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Categorized | Capital Check-Up

Capital Thinking Podcast

This week will begin with the Medicare Advisory and Payment Commission (MedPAC), which advises Congress on Medicare payment policy, releasing its annual March report to Congress.  MedPAC is required to review and make recommendations on payment policies for specific provider groups, such as home health agencies, skilled nursing facilities, inpatient rehabilitation facilities, and outpatient dialysis services, among others.  The House Ways and Means Health Subcommittee will hold a hearing on Tuesday and will hear from MedPAC’s Chairman, Glenn Hackbarth.  Additionally, the Senate Finance Committee will hold a hearing in which HHS Secretary Sebelius will testify on lessons learned from health reform during its first year of implementation.

Secretary Sebelius outraged Republican lawmakers last week for writing that the House-passed FY 2011 spending bill, H.R.1, would prohibit the Centers for Medicare and Medicaid Services to use funds to administer payments based on any rate calculated on the basis of the provisions in the Affordable Care Act.  Additionally, she stated that if the bill became law CMS would not have the legal authority to pay Medicare Advantage plans, claims for wellness visits (a new requirement under the health reform law) would not occur, and anti-fraud programs would be halted.  House Ways and Means Chairman Dave Camp and Senate Finance Committee Ranking Member Orrin Hatched called her claims baseless and referred to her letter as a senior scare tactic.

Last week, the Department of Health and Human Services held a press conference call to discuss efforts to support state flexibility in implementing the Affordable Care Act.  HHS and Treasury released a Proposed Rule detailing a process for approval of “State Innovation Waivers” under the Affordable Care Act.  Starting in 2017, States that meet specified standards for providing comprehensive and affordable coverage without increasing the federal budget deficit may be exempted from major requirements of the law.  State flexibility has been a major topic of discussion after several Governors testified on Capitol Hill about their concerns about a lack of flexibility under Medicaid.  Sens. Ron Wyden and Scott Brown introduced a bill, that President Obama has publicly supported, that allows stated to apply for waivers to set up their own health care exchanges, rather than implement the exchange model authorized in the health reform law.

The Congressional Budget Office (CBO) released the latest version of its report on spending and revenue options.  It includes a range of potential targets to offset new spending or reduce the deficit, although most are likely to provoke significant political and/or stakeholder opposition.  Among the health-related provisions of potential interest are proposals to block grant Medicaid long-term care payments; reduce GME funding for teaching hospitals; eliminate the Medicare critical access hospital and sole community hospital programs; impose limits on medical malpractice liability awards; and reduce Medicare payment rates in “high-spending” areas of the country.