's incredibly complicated," said the white-haired physician, whose department sees 50,000 patients a year. "It's hard to predict what's going to happen."
Sebelius Begins Push for High-Risk Pools
In one of the first steps toward implementing the recently adopted health care legislation, the secretary of health and human services, Kathleen Sebelius, on Friday sent a letter to governors and state insurance commissioners asking whether they were interested in creating high-risk insurance pools. The legislation calls for the creation of a high-risk insurance program to help cover the uninsured from now to 2014, when new government-regulated insurance exchanges begin to operate and regulations take effect barring insurers from denying coverage to people based on pre-existing medical conditions.
Obama seeks to reassure small business on health care
President Obama sought to reassure jittery small-business owners Thursday that they stand to benefit from the recently enacted health care law -- an assertion not universally shared by a traditionally Republican-leaning constituency. The president took his pro-reform message to Maine, a politically friendly state he carried by nearly 20 points in the 2008 general election. While in New England, he also planned to make a quick stop in Massachusetts for a couple of Democratic National Committee fundraisers.
Obama: US would go bankrupt without health changes
President Barack Obama says he did a full court press for a health care system remake because "this country was going to go bankrupt." At the same time, Obama said in a nationally broadcast interview Friday he isn't worried that his bold reach for a $1.3 trillion, 10-year makeover might cause his public approval ratings to plummet. He told CBS's "The Early Show" that forcing changes in the system was "the right thing to do."
MedPAC urges performance-based GME payments
The Medicare Payment Advisory Commission in a series of recommendations is calling on Congress to overhaul Medicare's graduate medical education, or GME, payments so that institutions are paid based on performance standards. The purpose of these recommendations is to support workforce skills that would reduce cost growth while improving quality, the commission stated. HHS should establish standards for distributing funds to GME institutions that specify “ambitious goals” for practice-based learning and improvement, using overpayments made to the indirect medical education pool to fund the new performance-based program
Democrats lie low after healthcare victory
The week after passing landmark healthcare reform and handing President Barack Obama an important victory, members of the U.S. Congress returned to their home districts for a recess to face constituents and justify their votes after the bruising legislative battle.
While Obama made flying visits across the country to tout the new legislation, a number of key Democrats, who led the charge for healthcare reform, seemed to keep a low profile and are doing little to beat the drum.
Post-reform polls show little movement
Much has changed in Washington over the last two weeks, as Congress passed a sweeping health-reform bill and Barack Obama's presidency became known by both friend and foe as a historically consequential one. But according to a host of new surveys, one thing hasn't changed all that much -- public opinion.
Obama to Sign Fix for Health-Care Measure, Student Loan Program
President Barack Obama today signs the last piece of legislation to enact the U.S. health-care overhaul that includes changes designed to make college more affordable. Along with making adjustments to the health-care law he signed last week, the measure revamps the student loan program to help more Americans earn a college degree. Under the change, private banks and processors are to be taken out of the loan origination business and will no longer collect fees for acting as middlemen.
The Rich Can't Pay for ObamaCare
The president intends to squeeze an extra $1.2 trillion over 10 years from a tiny sliver of taxpayers who already pay more than half of all individual taxes. It won't work. President Barack Obama's new health-care legislation aims to raise $210 billion over 10 years to pay for the extensive new entitlements. How? By slapping a 3.8% "Medicare tax" on interest and rental income, dividends and capital gains of couples earning more than $250,000, or singles with more than $200,000.
Insurance industry agrees to fix kids coverage gap
After nearly a year battling President Barack Obama and congressional Democrats over the health care overhaul, the insurance industry says it won't block the administration's efforts to fix a potentially embarrassing glitch in the new law. In a letter to Health and Human Services Secretary Kathleen Sebelius, the industry's top lobbyist said Monday insurers will accept new regulations to dispel uncertainty over a much-publicized guarantee that children with medical problems can get coverage starting this year.
Medicaid funding extension moving through Congress
The tax extenders bill that the Senate approved on March 10 included a much-anticipated six-month extension of stimulus Medicaid funding in addition to the latest Medicare physician pay patch. The move sent the package back to the House for approval. The Senate measure would extend through June 2011 the enhanced federal Medicaid funding enabled by the most recent federal stimulus bill. That law required states to maintain existing eligibility and enrollment standards in exchange for receiving $87 billion in additional Medicaid funding over 27 months.
The First Test Of New Health Law: Covering Hard-To-Insure People
It’s the first and one of the hardest tests of the Democrats’ ambitious plan to overhaul the nation’s health care system: in the next 90 days establishing a federally funded program to cover people turned down by private insurers because they have a pre-existing medical condition. The effort, to provide immediate relief to people who have no insurance options, will be closely watched as an early gauge of the Obama administration's ability to turn a complex new health care law into a smooth-running program.
The ObamaCare Writedowns
It's been a banner week for Democrats: ObamaCare passed Congress in its final form on Thursday night, and the returns are already rolling in. Yesterday AT&T announced that it will be forced to make a $1 billion writedown due solely to the health bill, in what has become a wave of such corporate losses. This wholesale destruction of wealth and capital came with more than ample warning.
Obama to name new Medicare/Medicaid chief: official
President Barack Obama has picked a top health policy expert to run Medicare and Medicaid, an administration official said on Saturday, filling a role at the heart of his historic healthcare reform. Obama plans to nominate Dr. Donald Berwick as administrator of the Centers for Medicare and Medicaid Services, a unit of the Department of Health and Human Services, the official said.
Democratic Senator: Health Care Law to Address 'Mal-Distribution of Income'
As Democrats tout the moral underpinnings of the federal health care system overhaul -- ensuring health care coverage for nearly all Americans -- one senator appeared to go off message when he said the legislation would address the "mal-distribution of income in America."After the Senate passed a "fix-it" bill Thursday to make changes to the new health care law, Sen. Max Baucus, D-Mont., chairman of the influential Finance Committee, said the overhaul was an "income shift" to help the poor.
GOP succeeds in forcing another House vote on health care
In a session that lasted into the early morning hours, Senate Republicans found violations in two provisions of the health care bill, forcing it back to the House for another vote. Democrats say they expect the House to approve it quickly. The GOP -- which has vowed to use every parliamentary tool available to undermine the recently enacted health care reform law -- launched its attempt to amend or kill legislation expanding the new law in a Senate session that finally adjourned at 2:45 a.m. Thursday.
