DCMedical News: Monday, March 12, 2018
DCMedical News
Washington, D.C.
Monday, March 12, 2018
THE BIG STORY TODAY IN HEALTH CARE
The Omnibus Budget bill:
Nine Congressional work days remain before expiration of the current Continuing Resolution (found here) funding the federal government. Speculation concerning the non-budgetary items to be included in the Omnibus budget bill continues, including these questions:
HHS Secretary Azar is committed to enforcing the law of the land. Does he propose to change that law, including in the Omnibus authority for short-term, limited-duration health insurance plans to provide long term coverage? That White House memo on Obamacare (here) and friendly news (here) say “maybe.”
If the Center for Budget and Policy Priorities (report here) is reflecting the left-center view on Cost-Sharing Reduction payments (“The market has largely adjusted to the Trump Administration’s decision to end CSR payments . . . eliminating CSR payments resulted in increased subsidies for many consumers, making coverage more affordable and more attractive,”), was Senator Collins’ vote for the tax cut in vain?
If the states appear set on using Medicaid as a general welfare program, instead of a health insurance program, will this be evident in Omnibus language (e.g. proposals for lifetime Medicaid limits, or maximum time eligibility), or will the states rely on CMS to regulate their wishes into law?
HOSPITALS AND HEALTH CARE FACILITIES
Anthem (here) and United Health (here) both cutting payment for hospital services they feel too costly.
HEALTH INSURANCE, MEDICARE, MEDICAID, COMMERCIAL
Your “Idaho package” is here:
(Idaho has proposed lower cost, lesser benefit, health insurance plans. CMS has said “no,” but inferred pathways toward “yes.”) Proposed rule for AHPs, here. Proposed rule for STLDIs, here. Governor Otter’s proclamation here. Idaho Department of Insurance bulletin to carriers here. Idaho Blue Cross’ letter to HHS here. CMS’ Administrator Verma’s letter to Idaho here. Actuary society letter here. Unhappy Members of Congress, letter here. Commentator Nicholas Bagley’s notes here.
Interest in the less expensive but also less comprehensive policies, already intense, increased as Covered California (report here) projected as much as 90% increase in health insurance exchange premiums over the next three years.
PHARMA
“Right to Try” will be up for House action tomorrow (Tuesday). The bill (found here) will (according to the bill’s proponents in the Energy and Commerce Committee, improve access to experimental treatments for patients with terminal diseases or conditions (Committee discussion here).
A study in JAMA Internal Medicine (here) shows that, despite introduction of generic competition in 2011, prescription for Lipitor continued high in 2012-2014, generating what the authors believe to be $2 billion in unnecessary expense. One hypothesis: “Lipitor OOP [out of pocket] cost was lower than that of generics in 2014, likely owing to deals made with pharmacy benefit managers to lower Lipitor copays below that of generics.”
The House Energy & Commerce health subcommittee will hold a two-day hearing March 21-22 to examine more than 20 bills intended to help combat the opioid crisis. One apparent moral hazard problem for their deliberations: researchers publishing in the Social Science Research Network (here) find “that broadening Naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality.”
EVENTS & MEETINGS
Your March Calendar:
March 13
1:00 p.m., The Alliance of Community Health Plans (ACHP) holds a briefing on "The Value of
Medicare Advantage, rsvp to achpcommunications@achp.org, 2203 Rayburn Bldg.
March 14
2:00 p.m., Open Payments “National Provider Call.” Provider (physician and teaching hospitals especially) chances to review the “sunshine law payment” methodology, to be followed (April 1-May 15) by the dispute period. Publication of payments for 2017 takes place in June.
Info at openpayments@cms.hhs.gov or call 1-855-326-8366
March 15
10:00 a.m., Senate Health, Education, Labor and Pensions Committee (HELP), hearing on the
340B drug discount program, 430 Dirksen S.O.B.
March 16
11:00 a.m., AHRQ, National Advisory Council for Healthcare Research and Quality, by WebEx, information at https://www.ahrq.gov/news/events/nac/.
March 26
PTAC, Physician-Focused Payment Model Technical Advisory Committee, continuing March 27, information at www.regonline.com/PTACMeetingsRegistration or livestream at www.hhs.gov/live.
FOR REFERENCE
Members of the Senate (here) and Members of Senate Committees (here), Senate Calendar (here).
Members of the House with their House Committees (here), House Calendar (here).
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
DCMedical News is published every day that either the House of Representatives or the Senate is in session.
Past issues can be accessed by clicking on “View this email in your browser.” Subscription information is found at the bottom of these pages. Trial subscriptions may end without notice.
March publication dates remaining: 13, 14, 15, 16, 19, 20, 21, 22, 23.
April publication dates: 9, 10, 11, 12, 13, 16, 17, 18, 19, 20, 23, 24, 25, 26, 27
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com