DCMedical News: Monday, October 1, 2018
DCMedical News
Washington, D.C.
Monday, October 1, 2018
DCMedical News is published every day either the House or the Senate is in session. To subscribe, please see below.
THE BIG STORY TODAY IN HEALTH CARE
Kavanaugh confirmation pending further inquiry. Appropriations for the Department of Health and Human Services signed (conference report, 369 pgs., here); five of twelve appropriations measured are signed, representing three quarters of FY 2019’s discretionary spending under the two-year February budget agreement. Massive opioid legislation (bill 660 pgs., HR 6, here) passed in the Housed 393-8 Friday, final vote pending in Senate.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Rural Health Testimony Before HELP Committee: The Senate Health, Education, Labor and Pensions Committee heard testimony September 25 on challenges to doctors, hospitals and patients. Alan Levine (testimony here), CEO of Ballad Health, told the Committee that many rural hospitals are at risk of closure; that fee-for-value payment models were more suited to urban areas than rural; that smaller, rural hospitals don’t have technical sophistication to manage risk models; that the area wage index adjustment is a major problem; and that rural hospitals can be repurposed for addiction, women’s health and other uses. Dr. Deborah Richter, a Cambridge Vermont family physician and addiction medicine specialist (testimony here), told the Committee that her un- and under-insured patients were more likely to suffer from delayed care, that the economy suffers from the way we finance health care, and that the primary care shortage is growing. Morgan Reed, Executive Director of The Connected Health Initiative (testimony here), told the Committee that telehealth needs better reimbursement and that the Stark laws need to be “filed down.” Tom Glause, Insurance Commissioner for the State of Wyoming (testimony here), told the Committee that Wyoming has the second highest commercial insurance rates in the country with a smaller market, outmigration for expensive care and cost shifting due to low Medicare payments.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Medicaid Enrollment Soars: The July 2018 enrollment report for Medicaid and CHIP (here) shows “73,189,584 individuals were enrolled in Medicaid and CHIP in the 51 states reporting July 2018 data. 66,692,681 individuals were enrolled in Medicaid and 6,496,903 individuals were enrolled in CHIP . . . nearly 15.6 million additional individuals were enrolled in Medicaid and CHIP in July 2018 as compared to the period prior to the start of the first Marketplace open enrollment period (July - Sept. 2013), in the 49 states that reported relevant data for both periods, representing nearly a 28 percent increase over the baseline period. (Connecticut and Maine aren't included because they did not report data for both periods.)” Tables and backup here.
MedPAC Coming to Town: The Medicare Payment Advisory Commission will meet this Thursday and Friday, October 4-5. Among the subjects to be addressed: Assessing Medicare’s payments for services provided in inpatient psychiatric facilities (here); Managing prescription opioid use in Medicare Part D (here); Medicare payment policies for advanced practice registered nurses (APRNs) and physician assistants (PAs), (here); Medicare’s role in the supply of primary care physicians (here); Opioids and alternatives in hospital settings: Payments, incentives and Medicare data, (here); Medicare policy issues related to non-urgent and emergency care, (here); and Episode-based payments and outcome measures under a unified payment system for post-acute care, (here). Can’t make it? DCMN will be there for you, reporting in the editions of 10/4, 10/5 and 10/9.
DRUGS AND DEVICES
What Does it Cost to Develop a New Drug: The $2.4 billion estimate of the industry-supported Tufts Center has raised doubts in the past (here). STAT+ reports (here) that a new study in JAMA Internal Medicine (several authors, including Hopkins’ Gerard Anderson, here) found the median cost to be $19 million.
READING AND REFERENCE
Final Federal Register Publication of FY 2019 Rules (Effective Dates for the regulations October 1, 2018, although some provisions are effective January 1, 2019): Hospital IPPS, here; Hospice payment, here; Inpatient psychiatric payment, here; Inpatient rehabilitation payment, here; and Skilled nursing facilities, here.
Also, “streamlining” of rules for Medicare appeals (proposed rule here, comments due December 2).
EVENTS & MEETINGS
Oct. 15
4:05-5:45 p.m., HHS Secretary Azar on “Affordable Medicines: Access, Innovation and the Public Interest,” at the National Academy of Medicine, Washington, DC. Additional information here.
Oct. 25
1:00 to 5:00, “Top Minds,” Chernew, Dafny and more, “Disrupting the Health Care Landscape: New Roles for Familiar Players,” NEJM Catalyst webinar, https://join.catalyst.nejm.org/events, also sign up for “New Marketplace Survey: Payers and Providers Remain Far Apart,” which reports (here) that “health care stakeholders are not working together to achieve value-based care, but instead are waiting on government regulators to change the payment model – including, possibly, single-payer health care.”
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
October publications dates: 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