Repeal and reform will be a winning issue this fall
Democrats are celebrating victory. The public outcry against what they've done doesn't seem to bother them. They take it as validation that they are succeeding at transforming America. But we've seen this movie before and it won't end happily for Democrats. Their morale rose when the stimulus passed in February 2009. The press hailed it as a popular answer to joblessness and a sluggish economy. At the time, Democrats thought it brightened their chances in the 2009 gubernatorial elections.
Medicare audits to be expanded
The use of auditors who pore over physician Medicare claims -- as well as bills from other government contractors -- to identify and recover past overpayments will be expanded under the Obama administration's latest crackdown on fraud, waste and abuse. The president on March 10 announced a new effort to improve federal payment accountability through the use of payment recapture audits. An executive memorandum directs the White House Office of Management and Budget to develop guidance within 90 days on actions agencies across the government should take to expand the use of these reviews.
Republicans Look to Voters for 'Final Say' on Health Care Reform
The economy hits unspeakable lows. The immediate provisions of health care reform fail to ease opposition. Anti-incumbent fever sweeps the nation, and Republicans ride the wave of discontent to take control of Congress. This is the elusive sequence Republicans appear to be banking on to translate voter dissatisfaction over health care reform into a 1994-style GOP tsunami. Republicans acknowledge the difficulty. But, with health care reform the law of the land as of Tuesday, the minority party is setting its sights on solving its woes by ending Democrats' reign.
Health Care: Changes Made to Senate Bill by House Democrats
The House of Representatives last night approved the biggest changes to the U.S. health-care system in more than four decades, extending coverage to tens of millions of uninsured Americans and attempting to curb rising medical costs. Under the bill, insurers will no longer be able to reject new customers with pre-existing medical conditions; new restrictions will also be placed on their ability to set premiums. Patients will have greater access to preventive care and young adults will be able to stay on their parents’ insurance until the age of 26.
States launch lawsuits against healthcare plan
The lawsuits were widely expected with announcements coming from the states' top legal officials less than 24 hours after the House of Representatives gave final approval to a sweeping overhaul of healthcare. State officials are concerned the burden of providing healthcare will fall to them without enough federal support. Eleven of the attorneys general plan to band together in a collective lawsuit on behalf of Alabama, Florida, Michigan, Nebraska, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington.
House approves sweeping healthcare overhaul
On a late-night 219-212 vote, House Democrats approved the most dramatic health policy changes in four decades. The vote sends the bill, already passed by the Senate, to Obama to sign into law.The overhaul will extend health coverage to 32 million Americans, expand the government health plan for the poor, impose new taxes on the wealthy and bar insurance practices such as refusing to cover people with pre-existing medical conditions.
Big Win for Obama, but at What Cost?
The House’s passage of health care legislation late Sunday night assures that whatever the ultimate cost, President Obama will go down in history as one of the handful of presidents who found a way to reshape the nation’s social welfare system.
After the bitterest of debates, Mr. Obama proved that he was willing to fight for something that moved him to his core. Skeptics had begun to wonder. But he showed that when he was finally committed to throwing all his political capital onto the table, he could win, if by the narrowest of margins
Stage set for historic health care reform vote
Former President Bill Clinton made several phone calls Saturday to lobby wavering Democrats to sign on to the health care reform bill, Democratic sources told CNN. Clinton made phone calls to an unspecified number of House Democrats on Saturday as leaders tried to round up the 216 necessary votes to pass the bill. According to CNN's latest count, 33 House Democrats plan to vote against the legislation. Thirty-eight Democratic "no" votes are needed to kill the bill.
Final health bill omits some of Obama's promises
It was a bold response to skyrocketing health insurance premiums. President Barack Obama would give federal authorities the power to block unreasonable rate hikes. Yet when Democrats unveiled the final, incarnation of their health care bill this week, the proposal was nowhere to be found. Ditto with several Republican ideas that Obama had said he wanted to include after a televised bipartisan summit last month, including a plan by Sen. Tom Coburn of Oklahoma to send investigators disguised as patients to hospitals in search of waste, fraud and abuse.
Obama Delays International Trip, Says Health Bill Is Rx for Deficit
President Obama again postponed a trip to Australia and Indonesia because of an expected House vote on health care reform, which Democrats now say will likely not come before Sunday afternoon. The president was scheduled to depart for his international trip on Sunday, but the White House said the president postponed his visit "in order to remain in Washington for this critical vote, " White House Press Secretary Robert Giibs said.
Pelosi Defends Deem-and-Pass Tactic
Speaker Nancy Pelosi (D-Calif.) dismissed as a “nonissue” a procedural maneuver House Democrats are eyeing to pass their health care overhaul in the wake of comments by Rep. Stephen Lynch (D-Mass.) that the move would be “disingenuous” and harm Congressional credibility. House Democrats are considering a process that would allow them to avoid a separate vote on the unpopular Senate version of reform by deeming that measure passed once they approve a package of changes to it.
Physicians seek gains in state liability reforms
The lack of comprehensive tort reform in national health system overhaul legislation has physicians turning to state lawmakers for relief from medical liability pressures. At the same time, physicians are fighting to protect state initiatives they consider critical to maintaining a balanced legal system and ensuring access to care. Whether seeking new tort reforms or protecting existing ones, these legislative battles are being waged with resistance from trial attorneys, who contend that the measures threaten patients' legal rights. The American Medical Association has tracked medical liability-related bills in more than 30 states so far in 2010.
House may try to pass Senate health-care bill without voting on it
After laying the groundwork for a decisive vote this week on the Senate's health-care bill, House Speaker Nancy Pelosi suggested Monday that she might attempt to pass the measure without having members vote on it. The tactic -- known as a "self-executing rule" or a "deem and pass" -- has been commonly used, although never to pass legislation as momentous as the $875 billion health-care bill. It is one of three options that Pelosi said she is considering for a late-week House vote, but she added that she prefers it because it would politically protect lawmakers who are reluctant to publicly support the measure.
Obama heads to Ohio looking for health care votes
With a fresh sense of urgency, President Barack Obama and congressional Democratic leaders pressed wavering rank-and-file lawmakers to back his health care overhaul, determined to give the party something to show voters in the midterm elections. Obama was set to head to northeast Ohio on Monday with a final sales pitch for health care legislation that the top Democratic vote-counter in the House said still lacked the necessary votes to pass.
