DCMedical News: Tuesday, May 8, 2018
DCMedical News
Washington, D.C.
Tuesday, May 8, 2018
DCMedical News is published every day either the House or the Senate is in session. Want to subscribe? See below. Add our new domain (dcmedicalnews.org) to your white list. Welcome to our new “courtesy trial” recipients.
THE BIG STORY TODAY IN HEALTH CARE
Federal Spending: Rescission plans are reportedly in the neighborhood of $15 billion, all unspent funds from prior years (including $7 billion in Children’s Health Insurance Program funds from FY2017 and reserves, and $800 million from the Center for Medicaid and Medicaid Innovation), the total not reaching the $60 billion (previously proposed by House conservatives) level which would compel some Medicare cutbacks. More: CBO reports (here) that, through seven months, federal revenues for FY2018 are up by 4%, outlays by 5%, receipts higher than previously expected due to strong-than-anticipated economic activity and therefore higher individual income and payroll taxes (up 8%); Medicare and Medicaid spending are up by 2%.
Insurance spending: Commercial carriers filing proposed rates for the individual market, some through the roof (CareFirst BCBS seeking an average of 64% in West Virginia, 26% in Maryland, but 91% for a CareFirst PPO in Maryland; Kaiser seeking 37% in Maryland; average rate increase proposed is 30% in Maryland).
Drug spending: Trump speech source of speculation, either a “comprehensive strategy” (modernization, administrative refinement, part B drugs under part D plans, point-of-sale rebates, approval of Medicaid waiver requests for limited formularies—see Alliance for Health Policy and Commonwealth program for 5-11, below—programs sponsored by Azar, Verma or Gottlieb), or a “deconstructive strategy” (past Presidential campaign positions, let Medicare negotiate drug prices, import more lower priced drugs, press other countries to pay more for pharma research). Discussion of issues here from the Financial Times.
HOSPITALS AND HEALTH CARE FACILITIES
Shadow of the Oracle: Board Chairman of Good Samaritan, Los Angeles, Charles Munger: "A lot of the medical care we do deliver is wrong — so expensive and wrong. It's ridiculous," Mr. Munger told CNBC. "A lot of our medical providers are artificially prolonging death so they can make more money."
HEALTH INSURANCE, MEDICARE, MEDICAID
Medicare and Medicaid documentation: Section 1871(c) of the Social Security Act requires CMS to publish a list of all Medicare manual instructions, interpretive rules, statements of policy, and guidelines of general applicability not issued as regulations at least every 3 months in the Federal Register. Here it is, for the first quarter of 2018.
PPACA Employer Mandate: The New York Times reports (here) that the IRS has begun to enforce the “employer mandate” (50 full-time employees or more) to provide health benefits to eligible employees or to face fines of more than $2,000 per worker. Thirty thousand business have received notices for shortcomings on the 2015 tax year, with penalty letters for the 2016 and 2017 tax years expected to follow soon.
UnitedHealth 10-Q (here): Some excerpts, current ratio=.71, medical loss ratio (medical costs/premiums)=81%, cash from operations $8.4bn, cash used for acquisitions $2.6bn, increase in cash for the quarter=$6.3bn, cash on hand=$18.2bn. Earnings from operations overall increased 19%, 12% from UnitedHealthcare, 29% at Optum.
EVENTS & MEETING
May 8
Republican primary elections in Indiana and West Virginia.
Subcommittee on Oversight and Investigations (House E&C) will hear testimony from the chief executives of AmerisourceBergen, Cardinal and McKesson, concerning pill dumping in W. Virginia and other matters.
10:00 a.m. House Way and Means Health Subcommittee Hearing on “The Current Status of and Quality in the Medicare Advantage Program,” Room 1100 Longworth House Office Building, announcement here.
May 9
9:00 a.m.-11:30 a.m., Kaiser Family Foundation (stars, including Gerard Anderson, Lawrence Brown, Martin Gaynor), “Why are Healthcare Prices So High, and What can be Done about Them?” Reagan/International Trade Center, Horizon Ballroom, 1300 Pennsylvania Avenue.
1:00 - 2:15 p.m., CMS Webinar: Participation Criteria for Year 2 of the Quality Payment Program, Registration: https://engage.vevent.com/rt/cms/index.jsp?seid=1091.
House Energy & Commerce Committee mark-up of 60 bills involving opioids, continued on May 17.
May 11
Noon, “State Opportunities to Address Prescription Drug Costs in Medicaid,” Alliance for Health Policy and Commonwealth Fund, 1 Constitution Avenue, NE, Washington, DC, sign up at http://www.allhealthpolicy.org/may-11-briefing/.
May 14
12:30 – 2:45 p.m., “Reimagining Health Care in America,” National Institute for Health Care Management, Room G50, Dirksen Senate Office Building.
May 15
10:00 a.m., Senate HELP Committee, Oversight of 340B Drug Pricing Program, 430 Dirksen Building.
May 16
11:00 a.m., National Advisory Council on Nurse Education and Practice (Federal Register here).
Through May 18, “2018 Medicare Advantage Summit,” Better Medicare Alliance, Hyatt Regency on Capitol Hill, Washington, DC, three days’ agendas here.
May 22
9:30 a.m., Washington Post, “America’s Health Future,” Verma, Murthy, Eyles (AHIP), contact molly.gannon@washpost.com.
May 24
8:30 – Noon, Health Care Costs in America, Alliance for Health Policy, Kaiser/Jordan Conference Center, 1330 G Street NW, Washington, DC.
May 30
9:30 a.m. – 5:00 p.m., HHS Pain Management Best Practices Inter-Agency Task Force (open to the public), inaugural meeting, continuing on May 31 9:00 a.m. to 3:30 p.m., in the Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C., Federal Register notice here, Task Force membership here.
June 19
AHIP Institute & Expo, San Diego, through June 22.
June 24
HFMA (Healthcare Financial Management Association) Annual Conference, Las Vegas, through June 28.
AcademyHealth, through June 26, Convention Center, Seattle, Washington.
Aug. 20
Meeting of Medicare Advisory Panel on Hospital Outpatient Program (through August 21), APCs, OPPS, the works, information here (Federal Register 5-3-2018), 7500 Security Boulevard, Baltimore, MD.
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.
May publication dates: 9, 10, 11, 14, 15, 16, 17, 18, 21, 22, 23, 24, 25.
June publication dates: 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 18, 19, 20, 21, 22, 25, 26, 27, 28, 29.
July publication dates: 9, 10, 11, 12, 13, 16, 17, 18, 19, 20, 23, 24, 25, 26, 27, 30, 31.
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com