Physician Fee Fix and Extenders Legislation 

The Senate did not act to extend the physician fee fix that would prevent a 21 percent Medicare payment cut from going into effect on June 1.  The House and Senate were poised to consider the “American Jobs, Closing Tax Loopholes and Preventing Outsourcing Act of 2010,” which would have provided an update to physicians for the remainder of 2010 and 2011, increased payments in 2012 and 2013 if spending growth is within reasonable limits, and provided an extra allowance for primary and preventive care in 2012 and 2013.

Due to concerns regarding the bill’s cost, which was scored at $200 billion, House Leadership scaled back the physician fee fix, COBRA, and unemployment extensions. That version of the bill would have provided a 2.2 percent update to physicians for the remainder of 2010 and a 1 percent increase in 2011 bill at a cost of $144 billion. 

In an effort to prevent the 21 percent Medicare physician payment cut, House Leadership separated the legislation into two pieces – the physician fee fix provision and other extenders. The extenders piece no longer includes an extension of COBRA and FMAP. Today, the House voted 245-171 to adopt the 19-month physician fee fix and 215-204 for the extenders package.      

The Senate is not expected to consider the physician fee fix or extenders legislation until the week of June 7.

CMS has already instructed MACs to hold Medicare physician claims for 10 days. 

Health Information Technology Grants

The Office of National Coordinator for Health Information Technology (ONC) at HHS announced that they will award an additional $30.3 in Beacon Community Cooperative Agreement Program grants. The grants will provide funding to allow communities to build and strengthen their HIT infrastructure.  Letters of intent are due on June 9, 2010, and grants will be awarded in August 2010. In May, ONC awarded 15 Beacon grants totaling $250 million.

This week, President Obama sent a legislative proposal to Congress that would give him the authority to rescind any spending approved by Congress. The President’s proposal, the “Reduce Unnecessary Spending Act of 2010,” would allow the Congress to vote without amendment to approve or reject the President’s proposed recessions. 

House Budget Committee Chairman John Spratt (D-SC) is expected to introduce legislation on behalf of the President.

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Congress to Consider Extenders Legislation This Week

This week, the House and Senate are expected to consider and vote on the “American Jobs and Closing Tax Loopholes Act” (H.R. 4213). House Ways and Means Committee Chairman Sandy Levin and Senate Finance Committee Chairman Max Baucus released the tax extenders legislation last week, which includes several health care provisions, including a six-month extension of the temporary increase in Federal Medicaid Matching Rate and extension of COBRA premium subsidy for individuals terminated on or before December 31, 2010. The bill would also provide an update to physicians for the remainder of 2010 and 2011. Payment rates would increase in 2012 and 2013 if spending growth is within reasonable limits. The bill provides an extra allowance for primary and preventive care in 2012 and 2013.

IRS Issues Guidance on Therapeutic Discovery Project Program

The Administration continues to rollout health reform regulations. Last week, the Internal Revenue Service released guidance on the Therapeutic Discovery Project Program that was established in the Patient Protection and Affordable Care Act. The health reform law authorized a two-year tax credit designed to encourage investments in new therapies to prevent, diagnose, and treat chronic diseases. Firms with 250 employees or less could receive up to 50 percent of the cost of biomedical research up to a maximum credit of $5 million. Applications for the credit are due on July 21, 2010. The IRS will make determinations of eligibility for credits no later than October 29, 2010.

National Commission on Fiscal Responsibility Reconvenes

The National Commission on Fiscal Responsibility will convene for its second meeting, this time on the Hill, on Wednesday. The meeting will be webcast at www.whitehouse.gov/live. The Commission has issued a request for comments and ideas to address the country’s fiscal challenges. Comments can be emailed to commission@fc.eop.gov and will be part of the public record.

The National Quality Forum (NQF) has requested public and member comments on its plan to establish a Partnership for Applying Measures to Improve Quality.  If the Secretary of Health and Human Services (HHS) assigns NQF with the responsibility to convene multi-stakeholder groups to provide input to the Secretary on the selection of new quality measures as required by the Patient Protection and Affordable Care Act, NQF will proceed with establishing the Partnership. 