Biggest Medicare Drug Plans Raise Prices 10 Percent On Average
The 10 insurers with the most Medicare drug plan customers raised premiums an average of 10 percent this year, an analysis released Friday by consulting firm Avalere Health shows. While the premium increases are far lower than those for many health care policies sold to individuals and small businesses outside Medicare, the rate rise is still many times higher than inflation, which is 2.6 percent for the last year. Premiums in the top 10 drug plans rose from $31.14 a month in 2009 to $34.30 this year, Avalere found. Across all plans, rates rose an average of six percent since last year, to $37.25.
Health care: Politicians Would Do Harm
"Primum nil nocere."First, do no harm. This guiding principle is a bedrock of medical care. Sadly, those politicians who would rewrite our health care laws do not live in the same universe as do the doctors and health care professionals who must practice it. Imagine if, like physicians, politicians were personally held to the incredibly high level of scrutiny that includes civil and financial liability for any unintended consequence of their decisions.
Insurer antitrust exemption would end under House bill
The House again adopted legislation that would more fully apply federal antitrust laws to the health insurance industry, but critics said the bill would neither improve competition nor lower premiums.On Feb. 24, the House voted 406-19 to adopt the Health Insurance Industry Fair Competition Act. No Democrats voted against the measure, which is supported by President Obama. At this article's deadline, the Senate had not acted on the bill.
Dems seek agreement, quick vote on health care
Under White House pressure to act swiftly, House and Senate Democratic leaders reached for agreement Friday on President Barack Obama's health care bill, sweetened suddenly by fresh billions for student aid and a sense that breakthroughs are at hand. "It won't be long," before lawmakers vote, predicted Speaker Nancy Pelosi. She said neither liberals' disappointment over the lack of a government health care option nor a traditional mistrust of the Senate would prevent passage in the House.
Obama’s Health-Care Push Challenged By Business Group
President Barack Obama is facing a renewed push against his health-care legislation as a coalition of business groups plans to spend as much as $1 million a day on advertisements to pressure lawmakers into opposing the bill. The campaign will last about 10 days and cost between $4 million and $10 million,said Bruce Josten, the top lobbyist at the U.S. Chamber of Commerce, which is helping lead the effort. The ads will start on national cable television and run in 17 states, Josten told reporters on a conference call.
Under Health Reform, Medicaid Would Cover Many Childless Adults
Marilyn Matthews has no job, no health insurance, and until now, no chance of qualifying for Medicaid. She’s unquestionably poor — her last regular paycheck was more than three years ago — and would meet the income criteria for Medicaid. The rub is that Matthews, 51, is a healthy adult with no children. While Medicaid is the main government health insurance plan for the poor, the joint state-federal program has excluded Matthews and millions of other adults with no dependent children since the 1960s
The Same Rotten Rx
If at first you don't succeed, try, try, try, try again. With Plans A, B and C having failed miserably, President Obama yesterday unveiled his latest "new and improved" version of health-care reform. He says that this incarnation "incorporates the best ideas from Democrats and Republicans — including some of the ideas that Republicans offered during the health-care summit." Unfortunately, its fundamental premise remains exactly the same — a government takeover of the health-care system.
South Carolina, Oklahoma And Arkansas Grapple With Medicaid Cuts To Help Balance Budget
States consider major cuts to Medicaid services and reimbursement rates to help fill gaps in the budget.
The Associated Press: "Lawmakers are considering cutting all services for nearly 26,000 people with disabilities as South Carolina tries to plug a $560 million budget hole. Parents say the proposed cuts to day care programs and other services would force them to give up much-needed jobs to stay home and care for their young and adult children." But "[l]awmakers say they have little choice.
Another Plus Month for Health-Care Jobs
The government said this morning that the unemployment rate held at 9.7% in February for the second month in a row. The health-care sector added 12,000 jobs.T hat continues the series of monthly job gains that has made health care an economic bright spot since the start of the recession. Read the latest Bureau of Labor Statististics summary. For February, the subsector for ambulatory health-care services posted the largest runup, adding 6,700 jobs. Nursing and residential-care facilities hired another 4,000, according to the BLS breakdown.
ER docs would get bulletproof lawsuit immunity, under Senate bill
A Senate committee advanced a controversial bill that would give emergency room doctors immunity from major lawsuits – even in cases of gross negligence. Approved on a 5-2 vote in the Health Regulation Committee, the bill would cap damages from lawsuit awards at $200,000 per incident for doctors, nurses and EMS personnel involved in ER cases.
Obama seeks to push healthcare to final vote
Although much uncertainty remains on the path to passage of the legislation, Obama opposed Republican calls to throw out broad bills passed by the House of Representatives and Senate last year and begin again with a more step-by-step approach.Americans are waiting for the administration to lead, Obama said in remarks at the White House backing a muscle tactic known as "reconciliation" as a way of overcoming rock-solid Republican opposition.
Fighting to protect tort reform laws
The movement to enact and preserve effective medical liability caps suffered a high-profile loss when the Illinois Supreme Court ruled that the state's noneconomic damage cap was unconstitutional. Justices on Feb. 4 said the 2005 law limiting damages to $500,000 for physicians and $1 million for hospitals violated the separation of powers between the Legislature and the judiciary. The Litigation Center of the American Medical Association and State Medical Societies and the Illinois State Medical Society jointly had filed a friend-of-the-court brief, urging the court to uphold the cap.
Reid Planning To Start Debate On COBRA, Medicaid Help Extensions
Senate Majority Leader Harry Reid is planning to start debate Monday on a bill that would extend COBRA health coverage benefit subsidies for people who have been laid-off. The measure, part of a larger package of expired government programs, also would help states with Medicaid reimbursements.
How Budget Reconciliation Works
Since Democrats no longer have a filibuster-proof majority in the Senate, some have talked of passing elements of health reform through budget reconciliation. Originally used as a device for easing passage of deficit reduction legislation, reconciliation may also be used to speed approval of other priority legislation calling for tax cuts or tax increases, or funding changes in mandatory entitlement programs, such as Medicare and Medicaid. Reconciliation is a powerful tool in the Senate because a reconciliation bill can pass with 51 votes. Debate is limited to 20 hours, and no filibuster is possible.
This new toolkit from the Alliance for Health Reform explains briefly how reconciliation works, and offers links to resources that go into more detail on subjects such as the “Byrd rule” and the important role of the Senate parliamentarian. Also included are resources tracing the history of reconciliation, and its use for legislation such as welfare reform and the Children’s Health Insurance Program during the Clinton Administration, and President George W. Bush’s tax cuts.
