Supreme Court declines expedited review of ACA, as noted below. Not noted below or in most media reports is the decision by Justice Kagan not to recuse herself. That's one more vote to uphold the Act for those of you keeping score at home.
In the days since President Obama announced a strengthened role for the Independent Payment Advisory Board (IPAB), the Medicare oversight panel created by the Affordable Care Act, there has been significant criticism of it. Critics argue that over time IPAB will ration health care and that IPAB removes Congress from the decision-making process, in effect denying constituents an opportunity to be heard.
In response to President Obama's announcement that he plans to cut federal health care spending by $480 billion over the next 12 years, Reps. David Camp (R-Mich.) and Fred Upton (R-Mich.), the chairmen of the Ways and Means and Energy and Commerce panels, wrote a letter to the President on Wednesday (4/20) requesting a detailed explanation of these cuts.
According to a CMS report released last Tuesday (4/19), more physicians are participating in "pay for reporting" programs focusing on using quality measures and electronic prescribing. CMS also reported that data from the Physician Quality Reporting System is showing growing rates in reports by health professionals that they are complying with evidence-based care practices.
In a proposed rule issued Tuesday (4/19), the CMS expressed that Medicare operating payments to acute care hospitals for inpatient services in 2012 to decrease by close to $498 million, or about 0.5 percent compared with 2011, while its payments to long-term acute-care hospitals are projected to increase by 1.9 percent, or about $95 million. The rule recommended expanding the list of measures CMS has proposed to adopt for fiscal year 2014 hospital value-based purchasing program, and proposed to adopt a Medicare spending-per-beneficiary measure for that program. The American Hospital Association said it was "deeply disappointed" by the proposal to decrease operating payments, arguing that CMS failed to realize that hospitals’ increased spending is the result of treating more complex and severe illnesses.
On Monday (4/25), the U.S. Supreme Court formally declined Virginia's "petition for certiorari before judgment." A federal appeals court in Richmond, Virginia will hear two challenges to the Affordable Care Act, including Virginia's petition, early next month. Additionally, an appeals court in Atlanta will hear arguments in the lawsuit filed by Florida and 25 other states in June.
On Thursday (4/21), a federal judge in New Jersey dismissed a lawsuit challenging PPACA brought by Nicholas Purpura and Donald Laster, Jr., for lack of standing.
HHS released a report to Congress, which contains plans to implement a value-based purchasing program for ambulatory surgery centers under Medicare. The report can be found here: http://www.cms.gov/ASCPayment/downloads/C_ASC_RTC%202011.pdf.
A new policy research brief from the Geiger Gibson/RCHN Community Health Foundation Research Collaborative at the George Washington University School of Public Health and Health Services evaluates the impact on medically underserved Medicare beneficiaries of CMS's Accountable Care Organization regulations. The report, which details how the regulation "effectively excludes medically underserved patients from participation in a major practice and quality advance," can be found here: http://www.rchnfoundation.org/images/FE/chain207siteType8/site176/client/Brief%2023%20ACO%20Regs%20Final%2004.18.pdf.
In the states:
1) In an effort to address the steady decline of primary care doctors compared to the increase in higher paid specialists, Oregon lawmakers have moved Senate Bill 210 to the Oregon Senate floor. SB 210 requires the Oregon Health Authority to pay primary care doctors either directly or through managed care plans on the Oregon Health Plan the Medicare rate, which is slightly higher than what they currently receive under Medicaid.
2) In North Dakota, a bill declaring the Patient Protection and Affordable Care Act null has passed the state senate and house. If Gov. Dalrymple signs the bill, the Affordable Care Act could be nullified in North Dakota.
3) Idaho Governor Butch Otter vetoed a bill intended to prevent Idaho from enacting optional provisions of the Affordable Care Act, and then replaced it with an executive order containing what many consider to be stronger language than that of the bill. Gov. Otter explained that the proposed bill would have required Idaho to forego the creation of an insurance exchange, whereas the executive order will allow Idaho to seek additional "health care solutions."
4) The Texas House approved HB 5, which directs Texas to join an interstate health care compact. The bill requires at least one state partner and approval from the U.S. Congress before it goes into effect. Lawmakers in several other states are considering similar initiatives.
5) The Texas Senate unanimously approved two bills that will reform how doctors and hospitals operate or are paid. Senate Bill 7 would encourage greater efficiency in Medicaid services by reducing payments for preventable readmissions and complications. Also under Bill 7, Medicaid patients would be required to make copayments for unnecessary emergency room visits. Senate Bill 8 would apply to non-Medicaid insurance programs and create a performance-based payment system.
6) On Monday (4/25), the Vermont Senate gave preliminary approval to a bill, a version of which already passed the House, which calls for setting up a health care exchange and sets up a board that would review and approve designs for a publicly financed program available to all residents. On Tuesday (4/19), a Colorado joint legislative committee advanced a bill to create a state health care exchange.
7) The Ohio Liberty Council, a coalition of tea party groups, has collected 300,000 signatures toward its effort to block provisions of the Affordable Care Act that require individuals and companies to choose certain health insurance carriers.
This week: On Wednesday (4/27) at 12:15 p.m., the Alliance for health Reform will hold a briefing in Room 325 of the Russell Senate Office Building entitled "Reporting of Quality Outcomes: What's the Best Path Forward?" On Friday (4/29) at 10:00 a.m. the Center for American Progress will welcome Dr. Atul Gawande to discuss health care costs.
As always, please feel free to contact us with any questions.
To view our compilation of this week's health care reform implementation news, click here.