WEEKLY E-BULLETIN


The US Supreme Court has not released its health care decision today.  It will do so on another day this week.

What Will Happen After the Supreme Court Rules?

Here’s a great Washington Post summary of all the issues surrounding the Supreme Court decision.  Click here.  If the Supreme Court strikes down the Affordable Care Act, Kaiser Health News reports on how the GOP will respond.  Click here.  The White House says it will be prepared if any part of the law is struck, but giving no details.  If the law is overturned, speculation is rampant on its impact.  Click here for a good summary of possibilities.  Former CMS administrator Don Berwick says no matter what the court does, reform cannot be undone.  Click here for that story.  What could a court loss mean for President Obama?  Click here for an interesting NY Times story on this.

IRS Issues New Tax Exempt Hospital Requirements

The IRS last week issued a proposed rule implementing new requirements for tax exempt hospitals. The 94-page rule provides guidance to hospitals relating to financial assistance and emergency care policies, charges for certain care provided to individuals eligible for financial assistance, and billing and collections. IRS addresses which tax exempt hospitals will be covered by the regulations and proposes to extend the requirements to government hospitals. The proposed rule does not contain additional guidance on the community needs assessment requirements, noting that further guidance on those will be addressed separately. Click here to read the rules.

Consumers To Receive $1.1 Billion in Insurance Rebates This Summer

Millions of consumers and businesses will receive $1.1 billion in rebates this summer from health insurance plans that failed to meet a requirement of the new health-care law, according to an HHS report last week. That Affordable Care Act requires insurance companies to spend at least 80 percent of subscriber premiums on health-care claims and quality improvement initiatives. The other 20 percent is left for administrative costs and profits. Plans that exceed that threshold must send the difference back to subscribers as a rebate.  Of course, if this federal health law is struck down by the Supreme Court, those checks may not have to be mailed.  Click here to see a state-by-state breakdown.  Click here for the Washington Post story.

CMS Puts a Hold on Rules Requiring Doc on Hospital Boards

CMS will not be enforcing, at least until further guidance is given, the new Conditions of Participation requirement for a hospital’s governing body to include a member of the medical staff.  CMS is presently reconsidering this policy in light of the numerous comments that have been received since publication of the final rule. “Therefore, surveyors should not attempt to assess compliance with this new requirement or cite deficiencies related to this specific requirement without receiving instructions from CMS.” Click here for the CMS memo.

Government Pays $5.7 Billion in EHR Incentives

More than 110,000 eligible professionals and over 2,400 eligible hospitals have been paid more than $5.7 billion by the Medicare and Medicaid EHR Incentive Programs since their inception, according to a report out last week from CMS.  Click here for more information.

Rx Data to be Given to EDs and Other Providers to Stop Abuse

Existing prescription drug use data will be made available to providers and pharmacists when treating patients in ambulatory and emergency departments through a new pilot program launched last week by HHS. The pilot projects – which will take place in Indiana and Ohio – will measure the effects of expanding and improving access to prescription drug monitoring programs and are designed to reduce the prescription drug abuse epidemic.  Click here for details.

ED Overcrowding Getting Worse: New Study

Emergency department overcrowding is getting worse, according to a new study out last week.  During the eight-year study period, the number of ED visits increased by 1.9% per year, a rate 60% faster than population growth.  Among potential factors associated with crowding, the use of advanced imaging increased most, by 140%. But advanced imaging had a smaller effect on the occupancy trend than other more common throughput factors, such as the use of intravenous fluids and blood tests, the performance of any clinical procedure, and the mention of two or more medications, according to the report.  Click here.

CDC:  Number of Uninsured Drops Between 2010 and 2011

In 2011, the percentage of persons uninsured  was 15.1% (46.3 million) for persons of all ages, 17.3% (45.9 million) for persons under age 65, 21.3% (40.7 million) for persons aged 18–64, and 7.0% (5.2 million) for children under age 18, according to a new CDC report out last week . Among persons of all ages, the percentage uninsured at the time of interview decreased from 16.0% in 2010 to 15.1% in 2011.  Click here for the CDC’s National Health Interview Survey for 2011.

NQF Endorses 14 New Patient Safety Measures

The National Quality Forum last week endorsed 14 patient safety measures with a focus on complications. The measures address a range of quality concerns, including medication safety, venous thromboembolism, surgical safety, and care coordination.  Click here to see the list of all the endorsed safety measures.

CMS to Start Accepting New ACO Applications

Organizations now have between August 1 and September 19, 2012 to apply for the Advanced Payment Model Medicare Shared Savings Program, according to regulations published last week by HHS.  Approved ACOs would begin January 1, 2013.  There are only five Advanced Payment ACOs underway today (click here for this list).  Click here to see the 4-pages of regulations.

AMA Wants ICD-11, Not ICD-10

In what is likely to cause continued controversy over the implementation of ICD-10, the AMA voted last week to evaluate ICD-11 as a possible alternative to ICD-10 for replacing ICD-9 – saying that it will report back to delegates in 2013 with its findings. Click here for the report.  At its annual policy meeting last week, the AMA adopted 11 new policies.  Click here to review a summary.  One of those policies was to support on a soda tax to fight obesity.  Click here for the LA Times story on that.  Click here to see the list of the AMA’s new board of trustees.

Committee Questions MedPAC Proposal on Senior Insurance Fees

MedPAC’s recommendation to Congress that seniors pay a special fee when they buy health insurance to supplement their Medicare coverage received some push back by a congressional health committee last week.  Click here for the news report.  Click here to review a 4 page summary of MedPAC’s recommendations to Congress.

“Upskilling” of Nurses, Others Growing

More and more hospitals and other provider organizations are requiring their nurses to have at least a bachelor’s degree, according to a good story last week in the New York Times.  So, many nurses are headed back to school.  The “upskilling” of nurses and other health professionals is a growing issue.  Click here for a slide-summary from Georgetown University that was released last week.

Kids with Hypertension Hospitalizations Increasing

The number of children with hypertension-related hospitalizations in the United States increased significantly from 1997 to 2006, with the fraction of inpatient charges attributed to hypertension also significantly increased, according to a study published last week.  Click here.

PCORI Releases $30 Million to 50 Projects

The Patient-Centered Outcomes Research Institute last week named the recipients of $30 million in research grants for pilot projects to advance methods to engage patients in the health research and dissemination process. The 50 awards include projects to develop tools and techniques to improve patient-centered care and decision-making; create new patient-centered care measures; and improve delivery of patient-centered counseling and care in various health care settings. Click here to see an interactive map detailing each of the awards.