Health Summit Marked By Partisan Rancor
"President Obama held more than six hours of talks Thursday with a bipartisan group of lawmakers on ways to salvage health-care reform legislation now stalled in Congress but ran into stiff opposition from GOP members who rejected key provisions and insisted that the effort start again from scratch. At the end ... Obama urged Republicans to 'do a little soul-searching' on measures they would accept to address what he called the core of the problem: covering more than 30 million Americans without health insurance and preventing insurance companies from denying coverage to people with preexisting conditions.
93 percent of Californians would potentially be insured under national health care reform
If national health care reform is enacted, 93 percent of California’s non-elderly population would have access to health insurance – a nearly 13 percentage point increase in statewide coverage – according to a new fact sheet released today by the UCLA Center for Health Policy Research. About four million of California’s 6.4 million nonelderly adults and children who were uninsured for all or part of the year in 2007 would directly benefit through the expanded coverage offered by federal health care reform proposals, according to the fact sheet’s author, Shana Alex Lavarreda, the Center’s director of health insurance studies.
White House unveils compromise health care bill
The Obama administration raised the stakes in the health care debate Monday, releasing a new blueprint that seeks to bridge the gap between measures passed by the Senate and House of Representatives last year. If enacted, the president's sweeping compromise plan would constitute the biggest expansion of federal health care guarantees since the enactment of Medicare and Medicaid more than four decades ago. The White House said it would extend coverage to 31 million Americans.
Medical Insurers Slam Proposed Supervision
The Obama administration's proposal to create a federal body to oversee insurance premiums drew fire Monday from insurers, which contended it would do little to contain spending and could ruin some companies. The plan, which Mr. Obama hopes to include as part of his health-care overhaul, would create a new agency to be called the Health Insurance Rate Authority to review premium increases and block those it deemed unreasonable. That would add federal supervision to a patchwork of state insurance regulators that examine premium increases
Sebelius Issues Sharp Rebuke Against Health Insurance Premium Hikes Across U.S.
News outlets paid close attention to HHS Secretary Kathleen Sebelius' release of a new report detailing double-digit insurance premium hikes for individual plans in six states across the country. Her examples included "requests that insurers made to state regulators to raise rates by 56% in Michigan, 24% in Connecticut, 23% in Maine and 20% in Oregon," The Wall Street Journal reports. "With the future of the health overhaul uncertain, the insurance industry finds itself in a delicate position.
No Place To Go: Even Severely Disabled Seniors Would Lose In-Home Care Under Proposed State Budget Cuts
Despite claims that proposed state budget cuts to programs that provide in-home care to disabled senior citizens will not affect those with the highest level of need, a new analysis by the UCLA Center for Health Policy Research finds that even severely disabled seniors will experience a total loss of services.
Both sides push health debate myths
To hear President Barack Obama tell it these days, the Oval Office has been wide open to Republicans on health care reform for the past year. And Republicans claim Democrats locked them out of the talks from the get-go, writing hyperpartisan bills that catered to their base. Neither is true.
Medicare pay freeze closer to passage in Congress
Congress took another step toward avoiding a 21.2% cut in Medicare physician payment slated for March 1 when the House passed legislation on Feb. 4 to authorize an increase in the government's debt limit and to implement statutory "pay-as-you-go" provisions. The vote cleared the way for President Obama's signature and will ensure the federal government has the capital necessary to avoid defaulting on its financial obligations.
Mass. Governor Wants to Cap Hospital, Doctor Rate Increases
Now that it’s expanded health-insurance coverage to nearly all of its citizens, Massachusetts is trying to figure out what to do about the rapid rise of health costs. The latest proposal comes from the state’s governor, Deval Patrick, who yesterday proposed a bill that would give the state the power to review — and, in some cases, reject — rate increases by doctors and hospitals.
Hawaii considers medical spending threshold for insurers
The chairs of the state House and Senate Health Committees have introduced bills in their respective chambers regulating the medical-loss ratio, the percentage of every premium that a company spends directly on members' care. The proposed law would mandate an 80% medical-loss ratio for individual and small group products and an 85% ratio for large group policies. Health plans also would be required to report their spending to the state each year
Obama budget freezes physicians' Medicare pay for 10 years
President Obama promised spending freezes during his first State of the Union address, but his $3.8 trillion fiscal 2011 budget request still would protect physicians from Medicare pay cuts and extend enhanced federal support for state Medicaid programs. Obama's proposal, unveiled Feb. 1, sets aside $371 billion over a decade to pay for the cost of preventing Medicare pay cuts under the sustainable growth rate formula. But the funding would only be enough to turn annual reductions into rate freezes, not to fund pay raises.
Can the States Nullify Health Care Reform?
On February 1, Virginia joined 29 other states with pending legislation aimed at limiting, changing, or opposing national health care reforms. Timothy Jost asks, what is going on here?
White House official: Feb. 25 health care meeting to be televised
President Obama's bipartisan meeting on health care reform planned for February 25 will be broadcast live, a senior administration official said Monday. Coverage details were not complete, but the official said the White House expected "the whole thing to be live." The half-day meeting is an attempt by the Obama administration to rescue health care legislation, a top domestic priority for the president.
Tax credits, Medicare fix in Senate jobs bill
The bill, likely to be less costly and more bipartisan than the one passed by the House of Representatives, also extends unemployment benefits and postpones a scheduled 20 percent cut in payments to doctors under the Medicare health insurance program for the elderly. The Senate legislation, which has yet to be formally introduced, faces more than the usual procedural hurdles as a record snowstorm has paralyzed Washington and made it difficult for many lawmakers to get to work.
Obama invites GOP leaders to health care talk
In the first major step to revive his health care agenda after his party's loss of a filibuster-proof Senate majority, President Barack Obama on Sunday invited Republican and Democratic leaders to discuss possible compromises in a televised gathering later this month. Obama's move came amid widespread complaints that efforts so far by him and his Democratic allies in Congress have been too partisan and secretive.
Idaho, Illinois allow external review of insurance denials
New laws in two states, Idaho and Illinois, will give patients the right to an independent review of health insurance benefit denials.Only five states now have no laws mandating external review of denials: Mississippi, Nebraska, North Dakota, South Dakota and Wyoming.
Health-Care Burden Shifts to U.S. Government as Spending Soars
Health-care spending in the U.S. will almost double in 2019 to $4.5 trillion, or more than 19 percent of the economy, as unemployment and aging baby boomers drive up government costs, economists forecast. Spending already jumped to $2.5 trillion, or 17.3 percent of the economy, in 2009, the economists from the U.S. Centers for Medicare and Medicaid Services said in their yearly estimate, published today in the journal Health Affairs.
