WEEKLY E-BULLETIN


Oct. 17, 2011


What Health Programs Will Congress’ Supercommittee Cut?

The supercommittee was inundated with recommendations this past week.  House Democrats are calling for a balanced approach, which means revenues must be included.  Ranking Ways and Means Committee member Rep. Sander Levin said the supercommittee should stay the course with the Affordable Care Act and any other cuts should be used to pay to fix physician Medicare payments and pay for the Medicare extenders.  Click here to see Ways and Means letter.  To see a good summary of the Senate Finance Committee GOP proposal, click here.  House GOP Judiciary Chairman Lamar Smith urged committee members to include tort reform because it scores big savings. Click here to read the letter.

If the supercommittee is successful in developing a bill that gets majority support, it will unlikely include any new health policy ideas that haven’t already been thoroughly vetted and probably already scored by the CBO.  This is according to our many congressional sources who have monitoring developments.  There isn’t enough time to vet major new ideas. The committee has until November 23 to produce its bill to the full Congress.

MedPAC’s Doc Payment Fix Sent to Congress

MedPAC formalized its recommendations to Congress to fix the Medicare physician payment formula.  They would cut specialists significantly, freeze primary care and make further payment reductions to other institutional providers.  Clickhere to read MedPAC’s letter to Congress.

More MA Plans Get 5-Star Rating

CMS has released it 5 star-rated health plans for 2012 and 9 plans got top honors – 6 more than last year.  There are 569 different Medicare plans.  A 5 star rating means more than just good press coverage.  It gives several advantages to the plan including a cash bonus and the ability to have year-round open enrollment.  Click here to read the USA Today story.  A comprehensive zip file of the plans is here.  How competitive is your state’s insurance market?  Kaiser Family Foundation is out with a new 9-page report.  Click here for the PDF file.

HHS Pulls Plug on CLASS Act

The CLASS long term care program created by the Affordable Care Act was dealt a fatal blow late last week when the HHS Secretary sent a letter to congressional leaders saying the agency’s review of the act revealed it is not actuarily sound.  Click here to read the government’s report to Congress.  Click here to read the political reaction.

OIG Recovers $1.8 billion in Medicaid Fraud

The OIG is out with an update showing it recovered more than $1.8 billion from the perpetrators of Medicaid fraud.  Top 5 recovery states:  Florida, New York, California, Texas and Ohio.  Click here for an interactive U.S. map.  Click here to see a Excel file list.

QIOs Take $300 Million Hit In Trade Bill

A little know provision in the trade bill the president is likely to sign would cut $300 million from Medicare Quality Improvement Organizations.  The funds would be used to help finance the trade adjustment assistant program.  The association representing QIOs said the cuts threaten the future of health care quality.  The QIO association response can be found here.

HHS Awards $82 Million for Nursing Education; $19 Million for Primary Care Workforce

If you’re willing to work at a critical shortage facility, there is money to help pay for your nursing education and nursing faculty.  The Health Resources Services Administration last week announced awards totaling $82 million to 1,716 persons.  Click here to see where the $ went.  The agency also awarded millions for primary care residency training and other primary care worker programs.  Click here to review the recipient list.  HHS also announced that there are now a record number of primary caregivers in the National Health Service Corp – more than 10,000.  Click here for the announcement.

$6 Million to Help Hospitals’ Maternity Care

The CDC last week awarded $6 million over three years to the National Initiative for Children’s Healthcare Quality to help hospitals nationwide make quality improvements to maternity care to better support mothers and babies to be able to breastfeed.  Click here for details.

CMS Likely to Announce Hospital Engagement Contractors (HEC) Shortly

At least three Hospital Engagement Contractor applicants were notified by CMS last week that they had been selected. All three Strategic Health Care clients were selected!  CMS has allocated $500 million to help pay for HECs.   HECs wlll 1) design intensive programs to teach and support hospitals in making care safer, conduct trainings for hospitals and care providers, provide technical assistance for hospitals and care providers, and establish and implement a system to track and monitor hospital progress in meeting quality improvement goals.

$80 Billion in Federal Grants

The federal government is expected to issue about $80 billion in health care grants this year.  Our 35 grants developers are helping hospitals and other health care organizations across the country tap into these funds.  If you want help securing grants, contact SHC’s Gwen Mathews at gwen.mathews@shcare.net.

New Funds in CMS Primary Care Demo

There’s new money for physicians in CMS’s Comprehensive Primary Care demo program.  Our team can help you apply.  Click here to read our policy team’s latest executive summary.

New Medicare Coverage for Alcohol Misuse, Behavioral Counseling

CMS late last week announced two new national coverage determinations that cover alcohol misuse screening and behavioral counseling for Medicare beneficiaries as well as screening for depression.  Click here for details.

CDC Report: Coronary Heart Disease Declines

A new CDC report showing state by state stats on coronary heart disease was released last week.  The number of Americans who report they have coronary heart disease – which includes heart attack and angina (chest pain) – continues to decline but rates vary widely from state to state and by race and ethnicity.  Kentucky had the highest rate.  Hawaii had the lowest rate.  Click here to read the PDF report.

Medicare Open Enrollment Starts; Likely to See Growth

Medicare’s open enrollment period started Saturday and HHS officials have been urging seniors to look at all their new options.  Open enrollment ends December 7.  According to a new Kaiser Foundation report (click here), Medicare Advantage enrollment continues to grow.  Click here for the HHS menu of resources for seniors interested in signing up with a plan. CMS has proposed new regulations to change Medicare Advantage and the Part D drug program.  Changes would take effect in the CY13 program.  Click here to see a summary of those changes.