W3vina.COM Free Wordpress Themes Joomla Templates Best Wordpress Themes Premium Wordpress Themes Top Best Wordpress Themes 2012

Tag Archive | "GAO"

Appellate Court Rules on Individual Mandate

On August 12, the U.S. Court of Appeals for the 11th Circuit Court ruled the individual mandate included in the Affordable Care Act unconstitutional.  In the decision, the judges explained that “the individual mandate contained in the act exceeds Congress’s enumerated commerce power.”

The federal appellate court, however, overturned several key rulings made by Judge Roger Vinson in the Northern District of Florida in the case brought by 26 States, the National Federation of Independent Business, and two individuals.  Specifically, the 11th Circuit Court judges found that the health care reform law could stand on its own without the individual mandate.  In addition, the court found that the Medicaid expansion is not unconstitutional.

The case heard before the 11th Circuit Court is the first to be decided in appellate court and found unconstitutional.  Earlier this summer, an appellate court in Cincinnati found the law to be constitutional.  Challenges brought separately by the State of Virginia and Liberty University are still pending in appellate court.  The Supreme Court is expected to consider a challenge to the Affordable Care Act, but we do not expect the Court to issue a ruling prior to the 2012 election.

In March, the Government Accountability Office (GAO) released a report examining alternatives to the individual mandate.  GAO found that mechanisms employed in Medicare Part B or Part D could be alternatives.  In Medicare Part B, the longer a senior waits to enroll, the higher the beneficiary’s monthly premium.  The report indicated that Congress could amend ACA so that uninsured individuals would pay a higher premium if they delayed purchasing insurance coverage.  GAO also noted that the government could limit the open enrollment period in the health insurance Exchanges to once every few years and require individuals who do not enroll in plans offered by the Exchanges to pay higher co-payments or deductibles.

Sen. Ben Nelson (D-NE) and Sen. Claire McCaskill (D-MO) are considering introducing legislation that would provide an alternative to the individual mandate.  Rep. Peter DeFazio (D-OR) introduced the “Personal Responsibility in Health Care Insurance Act” (H.R. 767), which would require individuals who do not want to purchase health insurance to sign an “affidavit of personal responsibility” and would prohibit them from using the bankruptcy court to reduce their health-related debt.

Posted in ReformComments Off on Appellate Court Rules on Individual Mandate

Comparative Effectivness Methodology Committee Members Announced

On Monday, January 21, Gene Dodaro, Comptroller General of the United States with the U.S. Government Accountability Office (GAO), announced the appointment of 15 members to the Methodology Committee of the Patient-Centered Outcomes Research Institute (PCORI).  The Affordable Care Act established the PCORI as a public-private partnership to support comparative effectiveness research (CER).  The PCORI is authorized to identify research priorities and establish a research project agenda to assist patients, health care providers, and policy makers in making informed health care decisions based on clinical evidence on the most efficient and effective way to prevent, diagnose, treat and/or monitor diseases.  Additionally, the institute will adopt research priorities and submit annual reports to the President, Congress, and the public on its findings.

The Methodology Committee will develop and improve the science and methods of comparative clinical research by developing methodological standards.  In addition to the expert members appointed today, the Director of the Agency for Healthcare Research and Quality (AHRQ) and the Director of the National Institutes of Health (NIH), or their designees, are also required to serve on the committee.  The GAO announced the appointment of 19 members to the Board of Governors of PCORI in September 2010.

Posted in Capital Check-UpComments Off on Comparative Effectivness Methodology Committee Members Announced

Patient-Centered Outcomes Research Institute Board of Governors Announced

The Government Accountability Office (GAO) announced the appointment of 19 members to the Board of Governors for the new Patient-Centered Outcomes Research Institute (PCORI) established under the Affordable Care Act to expand comparative effectiveness research efforts. The appointees will join the Director of the Agency for Healthcare Research and Quality (AHRQ) and the Director of the National Institutes of Health (NIH), or their designees, as members of the non-profit organization’s Board.

Members of the Board will be appointed for a six-year term and may be reappointed for one subsequent six-year term. The terms of the PCORI board members are staggered, with the first set of appointments made in September 2010 set at two, four, and six years.

Commissioners whose first term will expire in September 2016 are:

• Eugene Washington, MD, MSc, Vice Chancellor, UCLA Health Sciences, and Dean, David Geffen School of Medicine, University of California Los Angeles. Dr. Washington will serve as the chair of the PCORI Board of Governors.

