DCMedical News: Wednesday, November 28, 2018
DCMedical News-DCMN
Washington, D.C.
Wednesday, November 28, 2018
DCMedical News is published every day either the House or the Senate is in session. Subscribe to ensure continued receipt of your copy.
THE BIG STORY TODAY IN HEALTH CARE
Social Security “Upside Down”: A report by the Social Security Administration (New York Times report here) says that retirement benefits paid out each month now exceed the tax revenues and interest to fund the program, necessitating a dip into the Social Security Trust Fund for the first time in 35 years. Those reserves will be depleted by 2034.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Highest Paid U.S. Occupations: A profile of pharmacist salaries in Drug Channels (here) analyzed Occupational Employment Statistics, from the Bureau of Labor Statistics, for 2017. Based on the Standard Occupational Classification system, 14 of the top 15 highest paid U.S. occupations were in health care. For pharmacy, the average gross base salary reached nearly $122,000, with an increasing percentage of pharmacists (25% in 2017) employed in hospitals.
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Price Transparency: As of January 1, hospitals will be required (per the Inpatient Prospective Payment System Final Rule for 2019, here, at pg. 543) to “make public a list of their standard charges via the internet in a machine readable format, and to update this information at least annually.” Sample (here, 139 pgs.) for single view chest x-ray, varying, for example, in Modesto, CA, from $297 to $1804.
More Transparency: CMS inaugurates a surgical price “look up” tool, at https://www.medicare.gov/procedure-price-lookup/
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
North Carolina Medicaid Waiver a Comprehensive Strategy: The Medicaid waiver approved by CMS in October will enable North Carolina’s Department of Health and Human Services to pursue integration of physical and mental health care, pharmacy benefits, housing, food, transportation, employment and interpersonal safety, in pilot-program capitated Medicaid payments. CMS authorized $650 million in federal and state Medicaid funds for the waiver, for “implementing and capacity building stages.” Eight commercial plans have submitted bids to be a statewide pre-paid health plan, to “oversee whole body care for individuals considered as ‘mild’ to ‘moderate’ for behavioral health care.” (Report from Winston-Salem Journal here).
FMAP Set for Fiscal 2020: The Federal Medical Assistance Percentages (FMAP) have been set for the fiscal year beginning October 1, 2019 and ending September 30, 2020, in a Federal Register notice scheduled for publication today (here). The FMAP rates spell out the amount of federal matching for state medical assistance (Medicaid), Temporary Assistance for Needy Families (TANF), and various contingency and child support payments. Also listed (see chart, pages 8-9 of the Notice) are the eFMAP rates for the Children’s Health Insurance Program and the Enhanced Children’s Health Insurance Program (enhancement courtesy of Section 3005 of the HEALTHY KIDS Act). The FMAP is defined mathematically as 100%, less the state percentage, with the state percentage “that percentage which bears the same ratio to 45 per centum as the square of the per capita income of such state bears to the square of the per capita income of the continental United States,” but “shall in no case be less than 50 per centum or more than 83 per centum.” Top of the list (highest FMAPs): Mississippi (76.98%), West Virginia (74.94%), New Mexico (72.71%). States receiving the minimum (50%) as their FMAP are these 13: Alaska, California, Colorado, Connecticut, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Virginia, Washington, Wyoming.
READING & REFERENCE
Commonwealth Fund, 11-27-2018: “In the Wake of New Association Health Plan Standards, States Are Exercising Authority to Protect Consumers, Providers, and Markets,” here.
RAND Report, “Effect of Health Care Payment Models on Physician Practice in the United States,” sponsored by the AMA, report here, appendices here, MedPage report on study here.
Congressional Budget Office: Panel (list) of health advisors, here.
EVENTS & MEETINGS (Events Newly Added to This List Noted in Bold)
Nov. 27
9:00 a.m., The American Enterprise Institute for Public Policy Research (AEI) holds a discussion on "The new Medicare physician payment regulation: What does it mean for physicians and patients?" Seema Verma, Robert Berenson, AHIP, AMA. Contact: 202-862-5829 mediaservices@aei.org
9:00 a.m., Duke Margolis Center on “Root Causes of Drug Shortages and Finding Enduring Solutions,” Washington Marriott Metro Center, (McClellan, Gottlieb, FDA panel), agenda here.
Nov. 28
10:00 a.m., Senate HELP Committee Hearing: Reducing Health Care Costs: “Improving Affordability Through Innovation,” 430 Dirksen Senate Office Building, announcement here.
12:00 to 1:30 p.m., Understanding the Role of Rebates in Prescription Drug Pricing, Alliance for Health Policy, (Stars: Gerard Anderson, Hopkins; Jack Hoadley, Georgetown), Dirksen Room G-50, 50 Constitution Ave NE, Washington. Open to public, lunch served at 11:30 a.m. www.allhealthpolicy.org.
1:00 to 2:00: CMS briefing on proposed rulemaking for Medicaid and CHIP managed care regulation Comments, due January 14, 2019, register here: https://meetings.cms.gov/orion/joinmeeting.do?MTID=a5c77db9a01b8e77f7d5d03ab672ef0e
Nov. 29
The “Office of the National Coordinator” annual meeting, continuing November 30, two day tentative agenda (Jared Kushner!) here.
8:00 a.m. to 11:00 a.m., STAT Plus correspondents in a discussion of drug pricing, at Hogan Lovells in Washington, information at https://www.statnews.com/conversation-drug-pricing-2019/?utm_source=STAT+Newsletters&utm_campaign=bb45b691af-STATPlus_1113_event_subs_COPY_01&utm_medium=email&utm_term=0_8cab1d7961-bb45b691af-149691333
10:30 a.m.: Senate Health, Education, Labor and Pensions Committee marks up S.2076 (here), on dementia and Alzheimer’s; H.R.315, “Improving Access to Maternity Care” (here); reauthorization of “Emergency Medical Services for Children” (here) and reauthorization of the “Traumatic Brain Injury Program” in Room 430 Dirksen SOB.
Dec. 4
9:00 a.m., CMS sponsors a “Town Hall” meeting “To discuss fiscal year (FY) 2020 applications for add-on payments for new medical services and technologies under the hospital inpatient prospective payment system (IPPS).” Registration required by 11-19-2018, Federal Register notice here.
Dec. 18
First meeting, the HHS Deputy Secretary’s Innovation and Investment Summit. Program announced, here; participants selected, list here; FAQs here.
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
November publication dates: 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