DCMedical News: Monday, March 19, 2018
DCMedical News
Washington, D.C.
Monday, March 19, 2018
THE BIG STORY TODAY IN HEALTH CARE
There are four Congressional working days remaining before expiration of the Continuing Resolution on March 23. No resolution as yet on health policy issues. The bill is expected to be available this evening, following a Republican House conference at 5:45 p.m.; the bill is reported (Axios) to be more than $1 trillion, with a likely FY2018 deficit of $800 billion.
A significant question for the health field is whether premium stabilization through reinsurance and cost-sharing reduction payments will be part of the “Omnibus” budget bill.
CBO (here) and Oliver Wyman (benefits consultant, “proposal” here) both aver that the Alexander-Collins bill could reduce premiums in the individual and small group markets this fall by 10% for 2019 and 20% for 2020 and 2021. The Alexander-Collins bill (here) is an amalgam of the original Alexander-Murray bill (here) on C-SR payments and the original Collins-Nelson bill (here) on §1332 waivers and reinsurance. Murray and supporter Sen. Collins disagree on a provision that funds in the plans not be used to cover abortions.
The “Alexander-Collins” measure now also includes $30 billion for three years of reinsurance coverage and three years of cost-sharing reduction payments, more flexibility for states, and sale of catastrophic insurance plans for all ages (currently restricted to under age 30).
Insurers are following a calendar (here) for “Qualified Health Plans.” Plan submission for 2019 begins on May 9 and concludes June 20.
HOSPITALS AND HEALTH CARE FACILITIES
MedPAC’s March report to Congress (here, pg. 6) recommends no payment update for the four “fee for service” institutional payment systems (long-term care hospitals, LTACs; hospice; ambulatory surgery centers, and skilled nursing facilities, SNFs.)
The report recommends 5 percent base payment reductions for home health and inpatient rehabilitation facility services. It recommends further changes in these payment systems, including a requirement that ambulatory surgery centers report cost data; that payment to SNFs be frozen for two years while the post-acute care (PAC) payment system (SNFs, home health, IRF and LTACs) is redesigned (pg. 22ff); that home health payments have therapy eliminated as a factor in payment; and that the sorting of patients in IRFs by case mix (with resulting coding decisions, including outliers) be reviewed.
The PAC redesign stems (per the report) from MedPAC’s conclusion that the sum of payments for PAC providers is too high relative to the actual costs of treatments. The report’s 563 pages contain a wealth of health policy and health insurance information. It is one of two (the other in June) sent to Congress by MedPAC each year.
HEALTH INSURANCE, MEDICARE, MEDICAID, COMMERCIAL
Medicare sequestration: the Center for Budget and Policy Priorities reports (here) that Republican budget negotiators may want to cut back on the use of “CHIMPs, (CHanges In Mandatory Programs) to offset other non-defense appropriations. CHIMPs, unchanged, would lead to further sequestration in Medicare spending.
EVENTS & MEETINGS
Your March Calendar:
March 21
9:00 a.m., Energy and Commerce Health Subcommittee begins two days of hearings (bills here) on “Combating the Opioid Crisis: Prevention and Public Health Solutions,” 2123 Rayburn H.O.B., continuing March 22 at 10:00 a.m.
2:00 p.m., House Ways and Means Health Subcommittee, hearing on the implementation of MACRA’s physician payment policies, 1100 Longworth H.O.B.
March 22
1:30 p.m., Competition and Consolidation, Webinar sponsored by Alliance for Health Policy, AHCJ, NIHCM, worth a listen (Tom Scully, Chapin White, flyer here).
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: 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