• Steven Lipstein, MHA, President and Chief Executive Officer, BJC Health Care, a non-profit health care delivery system. Mr. Lipstein will serve as the vice chair of the PCORI Board of Governors.

• Christine Goertz, DC, PhD, Vice Chancellor for Research and Health Policy, Palmer College of Chiropractic and Palmer Center for Chiropractic Research.

• Sharon Levine, MD, Associate Executive Director for The Permanente Medical Group of Northern California, a large multi-specialty group practice within Kaiser Permanente’s integrated delivery system.

• Ellen Sigal, PhD, Chairperson and founder of Friends of Cancer Research, a cancer research think tank and advocacy organization.

• Harlan Weisman, MD, Chief Science and Technology Officer, Medical Devices and Diagnostics, for Johnson & Johnson.

• Robert Zwolak, MD, PhD, a vascular surgeon at Dartmouth-Hitchcock Medical Center and professor of surgery at the Dartmouth Medical School.

Commissioners whose first term will expire in September 2014 are:

• Lawrence Becker, Director, Strategic Partnerships and Alliances, Xerox Corporation.

• Arnold Epstein, MD, the John H. Foster Professor and Chair of the Department of Health Policy and Management at Harvard University School of Public Health, and practicing internist at Brigham and Women’s Hospital.

• Andrew Imparato, JD, President and Chief Executive Officer of the American Association of People with Disabilities.

• Robert Jesse, MD, PhD, Principal Deputy Under Secretary for Health and National Program Director for Cardiology, Department of Veterans Affairs.

• Freda Lewis-Hall, MD, Chief Medical Officer and Senior Vice President of the Pfizer Medical Division.

• Grayson Norquist, MD, MSPH, Professor and Chairman, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center.

Commissioners whose first term will expire in September 2012 are:

• Debra Barksdale, PhD, RN, Associate Professor, University of North Carolina (UNC) at Chapel Hill School of Nursing.

• Kerry Barnett, JD, Executive Vice President of Corporate Services and Chief Legal Officer, The Regence Group.

• Allen Douma, MD, Chief Executive Officer of Empower, LLC, and a member of the AARP Board of Directors.

• Leah Hole-Curry, JD, Program Director for the Health Technology Assessment (HTA) program, Washington State Health Care Authority.

• Harlan Krumholz, MD, Harold H. Hines, Jr. Professor of Medicine and Epidemiology and Public Health at Yale University School of Medicine.

• Richard E. Kuntz, MD, Senior Vice President and Chief Scientific, Clinical, and Regulatory Officer of Medtronic, Inc.

Posted in ReformComments Off on Patient-Centered Outcomes Research Institute Board of Governors Announced

GAO Seeks Nominations to Board of Governors of the Patient-Centered Outcomes Research Institute

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.

Posted in ReformComments Off on GAO Seeks Nominations to Board of Governors of the Patient-Centered Outcomes Research Institute

Industry Pay Up

As congressional leaders continue to negotiate a health care reform bill, sectors of the health care industry are being asked to bring billions of dollars more to the table to pay for reform. For example, the pharmaceutical industry has been asked cough up an additional $10 billion to help pay for health care reform, specifically to help cover the cost of closing the “doughnut hole” in the Medicare prescription drug program.

This request of PhRMA comes on the heels of a Government Accountability Office (GAO) report released this week on brand-name prescription drug pricing. At the request of Sen. Charles Schumer (D-NY), GAO analyzed price increases for brand-name drugs between 2000 and 2008, including the frequency of price increases, the characteristics of the drugs, and the factors that contributed to the price increases. According to GAO, between 2000 and 2008, 416 brand-name drug products representing 321 drug brands had extraordinary price increases. These price increases ranged from 100 percent to 499 percent, but in a few cases were 1,000 percent or more. The price increases occurred in 20 therapeutic classes, but 52 percent were in the following three classes: central nervous system agents, anti-infective agents, and cardiovascular drugs.

A House Energy and Commerce Subcommittee on Health hearing examined recent reports of rapid price increases for brand-name prescription drugs. Chairman Henry Waxman (D-CA) expressed concern regarding the drug industry positioning its pricing to prepare for enactment of the health care reform bill, since it announced it will “give up” $80 billion in profits. Chairman Waxman was referring to the Senate Finance Committee and President Obama’s health reform deal with the pharmaceutical industry that agreed to a 50 percent discount on brand-name drugs for beneficiaries in the doughnut hole. The House health care reform bill does not contain the $80 billion agreement and Chairman Waxman has been a vocal critic of the deal.

Posted in Legislation, ReformComments Off on Industry Pay Up