Supreme Court Decision Shocks Washington; What’s Next?

The US Supreme Court’s 5-4 decision last Thursday to uphold the Affordable Care Act — with Chief Justice John Roberts siding with the court’s four more liberal justices — shocked most of the Washington establishment.  Most, likely thought that, at a minimum, the individual mandate would be struck and that Justice Kennedy would be the swing vote.  Now, the next time the Affordable Care Act could be modified or repealed is early next year and only if the GOP wins the White House, keeps the House of Representatives and gains a clear Senate majority in the November election.  More than 30 national health care organizations, including specialty physicians, pharma and hospitals, issued formal reactions to the ruling.  Click here to see a good summary of those reaction statements.

Court Decision Impacts Medicaid Expansion

The Court’s most significant change to the law involves the expansion of Medicaid to cover the uninsured.  The court gave new flexibility to states, which appear to be able to opt out of the expansion.  Click here for a good New York Times story on the issues.  The Washington Post also had a good summary of the issue.  Click here.

For an excellent review of the major issues in the law and when they will be implemented, click here for a summary.


HHS Announces New Funding for State Exchanges

Following the Supreme Court’s health care ruling, HHS announced a new funding opportunity to help states implement the health care law.  When the law is fully implemented in 2014, insurance exchanges will provide people and small businesses with one-stop shops to find, compare and purchase affordable, high-quality health insurance. The new funding will provide states with 10 additional opportunities to apply for funding to establish a state-based exchange, state partnership exchange, or to prepare state systems for a federally facilitated exchange.  To date, 34 states and the District of Columbia have received approximately $850 million in Exchange Establishment Level One and Level Two cooperative agreements to fund their progress toward building exchanges. Click here for details and here to see what your state has done.


Prescription Drug Savings Continue to Mount Under the Affordable Care Act: CMS

More than 5,254,000 seniors and people with disabilities have saved a total of $3.7 billion on prescription drugs since the health law was enacted, according to data released last week by CMS.  The agency also said in the first five months of 2012, 745,000 people with Medicare saved a total of $485.3 million on prescription drugs in “donut hole” coverage gap for an average of $651 in savings this year. Click here for more.

New Summary on IRS Tax-Exempt Regs for Hospitals

The Treasury Department and IRS published proposed regulations on new requirements for tax-exempt hospitals. The proposed regulation provides guidance to hospitals on financial assistance and emergency care policies, allowable charges for care provided to individuals eligible for financial assistance, and billing and collection actions. The proposed rule does not contain additional guidance on the Community Health Needs Assessment or consequences for failing to satisfy section 501(r) requirements, noting that further guidance on those will be addressed separately in future rule making. All comments on the proposed rule must be received by the IRS by September 24, 2012.  Click here for an excellent summary and a copy of the regs.


Pension Rules that Help Hospitals, Others Passes Congress

The U.S. House and Senate last week approved a highway bill conference report that includes changes to pension contribution rules. According to a 91-page summary, pension plan liabilities will continue to be determined based on corporate bond segment rates, which are based on the average interest rates over the preceding two years. However, beginning in 2012 for purposes of the minimum funding rules, any segment rate must be within 10% (increasing to 30% in 2016 and thereafter) of the average segment rate for the 25-year period preceding the current year. The provision is intended to stabilize the fluctuation of interest rates from year to year, resulting in fewer sharp declines and fewer sharp increases in interest rates. Click here for the summary.


FDA OKs New Test That Identifies Multiple Bacterias

The FDA last week allowed marketing of the first nucleic acid test that can identify 12 different bacterial types known to cause bloodstream infections. The test allows for simultaneous identification of the bacteria and three associated resistance genes in just a few hours after the first sign of bacterial growth. Traditional methods may require two to four days to produce bacterial identification and resistance results.  Click here for details.


FDA Bill that Speeds New Drugs to Market Passes Congress

In what is likely the last major health care bill to get full congressional approval this year, a measure that would generate $6 billion in fees over five years for the Food and Drug Administration is headed to President Obama for his signature after passing the Senate lat week, a rare moment of bipartisan cooperation in a divided Congress.  Click here for a report from the Washington Post.

Bipartisan Group Takes CMS’ Audit Contractors to Task

A bipartisan group of 11 senators and representatives last week asked the GAO to study how CMS coordinates Medicare’s various audit contractors to ensure their interactions with health care providers are not duplicative and their audit criteria and methodologies are valid, clear and consistent.  Those members of Congress are all on committees of jurisdiction, adding strength to the letter.  Click here for a copy of the letter.


Top 50 Fittest Cities Ranked

Minneapolis-St. Paul is No. 1 on the American College of Sports Medicine’s 2012 American Fitness Index ranking for the second year in a row because of the area’s emphasis on physical activity. Oklahoma City ranked at the bottom of the list because of high obesity and smoking rates.  Rounding out the top five: Washington, D.C., Boston, San Francisco and Hartford.  Click here for an interactive national map to see if your city is on the list.


California Court:  Nurses Can Administer Anesthesia Without Supervision

The California Supreme Court ruled that nurse anesthetists may administer anesthesia in hospitals without physician supervision. The ruling ends a legal dispute between doctors’ organizations and nurses and hospitals.  Click here for the story.


Preventative Mammography Rates Drop

Preventive mammography rates in women in their 40s have dropped nearly 6% since the U.S. Preventive Services Task Force recommended against routine mammograms for women in this age group, according to a study presented last week.  Click here for details.