Medicaid, CHIP payments to be reviewed by new federal commission
A newly appointed commission will examine how Medicaid physician pay affects access to care by Medicaid patients and those in the Children's Health Insurance Program, among other issues. The Medicaid and CHIP Payment and Access Commission, or MACPAC, will be chaired by Diane Rowland, ScD, executive director of the Kaiser Commission on Medicaid and the Uninsured. The U.S. comptroller general appointed the panel's 17 members Dec. 23, 2009
Rangel: Lawmakers writing compromise health bill
Leading lawmakers hoping to revive President Barack Obama's stalled health care overhaul have started writing a compromise bill, but it's unclear when the legislation will be ready for votes, a top House Democrat said Tuesday. The measure would change the massive Senate-approved health bill to what bargainers from the White House, Senate and House agreed to last month, Rep. Charles Rangel, D-N.Y., said in a brief interview.
Medicare pay overhaul heats up as health reform moves to back burner
With a comprehensive health system reform effort effectively on hold after the victory of a Republican Senate candidate in Massachusetts, physician organizations are mobilizing to prevent Medicare doctor payment reform from also becoming a casualty of the altered political landscape on Capitol Hill. The American Medical Association, other physician organizations and seniors groups were hoping to follow health reform passage with a long-term solution to the Medicare physician payment system, which is primed for a 21.2% cut starting March 1.
Focus of health care bill may be changing, officials signal
Democratic efforts to pass a health care bill have stalled a bit, and the immediate focus may be shifting toward health insurance reform instead of quickly trying to pass a comprehensive bill, White House officials signaled Sunday. Robert Gibbs, the White House press secretary, told CNN's "State of the Union" that passing a health care bill was "still inside the five-yard line."
Minnesota Ends Prescription Importation Program
Citing lack of use, the state of Minnesota will end its 6-year-long prescription drug importation program on March 1. Minnesota was the first state to start a prescription drug importation program, which provided Minnesota residents access to cheaper medications from Canadian suppliers through an online pharmacy. Since its launch in January 2004, Minnesota RX Connect has filled 25,000 prescriptions at a savings of $1.7 million. Other states followed with programs of their own, but these sites have since shut down.
Pelosi: House won't support Senate health care bill, at least for now
The Senate health care bill has too many unpopular provisions to win approval from the House at this time, House Speaker Nancy Pelosi said Thursday.Pelosi's comment to reporters appeared to dash the chances that Democrats will take the easiest route for passing a health care bill: having the House approve the Senate version unchanged.
Obama urges lawmakers "coalesce" on healthcare deal
Obama acknowledged that voter anger helped carry Republican Scott Brown to a stunning victory in Tuesday's Massachusetts election which has imperiled the president's healthcare effort and the rest of his legislative agenda. "People are angry, they are frustrated. Not just because of what's happened in the last year or two years, but what's happened over the last eight years," Obama told ABC News on the anniversary of his first year in office.
Hoyer: Senate bill 'better than nothing'
The number-two Democrat in the House said Tuesday that the Senate's version of health care legislation is "better than nothing," and that Democrats are determined to advance some form of their health overhaul regardless of what happens in Massachusetts, where a special election could hand Republicans a crucial 41st Senate seat. Speaking to reporters at his weekly briefing, House Majority Leader Steny Hoyer (D-Md.) repeatedly ducked questions about the House strategy on health care if Republican Scott Brown upsets Democrat Martha Coakley in the race for the late Edward M. Kennedy's Senate seat, a possibility that would give Republicans the power to block another vote on health care in the chamber.
Top Senate Democrat Outlines 'Nuclear Option' Strategy for Health Care
A top Senate Democrat for the first time Tuesday acknowledged that the party is prepared to deal with health care reform by using a controversial legislative tactic known as the "nuclear option" if Republican Scott Brown wins the Massachusetts Senate election. Calling the state's special election "an uphill battle to put it mildly," Senate Majority Whip Dick Durbin, D-Ill., said "there are options to still pursue health care" should Democrat Martha Coakley lose to Brown.
California to Set Time Limit to See Doctors
California is poised to become the first state to set time limits for doctors to see patients, the Department of Managed Health Care said. Regulations to be announced Wednesday require family practitioners in health maintenance organizations to see patients seeking an appointment within 10 business days. The deadline for specialists is 15 days. A patient seeking urgent care that does not require prior authorization must see a doctor within 48 hours.
Democrats consider backup plan for health care reform
Faced with the once-unthinkable prospect of losing the Massachusetts Senate race, Democratic officials on Capitol Hill are quietly talking about options for passing health care reform without that critical 60th Senate vote. Top White House aides insist they are not engaging in any talk of contingency plans, because they believe Democrat Martha Coakley will beat Republican Scott Brown in Tuesday's crucial Senate battle.
Organized medicine pushes back on expansions of scope of practice
In 2009, physicians fought a blitz of scope-of-practice expansions by other health professionals on legislative, legal and regulatory fronts.Organized medicine defeated attempts by naturopaths to seek licensure, prevented chiropractors from being able to perform invasive procedures and achieved further regulation of lay midwives. The efforts were among more than 300 scope-related bills the American Medical Association tracked last year
Obama Health Plan’s Success Rides on Cost Curbs
As Democratic Senate and House leaders privately hammer out a final compromise on their competing versions of health-care legislation, the controversies focus on a government-run option and abortion. These are irrelevant to the important decisions that will affect the credibility and sustainability of the measure.
For health care, a frantic ride in the final days
Like a roller-coaster ride on its last twisting turns, President Barack Obama's campaign to remake health care is barreling into final days of breathless suspense and headlong momentum. Democrats, led by Obama himself, are deploying this weekend to salvage an unpredictable Senate race in Massachusetts, while senior White House and congressional staffers in Washington hurry to finish work on cost and coverage options at the heart of the sweeping legislation.
Differences remain over what health care bill will look like
In the three weeks since the Senate passed its version of health care reform, Democratic leaders, the White House and rank-and-file members of Congress have been working behind the scenes to find common ground between the House and Senate bills. Negotiations are expected to pick up as House lawmakers return to Capitol Hill this week. The Senate is back in session next week.
