DCMedical News: Monday, Sept. 17, 2018
DCMedical News
Washington, D.C.
Monday, Sept. 17, 2018
DCMedical News is published every day either the House or the Senate is in regularly scheduled session.
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THE BIG STORY TODAY IN HEALTH CARE:
Health Appropriations: The House-Senate Conference Committee agreed to an appropriations measure (contained in a joint-Defense-Labor/HHS bill) increasing program funds for FY2019 from FY2018 by $2.3 billion. The increases come in NIH/research funding, $4 billion for mental health and opioid treatment, and preservation of funds for administration of PPACA. The President may sign the bill—which contains a “continuing resolution” to fund other government departments until December 7—this week.
Senate today: Action expected on a gag clause/transparency bill for pharmaceutical sales, opioid legislation.
Maryland Attorney General Seeks an Injunction to Affirm the Constitutionality of PPACA: The complaint, here, seeks continued enforcement of the law, the opposite of the goal sought by 20 red state attorneys general in Texas (complaint here).
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
More on PPACA: The House will vote when back in session on HR 3798, here, Ways and Means Committee report here, to change the definition of full-time employee under a “employer mandate” of the Patient Protection and Affordable Care Act, from 30 to 40 hours per week, to defer further the “Cadillac tax” (a 40% excise tax on “high cost” health plans) from 2022 to 2023, and to make changes in the “employer mandate” definition of full-time retroactive for tax years 2015 – 2018.
Medicare changes passed in House September 12: the House passed four bills related to Medicare, including HR 6690, here, the “Fighting Fraud to Protect Care for Seniors Act” (H.R.6690) would require the Centers for Medicare & Medicaid Services (CMS) to establish a pilot program to evaluate the use of "smart card" technology in Medicare; HR 6561, here, the “Comprehensive Care for Seniors Act of 2018” which would require CMS to finalize a Programs of All-Inclusive Care for the Elderly (PACE) rule by December 31, 2018 (the proposed rule, here, was published in August, 2016, allowing, among other provisions, practitioners other than primary care physicians to provide PACE services); HR 6662, here, the “Empowering Seniors' Enrollment Decision Act of 2018” to expand flexibility for Medicare Advantage enrollment; and HR 3635, here, the “Local Coverage Determination Clarification Act of 2018” to aid medical device manufacturers with elimination of local coverage determinations (LCDs) that are inconsistent with national coverage determinations.
MACPAC Issues Background and Policy Statements: The Medicaid and CHIP Payment and Access Commission published (this summer) reactions to the Administration’s “blueprint” for lowering drug costs, here; a paper (here) on “ways states can support employment among Medicaid beneficiaries without mandating workforce participation” with “state options and examples of strategies states have used to promote and support work among target populations”; an explanation of Medicaid base and supplemental payments to hospitals (here); and a compendium of materials (here) describing the home and community-based services (HCBS) provided to Medicaid enrollees who used HCBS in 44 states in 2012, focusing on the 3 percent of HCBS users with the highest spending on HCBS in each state.
READING
MACPAC Offers Health Expenditures in One Place: MACStats, updated online at https://www.macpac.gov/macstats/, including these:
Medicaid as a Share of State Budgets Including and Excluding Federal Funds by State, SFY 2016
Federal Medical Assistance Percentages (FMAPs) and Enhanced FMAPs (E-FMAPs) by State, FYs 2015–2019
Historical and Projected National Health Expenditures by Payer for Selected Years, CYs 1970–2026
Medicaid as a Share of State Budgets Including and Excluding Federal Funds, SFYs 1990–2016
Income as a Percentage of the Federal Poverty Level (FPL) for Various Family Sizes, 2018
EVENTS & MEETINGS
Sept. 17
Noon, CMS Administrator Verma meets with providers at Washington Hospital Center to
discuss administration plans.
Sept. 18
10:00 a.m., Senate HELP (Health, Education, Labor and Pensions Committee) hearing on transparency and health care costs. (A transcript of the HELP hearing on costs, 6-27-2018, can be found here, with testimony from Dr. Melinda Buntin of Vanderbilt, Dr. Ashish Jha of Harvard, Dr. Niall Brennan of the Healthcare Cost Institute and Dr. David Hyman of Georgetown. A transcript here and written testimony here from the HELP hearing of 7-17-2018 includes Vanderbilt’s Dr. Jeff Balser, Montefiore’s Dr. Steven Safyer, Dr. David Lansky of the Pacific Business Group and Dr. Brent James of Stanford. Testimony from another HELP hearing on costs on 7-31-2018—focusing on administrative expense—can be found here from Becky Hultberg, here from AHIP’s Matt Eyles, David Cutler here, Robert Book here.)
Noon, Families USA, “What’s at Stake for Medicaid in 2018 Elections,” conference call with focus on Nebraska, Utah, Idaho, information at press@families.usa.org
Sept. 26
8:30 a.m. to 4:00 p.m., Medicare & Medicaid Programs, and Other Program Initiatives, and Priorities; Meeting of the Advisory Panel on Outreach and Education. Registration required, information at https://www.regonline.com/apoe2018sept26meeting, notice and background here.
9:00 a.m. to 4:00 p.m., continuing September 27, meeting of the National Advisory Council on
Nurse Education and Practice. Details here.
Sept. 27
10:00 a.m., Senate HELP Committee continues hearing on costs, this hearing focusing on innovation.
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
September publication dates: 18, 20, 21, 24, 25, 26, 27, 28.
October publications dates: 1, 2, 3, 4, 5, 9, 10, 11, 12, 15, 16, 17, 18, 19, 22, 23, 24, 25, 26
November publication dates: 13, 14, 15, 16, 26, 27, 28, 29, 30
December publication dates: 3, 4, 5, 6, 7, 10, 11, 12, 13, 14
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com