DCMedical News: Wednesday, May 9, 2018
DCMedical News
Washington, D.C.
Wednesday, May 9, 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
Spending, Continued: Rescission package (here, 40 pgs.), with President’s transmittal, OMB letter and reduced health programs. See page 15 for reduction in CHIP unobligated balance, page 16 for $800 million reduction for various fiscal years for the Center for Medicare and Medicaid Innovation, page 17 for a reduction of enrollment contingency fund for CHIP. The total $15 billion rescission would result in $3 billion reduction in deficit. The rescission request starts a 45-day clock; funds must be spent if no congressional action results in the 45-day period. CBO to release analysis of FY2019 administration budget May 24.
DOCTORS AND OTHER HEALTH CARE PROFESSIONALS
Nuance sought, or case finding: An article and editorial in JAMA Internal Medicine (here) chronicles the update in PSA screening for prostate cancer, as follows: “In abandoning its 2012 objection to prostate-specific antigen (PSA)–based screening for prostate cancer (D recommendation), the US Preventive Services Task Force (USPSTF) now supports individualized decision making for men aged 55 to 69 years . . .The USPSTF recommendations, which have consistently been evidence based, appear to have a large influence on practice patterns . . .The new C recommendation may well be associated with a resurgence in prostate cancer screening and increased numbers of prostate cancer cases diagnosed, especially if the new guidelines are misunderstood to be endorsing screening rather than offering a more nuanced message about decision making.”
HEALTH INSURANCE, MEDICARE, MEDICAID
Association Health Plans (AHPs): Agriculture appropriations bill (here) provides for assistance in the development of farm area association health plans. More general approval of AHPs (proposed rule here) is expected by the summer, per OMB.
Medicare: InsideHealthPolicy reports that House Ways & Means health subcommittee Chair Peter Roskam “intends to advance legislation this year that would reduce regulations in Medicare.” The health subcommittee is reviewing hundreds of written submissions from health care providers concerning “unnecessary” regulations. Roskam noted “Some of these regulations are obtuse. They’re cumulative. They’re foolish. They have no relationship to patient health and so forth. And administrators find themselves like they’re stuck in a Kafka novel.”
Medicaid: Lifetime limit (36 months) turned down for Kansas, will probably be turned down for Arizona, Utah, Wisconsin and Maine, attempts to limit how long beneficiaries can remain on Medicaid.
Exchange Plans: Alaska, Minnesota and Oregon have reinsurance waivers to subsidize the cost of the most expensive patients; similar waivers are being pursued by Louisiana, Maine and Wisconsin, more urgent in light of early 2019 blockbuster rate requests (see DCMN 5-8-2018). Next up: North Dakota in its reinsurance waiver request plans to continue the “essential health benefits,” in contrast to Idaho. North Dakota’s existing high risk program (Comprehensive Health Association of North Dakota, CHAND) would be converted to an “invisible” risk pool. CHAND now has lifetime limits of $1 million, relatively high premiums, and waiting periods for coverage of pre-existent conditions.
PHARMA
Cost of drugs and supplies in hospitals: Proposals to eliminate the “safe harbor” for kickbacks (rebates from drug manufacturers to pharmacy benefit managers) may also help with supply costs. Two authors on the WSJ op-ed page (here) Tuesday took aim at this hidden corner of drug and supply costs. In “Where Does the Law Against Kickbacks Not Apply? Your Hospital,” Dr. Frederick Blum and Phillip Zweig note that Amazon may have backed away from its challenge in the hospital drug and supply market partly because of “the barrier posed by hospitals’ tight relationships with group purchasing organizations, or GPOs.” The GPO industry, these authors contend, “rests on myriad conflict of interest,” with many of the conflicts involving personal compensation to hospital executives and especially to hospital association and hospital group purchasing organizations, notably Premier. An analyst covering the proposed public offering of Premier in 2013 wrote that “many hospital executives who are part of the Premier alliance have learned to rely on that share back as an integral part of their annual compensation.” Only hospital and GPO-authorized distributors and purchasing organizations are eligible for manufacturer rebates made as part of group purchasing negotiations.
EVENTS & MEETING
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
12:00 – 1:30 p.m., “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.
CMS HCPCS Public Meetings for Drugs, Biologicals, Imaging Agents, continuing May 14 and 15.
Agendas here and here.
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. Evaluation of Advanced Primary Care (APC) groups; packaging of Outpatient Prospective Payment System (OPPS) services and costs; group weights, structure, appropriate level of supervision.
Further 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: 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