Another Rank Health Care Deal
What happens when the irresistible force of the Democratic urge to tax runs up against the immovable object of Democratic loyalty to the labor unions? Another ugly deal in a health-care bill that already was a grotesquerie of pay offs to favored politicians and interests. The levy in question is a 40 percent excise tax on high-end employer-provided insurance plans that - typically - has been sold as a tax on "the rich." It's called the "Cadillac tax," a name redolent of corporate executives cackling in their Escalades over their cushy benefits.
AP sources: Employer health mandate may be dropped
House and Senate negotiators working on President Barack Obama's health overhaul bill appear likely to drop a proposed income tax increase on high-wage earners and possibly jettison a requirement for large businesses to offer coverage to their employees, Democratic officials said Tuesday. Negotiators are considering extending the Medicare payroll tax, which now applies only to income from wages, to cover some of the investment earnings of couples making more than $250,000 a year, and individuals earning above $200,000.
Medicare cost plans face uncertain future
Under federal law, the more than 20 Medicare cost plans operating in areas deemed to have sufficient competing Medicare Advantage options for beneficiaries must shut down by 2011 or else convert to Medicare Advantage plans themselves. But a December 2009 report from the Government Accountability Office said some insurers are worried about the effects those conversions would have on the program.
Married Couples Pay More Than Unmarried Under Health Bill
Some married couples would pay thousands of dollars more for the same health insurance coverage as unmarried people living together, under the health insurance overhaul plan pending in Congress. The built-in "marriage penalty" in both House and Senate healthcare bills has received scant attention. But for scores of low-income and middle-income couples, it could mean a hike of $2,000 or more in annual insurance premiums the moment they say "I do."
Help for Medicare beneficiaries expands
The Centers for Medicare & Medicaid Services will award new grant money to states in 2010 to support community outreach for Medicare beneficiaries. A total of $45 million in grants will be available to the 54 State Health Insurance Assistance Programs, or SHIPs, CMS announced Dec. 16, 2009. States must apply by Feb. 16, and funds will be awarded in April. The agency said the SHIP grants will help states provide more one-on-one counseling to assist beneficiaries with Medicare prescription drug and plan enrollment information.
Obama Presses House Democrats to Back Insurance Tax
President Barack Obama is pressing U.S. House Democrats to drop their opposition to a tax on high- end insurance plans as lawmakers try to craft a final health- care measure by early next month, a Democratic aide said. The president expressed a preference for a Senate proposal to tax so-called Cadillac plans in a meeting yesterday with House Speaker Nancy Pelosi and top party lawmakers, the aide said. The White House meeting came on the eve of a conference call Pelosi plans for 1 p.m. today with House Democrats.
Health Care Spending Rose at Historically Slow Rate in 2008
Health care spending rose to a whopping $2.3 trillion in 2008 -- 16.2 percent of the nation's economy -- but Americans paid less than one-eighth of the total spending out-of-pocket while government and private insurers split the rest, according to a newly released government report. Spending per person totaled $7,681, with individuals paying roughly $912 of that, according to the report by the Centers for Medicare and Medicaid Services. The government and private insurance companies paid for the remaining costs.
Obama, Dems to sidestep GOP on health care
President Obama gave his blessing Tuesday for congressional Democratic leaders to bypass formal House and Senate talks to meld their health care bills, according to two congressional Democratic leadership sources. The two sources told CNN that Obama and Democratic congressional leaders will instead hold informal negotiations to sidestep possible Republican delays of the process, likely shutting out Republicans from talks on the final health care bill.
GOP pushes to air health bill talks
The top House Republican said Wednesday it would be “a disgrace” if Democrats ignored President Barack Obama’s campaign commitment to broadcast negotiations on the health care bill on C-SPAN. “Let’s be clear,” House Minority Leader John Boehner (R-Ohio) said in a news release. “Skipping a real, open conference would shut out the American people and break one of President Obama’s signature campaign promises.”
Democrats begin work to finalize health bill
President Barack Obama and congressional leaders are embarking on the tough work of ironing out differences between the House and Senate health care legislation with the aim of finalizing a bill quickly as midterm elections loom. "Now is not the time to get stuck on any one point," Rep. John Larson, D-Conn., said Tuesday as he headed into a meeting with Speaker Nancy Pelosi and other House leaders to discuss their priorities for the final bill. "The important thing for us now is to close ranks behind the president and get a bill done."
Medicaid rolls grew 5% in 2008
Medicaid enrollment increased by an average of 4.8% nationally between December 2007 and December 2008 to reach 44.7 million, according to figures compiled by the Kaiser Family Foundation. Six states experienced double-digit increases: Colorado, Florida, Hawaii, Indiana, Maryland and Wisconsin. Wisconsin led all states with a 16.8% enrollment spike in the 12-month period, in part due to an expansion of Medicaid eligibility in BadgerCare Plus in February 2008.
Senate Likely to Have Edge as Democrats Craft Final Health Bill
Senate Democrats will have the upper hand as U.S. lawmakers return to Washington this month to confront the last major hurdle in the effort to overhaul the nation’s health-care system. With Democrats in both chambers under pressure to craft compromise legislation, the biggest areas of contention are the different taxes the House and Senate chose to fund their bills, how strictly to bar federal money for abortion and whether to create a government-run program to compete with private insurers.
In Health Bill for Everyone, Provisions for a Few
Early versions of the Senate’s far-reaching health care bill said that small businesses with fewer than 50 workers would not be penalized if they failed to provide insurance. That was before labor unions in the construction industry went to work and persuaded Senate leaders to insert five paragraphs.
13 state AGs threaten suit over health care deal.
Republican attorneys general in 13 states say congressional leaders must remove Nebraska's political deal from the federal health care reform bill or face legal action, according to a letter provided to The Associated Press Wednesday. "We believe this provision is constitutionally flawed," South Carolina Attorney General Henry McMaster and the 12 other attorneys general wrote in the letter to be sent Wednesday night to House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid.
Mayo Clinic in Arizona to Stop Treating Some Medicare Patients
The Mayo Clinic, praised by President Barack Obama as a national model for efficient health care, will stop accepting Medicare patients as of tomorrow at one of its primary-care clinics in Arizona, saying the U.S. government pays too little. More than 3,000 patients eligible for Medicare, the government’s largest health-insurance program, will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic in Glendale, northwest of Phoenix, said Michael Yardley, a Mayo spokesman.