NQF envisions that the Partnership would provide input regarding Hospital Compare, the Physician Quality Reporting Initiative (PQRI), the hospital readmissions reduction program, the payment adjustment for hospital acquired conditions, measures for demonstrations (medical homes, accountable care organizations, bundled payments), and public reporting websites.

Any stakeholder who is interested in the quality provisions of the health reform law should take the opportunity to provide NQF with comments, which are due to NQF by June 15, 2010 at 6:00 pm Eastern Time.

After months of debate and considerable political maneuvering, President Barack Obama signed the Patient Protection and Affordable Care Act (H.R. 3590/P. L. 111-148) into law on March 23, 2010. On March 30, 2010, the President signed into law the Health Care and Education Reconciliation Act of 2010 (H.R. 4872/P. L. 111-152), which makes select changes to H.R. 3590.

Together, these laws are designed to expand health insurance coverage to 32 million Americans who are currently uninsured, while reining in rapidly-growing health care costs. Health care spending is the fastest growing line item in the federal budget. Health care premiums have doubled in the last decade and have been an increasing burden to employers and employees, as well as state and local governments. This memorandum details the impact of the newly-enacted health reform laws on employers.

The IRS, Department of Treasury, Employee Benefits Security Administration, Department of Labor, and Department of Health and Human Services released interim final rules for group health plans and health insurance issuers relating to dependent coverage of children to age 26. 

The interim final rules are effective 60 days from the date of publication in the Federal Register (May 13, 2010).  Comments on the rules are due 90 days from the date of publication. 

On Friday, the Government Accountability Office (GAO) announced that it is accepting letters of nomination for the Board of Governors of the Patient-Centered Outcomes Research Institute (PCOR).

The Patient Protection and Affordable Care Act outlines the qualifications to serve on the Board.  It requires that the Board members bring a range of perspectives and have scientific expertise in clinical health sciences research, including epidemiology, decisions  sciences, health economics, and statistics.   

Nominations are due on June 30, 2010.

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In his weekly address, President Obama discussed the implementation of health care reform and the benefits of the legislation to young adults, retirees, and families.

Source: http://www.whitehouse.gov/blog/2010/05/08/weekly-address-health-reform-starts-kick

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Health Care Reform Regulations

This week, the Health Resources and Services Administration will publish notice to establish a rulemaking committee. The Patient Protection and Affordable Care Act requires the Administration to establish a methodology and criteria for designation of medically underserved populations and primary care health professions shortage areas.  The rulemaking committee will work to reach consensus among technical experts and stakeholders on an interim final rule on the methodology and criteria.   

The interim final rules for group health plans and health insurance issuers related to dependent coverage of children to age 26 is currently under review at the Office of Management and Budget. The interim final rule is expected to be one of several forthcoming rules required under the Patient Protection and Affordable Care Act.   

House Appropriations Chairman Announces Retirement

Last week, House Appropriations Committee Chairman Dave Obey announced his retirement.  He served as the Chairman of the full Committee and the Labor-Health and Human Services Subcommittee. Rep. Norm Dicks of Washington is expected to serve as Chairman of the full committee. Rep. Nita Lowey of New York, the second ranking Democrat on the Labor-HHS Subcommittee, or Rep. Rosa DeLauro of Connecticut, Chairwoman of the Agriculture Subcommittee, will likely serve as the Labor-HHS Subcommittee Chairwoman upon Chairman Obey’s retirement.  

Medicare Physician Fee Fix 

Congress has three work weeks prior to adjourning for Memorial Day recess. With the physician fee fix set to expire on May 31, the House is posed to move an extenders bill that would include an extension of the Medicare physician fee fix. Majority Leader Steny Hoyer stated that the House would act within the next two weeks. If the cost of the extenders package is not offset, we expect that the Senate will not be able to move the legislation. In the midst of the financial reform debate, several Senators have been working on an extenders package, which would also prevent the drastic Medicare physician payment cuts from going into effect.

The Department of Health and Human Services released its semiannual regulatory agenda, which details the rulemaking actions currently underway.