Proposed Rule Makes It Harder for States to Cut Medicaid Provider Payments

In what is likely to cause more fighting between the GOP and the Obama Administration over health care spending,   the Obama administration is proposing a rule that would make it much more difficult for states to cut Medicaid payments to doctors and hospitals.  The rule could also put pressure on some states to increase Medicaid payment rates, which are typically lower than what Medicare and commercial insurance pay. The rule was filed Friday.  Click here to read.

House GOP Medicare Plan Stalls

House Republicans will not likely move forward this week on their plans to dramatically revamp Medicare as all sides continue a bipartisan effort on developing the FY2012 budget.  Backlash at home during the two week spring break and polls showing a majority of Americans opposing the GOP plan had Republican leaders saying last week that their Medicare plan could not make it through the Senate or the White House.  Click here to read a good NY Times summary.  Here is a Washington Post summary.

Ohio Senator Sherrod Brown last week sent a letter signed by 50 senators to President Obama and House Majority Leader Cantor opposing the House GOP Medicare plan.  Click here for a copy of the letter.

Here’s one of the latest national polls on the issue (scroll down just beyond the Presidential poll).

House Repeal Efforts Continue; Court Cases Move Forward This Week

House Republicans voted alst week to take away funding for state health exchanges and school-based health centers.  The Senate said the bills were DOA.  Meanwhile, The U.S. Court of Appeals for the 4th Circuit on Tuesday will hear two cases that challenge the constitutionality of the law’s requirement that all Americans have health insurance. It’s a landmark moment. The cases — one brought by Virginia and the other by Liberty University in Lynchburg — are the first to advance from federal district courts to the appeals level, possibly the last stop before the Supreme Court.  For those who can’t get enough of these court cases, you can download the oral argument audio files.  Click here.

Join IPAB Repeal Effort

For providers, one of the most troubling components of the health reform law is the creation of the Independent Payment Advisory Board.  President Obama wants to strenthen it further to reign in health spending.  The author of legislation to repeal the IPAB, Sen. John Cornyn (R-TX) is looking for support from health care providers for his legislation.  If you are interested in adding your name to the letter attached here, please email Peggy Tighe, a partner at Strategic Health Care, at Peggy.Tighe@shcare.net.

Lawmakers Seek SGR Solution; AMA Offers One

The House Energy and Commerce’s Health Subcommittee started its public hearing process last week in an effort to find a solutions to the physician Medicare payment formula.  Without a solution, physicians will see a 29.5 percent payment reduction in Medicare January 1, 2012.  The AMA proposed the following solution:  (1) Repeal the SGR (Sustainable Growth Rate);  (2) Implement a five-year period of stable Medicare physician payments that keep pace with the growth in medical practice costs; and (3) Transition to an array of new payment models designed to enhance care coordination, quality, appropriateness and costs.  To read the AMA’s and other witness testimony, click here.


AMA Membership Drops

According to a demographics report on its website, AMA membership fell almost 5.3% last year, to just below 216,000 as of last December.  Click here for the report.

Health Plans Opening More Clinics

A growing number of Medicaid and Medicare health plans for the disabled are opening up community-based clinics to provide services to enrollees with chronic conditions, according to a new report fromKaiser Health News.  Bravo Health has opened up three clinics in the past year, two in Philadelphia and one in Baltimore. It stays open late and offers services not typically available in physician offices, such as IV therapies, which can cost $10,000 or more if provided by local hospitals. Other plans have also been hiring physicians to open clinics. Click here to read more.


HHS Gives Storm Stricken States More Flexibility

As several states continue to recover from devastating storms, HHS said it is giving at least four states – Alabama, Kentucky, Mississippi, and Tennessee, more flexibility to make sure their residents have access to Medicaid.  Read the HHS letter here.

CMS To Hold Meaningful Use Conference Call

CMS will hold a national provider education call about meaningful use on Thursday, May 19, at 2:30 p.m. EDT.  This call will cover:  The definition of meaningful use; The requirements for Stage 1 of meaningful use (2011 and 2012);  How to attest to having met meaningful use; and an overview of the meaningful use objectives specification sheets:

To receive the call-in information, you must register for the call.  Registration will close at 2:30 p.m. EDT on May 18, or when available space has been filled.  Click here to register.

For the latest health care news, visit our website at www.strategichealthcare.net

Paul Lee
Senior Partner
Washington, DC