The not-so-sweet side of closing 'doughnut hole'
Six years after Congress added a prescription drug benefit to Medicare, Democrats in the House and Senate are poised to make a central change that they and most older Americans have wanted all along: getting rid of a quirk that forces millions of elderly patients with especially high expenses for medicine to pay for much of it on their own. The closing of an unusual gap in Medicare drug coverage -- a gap that Republicans had, when they controlled Capitol Hill and the White House, insisted was needed for the government to be able to afford the program
Despite Subsidy, Cobra's Bite Still Stings for Many
The government is expanding a massive safety net to help the unemployed buy health insurance, but millions of people can't access the aid because of the way the program was designed. As a cornerstone of the economic stimulus plan, the administration of President Barack Obama allocated $25 billion to pay 65% of health-insurance premiums for workers laid off this year. Earlier this month, Congress extended the program for people laid off through February 2010 and expanded the aid to 15 months from nine.
Top House Democrats Signal Willingness to Drop Government Insurance Plan
Two House Democrats who favor a government insurance plan, a central element of health care legislation passed in their chamber, acknowledged Sunday it might have to be sacrificed as negotiators work out a final agreement with the Senate. Rep. James Clyburn of South Carolina, the No. 3 Democrat in the House and one who had appealed to President Barack Obama not to yield on the so-called public plan, set out conditions for yielding himself.
Report outlines why and how often insurers rescinded coverage
A committee of the National Assn. of Insurance Commissioners has released a draft report detailing rescission rates and practices of major insurers across the country between 2004 and 2008. The report comes on the heels of criticism from members of Congress, and years of state regulatory investigations and fines stemming from alleged improper rescissions of individual health policies. The NAIC received data from 49 companies that collectively cover 80% of the individual insurance market. Those companies reported revoking a total of 27,246 policies between 2004 and 2008, at an average rate of 3.7 rescissions for every 1,000 policies issued.
Next step: Turn two health care bills into one
The Senate on Thursday passed its version of the health care bill, inching the country closer to the biggest expansion of medical coverage since Medicare was enacted more than four decades ago. Senate Democrats declared victory after the 60-39 party line vote, but one of the most complicated tasks is still ahead. A conference committee must reconcile the differences -- notably a public option, how to pay for the plan that emerges, and coverage for abortion -- and merge them into one.
Medicare physician pay cut delayed until March
President Obama has signed legislation that would prevent a 21.2% Medicare payment cut from taking place Jan. 1 by freezing physician rates for two months. The temporary patch, which expires after Feb. 28, 2010, is intended to give Congress additional time to craft a more lasting solution to the doctor pay problem. It piggybacked on the fiscal 2010 appropriations bill for the Defense Dept., which helps fund the wars in Afghanistan and Iraq. The White House announced Dec. 21 that the president had signed the legislation.
Senate approves health care reform bill
The Senate passed a $871 billion health care reform bill Thursday morning, handing President Obama a Christmas Eve victory on his top domestic priority. The bill passed in a 60-39 party line vote after months of heated partisan debate. Every member of the Democratic caucus backed the measure; every Republican opposed it.
Special deals, carve-outs keep health care afloat
Democrats call it compromise. Republicans call it bribery. But both sides agree that special deals are why the Senate is on track to pass a health care bill by Christmas. It wasn't clear whether Senate Majority Leader Harry Reid had the support needed to move ahead with his chamber's health care bill until Sen. Ben Nelson, the last Democratic holdout, had a change of heart this weekend.
Democrats put health care bill on brink of passage
Democrats pushed sweeping health care legislation to the brink of Senate passage Wednesday, crushing a year-end Republican filibuster against President Barack Obama's call to remake the nation's health care system. The 60-39 vote marked the third time in as many days Democrats have posted a supermajority needed to advance the legislation.
Special deals, carve-outs keep health care afloat
Democrats call it compromise. Republicans call it bribery. But both sides agree that special deals are why the Senate is on track to pass a health care bill by Christmas. It wasn't clear whether Senate Majority Leader Harry Reid had the support needed to move ahead with his chamber's health care bill until Sen. Ben Nelson, the last Democratic holdout, had a change of heart this weekend.
Final Senate vote on health care set for Thursday morning
The Senate will hold its final vote on a sweeping health care bill Thursday morning under an agreement that Majority Leader Harry Reid announced Tuesday. The vote had been expected on the night of Christmas Eve due to Republican delay tactics to hold off the measure. Reid has insisted it be passed before Christmas. Reid and Senate Minority Leader Mitch McConnell, R-Kentucky, decided on a timetable to vote on the health care bill and an extension of the federal debt limit on Thursday morning.
Businesses Brace for Health Bill's Costs
Companies are alarmed at potentially costly provisions in the Senate health-care bill, many of which they hope will be scrapped during a final round of negotiations early next year. A scramble to massage the hefty measure, instead of pushing to kill it, reflects the view of many in the business community that a sweeping remake of the U.S. health-care system now appears inevitable. The U.S. Chamber of Commerce is among a few big business groups calling for Congress to scrap the overhaul effort.
Changes in Senate Bill Give Democrats Little Wiggle Room for House Compromises
The Senate is preparing for another key vote early Tuesday morning on Democratic health insurance reform, putting it one step closer to a final vote on Christmas eve and leaving fewer opportunities for alterations before it reaches President Obama's desk. Finalizing the bill also comes much to the chagrin of Republicans who say President Obama broke campaign pledges by accepting the package.
Medicare use, spending found to vary across country
Regional variations in the use of Medicare services across the U.S. do not directly translate to regional variations in spending, the Medicare Payment Advisory Commission noted in a Dec. 1 study. "The two should not be confused," MedPAC stated in the report compiled for Congress, which has been focused on reining in Medicare spending as it attempts to pass comprehensive health system reform.
Emanuel Tests Limits of His Persuasion in Health-Care Overhaul
When Pfizer Inc. Chief Executive Officer Jeffrey Kindler saw that health-care legislation unveiled by House Democratic leaders in October threatened to squeeze drugmakers’ profits, he got on the phone with White House Chief of Staff Rahm Emanuel. Kindler was upset that the House measure would require pharmaceutical companies to forgo $140 billion in revenue over 10 years, said a person familiar with the discussion. He wanted assurance from Emanuel that the White House would honor an agreement to limit the drugmakers’ cost to $80 billion. The deal held.
Kansas liability cap faces high court challenge
Kansas' stable medical liability climate could come unhinged if a long-standing cap on noneconomic damages is overturned, state physicians warned. A constitutional challenge to the $250,000 cap, which applies to all personal injury cases, stands before the state Supreme Court after justices heard oral arguments on Oct. 29. The case stems from a $759,000 jury verdict in 2006 to Amy C. Miller, who underwent an oophorectomy that allegedly went awry. The physician involved denied any wrongdoing. A trial judge later reduced the award to the state's cap.
