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Tag Archive | "COBRA"

Capital Thinking Podcast

Last week, the House and Senate adjourned for the Fourth of July recess without extending the Medicaid FMAP funding increase or COBRA insurance despite the call of numerous Governors on Congress to extend the enhanced FMAP funding through June 2011. Republican Senators continue to object to extending these provisions unless they are fully offset. Republican Senator Scott Brown of Massachusetts introduced a bill to extend the FMAP funding. The bill would be paid for with unused stimulus funding. However, reapportioning stimulus funding stands little chance of being politically palatable to Democrats. Congressional staff have signaled determination in passing an FMAP extension, perhaps in a supplemental spending bill or Gulf relief legislation.

The House amended and passed a Senate-approved war supplementing spending bill before it adjourned. The House amended the bill to include Senator Herb Kohl’s legislation, the “Preserve Access to Affordable Generics Act,” which would ban agreements between brand name and generic drug manufacturers. Senator Kohl has called such agreements “one of the most egregious tactics used to keep generic competitors off the market leaving consumers with unnecessarily high drug prices.” The Generic Pharmaceutical Association, however, expressed opposition to the amendment noting that such agreements have, at times, allowed generic drugs to come to market before the patents of the name brand drugs expire.

Last week, the Centers for Medicare and Medicaid Services released the 2011 Physician Fee Schedule Proposed Rule. CMS estimated that without Congressional action, physician payments would be cut by 23 percent beginning on December 1 and reduced by an additional 6.1 percent beginning January 1, 2011. Congress is almost certain to have a lame duck session in which Members will pass another short-term SGR fix.

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Capital Thinking Podcast

On June 24, the House passed the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010,” which will increase Medicare reimbursement to physicians by 2.2 percent through November 30, 2010.  President Obama signed the legislation into law on June 25.  Amy Hall, Director of the Office of Legislation at the Centers for Medicare and Medicaid Services (CMS) issued a notice to Hill staff explaining that Medicare physician “claims containing June 2010 dates of services which have been paid at the negative update rates will be reprocessed as soon as possible.”  The notification indicated that contractors have been instructed to stop processing claims with the 21 percent cut and to hold claims for services provided in June until the 2.2 percent update is loaded into the claims processing systems.

After eight weeks of consideration of various versions of the “American Jobs and Closing Tax Loopholes Act of 2010” (H.R. 4213) that would extend the Medicaid FMAP funding increase, COBRA insurance, and unemployment benefits, the Senate continues to be in a holding pattern.  Senate Majority Leader Harry Reid most recently failed to get 60 Senators to support cloture on June 24.  Senator Ben Nelson voted with Republicans to block the measure.   The majority has not signaled whether it will try to pass another version this week, but it is the last week Congress is in session before the week-long July 4th recess.

HHS has two major deadlines mandated by the health reform law, the Affordable Care Act, this week – the Department must establish high-risk pools and launch a health insurance web portal by July 1.  Thirty-one states have agreed to run their own high-risk pools, while 20 states will have pools administered by the federal government.

This week the House Education and Labor Committee will hold a hearing on H.R.5504, the “Improving Nutrition for America’s Children Act.”  The bipartisan bill aims to improve the meals children eat both in and out of schools, as well as support community efforts to reduce childhood hunger.  Additionally, the legislation establishes nutrition standards for all foods sold in schools.  The Senate Agriculture Committee has already marked-up its version of a child nutrition reauthorization bill, which awaits floor time.

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Senate Continues Consideration of Extenders Package

The Senate continues to focus its attention on consideration of legislation to extend unemployment benefits, COBRA insurance, and the increased FMAP rate.  This afternoon, Senate Finance Republicans circulated the most recent Senate amendment in the nature of a substitute for H.R. 4213, the American Jobs and Closing Tax Loopholes Act of 2010, compared to an earlier version along with a CBO score of the legislation.

On the Senate floor, Majority Leader Harry Reid (D-NV) indicated that Senate Finance Committee Chairman Max Baucus (D-MT) is working to revise the substitute amendment.  The Majority Leader signaled that he will determine how to proceed on the measure later tonight or tomorrow morning. 

UPDATE:  Sen. Baucus filed a revised subsitute amendment during the evening of June 23. A cloture vote on the measure is expected on Friday.

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Capital Thinking Podcast

After a fairly quiet Congressional recess, the Senate is expected to address pending cuts to physicians that treat Medicare patients when they return this week.  Before Congress left town, the House voted to postpone the 21 percent payment cut for 19 months.  However, other health care benefits, such as an extension of COBRA, which helps unemployed individuals retain their former employer’s health insurance, and enhanced federal payments to states for Medicaid were removed from the bill prior to House passage.  Conservative Democrats voiced concern over the provisions because they added billions of dollars to the deficit.

HHS Secretary Kathleen Sebelius announced the availability of $60 million in Affordable Care Act grants to states and communities to help individuals and their caregivers better understand and navigate their health and long-term care options.  The Administration on Aging and the Centers for Medicare & Medicaid Services will work collaboratively towards an  integrated approach that focuses on the unique needs of seniors, disabled Americans and their caregivers as they seek health care and long-term care.  Funds will be available to states, area agencies on aging, State Health Insurance Assistance Programs, and Aging and Disability Resource Centers.

The Congressional recess did spark debate within the blogosphere over a New York Times article that critiqued the Obama Administration’s use of data from the Dartmouth Atlas Project, an influential research body that has demonstrated geographic variations in the amount of care that hospitals and doctors provide.  The article suggested that the research was only a map of the quality of care provided across the country and could not be used to justify wasteful spending or inefficient care in the health care system as a whole.  Jonathan Skinner and Elliot Fisher, leaders of the Dartmouth Project disputed the Times article stating that it had misrepresented the facts.

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