Obama Presses Senators to Defy Past, Vote Health Bill
President Barack Obama and top Democrats said they are on the verge of passing the most sweeping overhaul of the U.S. health-care system in four decades after making last-minute changes to win over holdouts. “We are on the precipice of an achievement that’s eluded Congresses and presidents for generations,” Obama said yesterday after meeting with Senate Democrats. The bill includes “the most significant reforms to our health-care system since the passage of Medicare.”
Passage of Senate Health Care Bill Could Hinge on Abortion Funding
With Sen. Joe Lieberman apparently on board the health care reform train and the public option off the table, Senate Democrats are turning their attention to what could be the last remaining hurdle to passing a bill out of their chamber -- abortion funding. The abortion issue, and to a lesser extent Medicare cuts, remain major points of contention as at least one Democratic senator -- Ben Nelson of Nebraska -- indicated he'd break from party lines to strike down the sweeping legislation if the bill does not toughen restrictions to ensure taxpayer dollars don't fund
Obama: Health reform at ‘precipice’ of passage
Prodded by President Barack Obama, Senate Democrats won tentative backing from one holdout and worked intensely to satisfy another Tuesday as they grappled with the last, lingering disputes blocking passage of health care legislation by Christmas. Despite the push, Sen. Ben Nelson of Nebraska remained publicly uncommitted — even after a private meeting with Obama.
Window closing for healthcare reform: Biden
Biden was speaking just hours before Democratic lawmakers were to meet at the White House with President Barack Obama, who is pressing them to reach agreement and pass a bill on his signature domestic policy issue. Obama has invested much of his political capital in trying to get the Democratic-controlled Congress to pass a healthcare bill by the end of the year. The bill has been passed by the House of Representatives, but Democrats have struggled to win the 60 votes they need in the Senate.
McCain Takes Center Stage in Health Fight
Sen. John McCain kept a relatively low profile for months after he lost the 2008 presidential election to Barack Obama. Those days are over. In the health-care battle, the Arizona Republican has suddenly emerged as the John McCain of old -- a vigorous political combatant. He has publicly hammered Democratic proposals, engaged in heated exchanges on the Senate floor and lent his voice to automated telephone calls pressuring Democratic senators in Arkansas, Colorado and Nebraska on their looming health-care votes.
Lieberman a major problem for Senate Democrats on health care
A few weeks ago, Senate Majority Leader Harry Reid said colleague Joe Lieberman was the least of his problems in passing a health care bill. Today, Lieberman has emerged as the main obstacle to Reid's efforts to get a health care bill through the Senate before Christmas, if ever. An independent from Connecticut who sits with the Democratic caucus, Lieberman ratcheted up his public opposition to the bill Sunday.
McCain Charges Democrats Pandering to Drugmakers on Import Ban
Senate Republicans accused Democrats of pandering to the pharmaceutical industry and putting off a vote on a bipartisan plan to allow the importation of cheaper medicines from Canada and other nations. Arizona Senator John McCain, the Republicans’ 2008 presidential nominee, said Democrats were protecting a deal President Barack Obama struck with drugmakers in June to win support for an overhaul of the U.S. health-care system. The proposal would be an amendment to that legislation.
Upcoming HIPAA changes catching some unaware
Some hospitals and others that will be impacted by changes to the Health Insurance Portability and Accountability Act don't know that rule changes are set to go into effect in 2010, a recent survey found. The Healthcare Information and Management Systems Society conducted a survey of 150 hospital information technology executives and 26 business associate firms.
Inside the MedPAC meeting, where the tough cost calls get made
Anyone in the Washington area who wants a glimpse of what the future of American health care will increasingly look like if health-care reform legislation passes can head over to the Ronald Reagan Building and International Trade Center Thursday or Friday for the big MedPAC meeting. Haven't heard of MedPAC? Well, you might soon. It's the 17-member commission that advises Congress on Medicare -- most notably, recommending payments rates to hospitals and other medical providers
Pelosi backs expansion of Medicare in Senate plan
House Speaker Nancy Pelosi voiced support for one element of the tentative accord -- to expand Medicare, the government health insurance program for those age 65 or older. "There's certainly a great deal of appeal about putting people 55 and older on Medicare," Pelosi told reporters as the Senate conducted its 11th day of debate on sweeping legislation. "That is something that people in the House have advocated for years," Pelosi said.
Obama Praises Senate Deal on Health Bill
A new agreement by Senate Democrats on legislation to overhaul U.S. health care got a blessing Wednesday from the White House."The Senate made critical progress last night," President Barack Obama said at White House event announcing funding for community health care. He praised lawmakers for striking a deal that would scale back a government-run insurance plan and expand Medicare to some people ages 55 to 64.
Health reform bills would set approval path for generic biologics
The two national health system reform bills would provide a first-ever approval process for generic biopharmaceuticals. But the bills also would give more protection to original biologic drugs than that supported by the Federal Trade Commission and proposed by President Obama's 2010 budget. Both the House-adopted health system reform bill and the Senate measure under debate would give brand-name manufacturers of biologic drugs at least 12 years before a competitor could introduce generic versions of the medications.
Senate rejects abortion measure in health bill
Democratic Senator Ben Nelson's amendment to tighten the bill's restrictions on the use of federal funds for abortions, identical to a provision approved by the House of Representatives last month, was killed on a 54-45 vote. Without the abortion language, Nelson had threatened he would not back the final healthcare bill when it came to a vote. If he followed through, Democrats would be one vote short of the 60 they need to pass the measure.
Medical lawsuit limits favored by public
Physicians and other tort reform advocates say an Associated Press poll released Nov. 19 shows the public agrees that limiting medical liability lawsuits is key to successfully overhauling the health care system. The nationwide survey by the news organization showed that 54% of Americans favor limits on such lawsuits, while 32% opposed such measures (surveys.ap.org/data/gfk/ap-stanford-rwj%20healthcare%20topline%20final_nov18%20edits.pdf).
Health-Care Bill Breakthrough Eludes Senate After Week of Work
Seven days of debate that stretched through the weekend have left Senate Democrats no closer to passing legislation to overhaul the U.S. health-care system. The lawmakers today plan to debate limits on the use of federal funds for abortion, a major issue dividing Democrats along with whether to create a new government-run insurance program. Behind closed doors, senators working on their own and with Majority Leader Harry Reid are finding compromise elusive.
