Customized Briefing for Kimberly Barry-Curley
From NAHU
Leading the News
Legislation and Policy
Public Health and Private Healthcare Systems
Senior Market News
March 8, 2012
Also in the News
Leading the News
Kansas Legislature Seeks Delay Of Medicaid Managed Care Plan's Implementation.
The Topeka Capital-Journal
(3/8, Carpenter) reports, "A majority of the Senate and one-third of the House signed a resolution by
Wednesday seeking a six-month delay in implementation of the governor's managed care reform of health care for children, seniors and
the disabled on Medicaid." However, "the administration of Gov. Sam Brownback dismissed the misgivings of legislators and declared
there was no justification to postpone the start past Jan. 1."
The Lawrence Journal World
(3/8, Rothschild) reports, "The six-month delay will give legislators another legislative session to
analyze the plan to ensure that providers meet the needs of Medicaid recipients 'without causing interruptions or delays in services'....said"
Kansas Sen. Dick Kelsey.
KCStar: Six-Month Delay A Reasonable Idea. The Kansas City (MO) Star
(3/8) editorializes, "The Brownback
administration is right to want to control Medicaid costs, even though Medicaid spending as a proportion of the Kansas budget is below the
national average." However, "the fears of lawmakers, medical professionals and defenders of vulnerable Kansas citizens are wellfounded." The Star argues that "a six-month delay and some sensitivity to the needs of disabled citizens are not too much to ask."
From NAHU
Join NAHU CEO Janet Trautwein, National Legislative Council Chair Troy Cook, and NAHU SVP of Government
Affairs Jessica Waltman for a free, member-exclusive, legislative town hall meeting on March 21 at 1:00 p.m
EST. During this 90-minute webinar, we will discuss current legislative and regulatory priorities for association and
our direction with health reform moving forward.
There will be a formal presentation and an opportunity to ask verbal and online questions. The webinar has a
maximum limit of 1,000 participants, so please click here and sign up today!
Legislation and Policy
Pennsylvania Bill Seeks To Shield Residents From ACA's Individual Mandate.
The Pittsburgh Post-Gazette
(3/8, Olson) reports, "Another effort is under way in the state Capitol to prevent Pennsylvanians from
being subject to the federal health care law and its requirement that all residents purchase health insurance." Legislation "from Senate
President Pro Tem Joe Scarnati, R-Jefferson, would amend the state Constitution to prohibit anyone from being mandated to obtain health
coverage or being fined for not doing so."
House Republicans Propose Two Medicaid Reform Bills.
The Hill
(3/8, Pecquet) reports in its "Healthwatch" blog, "House Republicans are floating dueling Medicaid reform bills as Budget
Committee Chairman Paul Ryan (R-WI) prepares to unveil his own proposal in the coming weeks." The Republican Study Committee's
legislation "gives states maximum flexibility to run the program as they see fit," while "Energy and Commerce member Bill Cassidy (R-LA)
has been touting his own Medicaid reform proposal, which would replace the current open-ended federal matching rate system for states
with a per patient, per month budget depending on the characteristics of each state's patient population." CQ
(3/8, Ethridge, Attias,
Subscription Publication) also reports on the proposed legislation.
Shelby Suggests Healthcare Reform Law Repeal May Impact Medical Programs.
The Hill
(3/8, Pecquet) reports in its "Healthwatch" blog that Sen. Richard Shelby (R-AL), in an opening statement at a hearing on
the HHS' proposed budget for FY 2013, said that the "healthcare reform law skews healthcare funding in a way that would put many of the
nation's medical programs at risk if the law is repealed." He suggested that "lawmakers should start taking a hard look at how they can
mitigate some of the impacts of repealing the law." In addition, Shelby "raised concerns with the budget's flat-funding of medical research
at the National Institutes of Health, at $31 billion."
Consumer Advocates Oppose HHS' Rule On Delaying Benefits Summaries.
The Hill
(3/8, Baker) "Healthwatch" blog reports, "Prominent consumer advocates clashed with business groups Wednesday over
whether the Health and Human Services Department should delay new rules under the healthcare reform law." Groups like AARP, the
American Cancer Society Cancer Action Network, Families USA, and Planned Parenthood "want HHS to hold off on rules that require
healthcare plans to provide a standardized, plain-English summary of their benefits. Advocates say such a delay would undermine an
effective, relatively painless part of the new law."
Fortenberry To "Rebuild Momentum" For Contraception Insurance Coverage Bill.
CQ
(3/8, Ethridge, Subscription Publication) reports, "Rep. Jeff Fortenberry (R-NE) said Wednesday that he must 'rebuild the
momentum' for his bill addressing health insurance coverage of contraceptive services, following GOP leaders' shift to near silence on the
issue." The proposed "bill would allow a health insurance plan to deny coverage for any medical services that counter the plan sponsor's
religious beliefs or moral convictions."
Idaho Legislators Will Not Consider Bill Establishing Healthcare Exchange.
The Twin Falls (ID) Times-News
(3/7, Davlin) reported, "At the beginning of Idaho's 2012 legislative session, both Senate President
Pro Tem Brent Hill and House Speaker Lawrence Denney thought that establishing a state health care exchange would be a hot topic -one that might keep Idaho's lawmakers in Boise longer than normal." Now, "with only a couple of weeks left in the session, both Denney
and Hill said Tuesday that the issue is dead in the water." According to the Times-News, "Rep. Fred Wood, R-Burley, has been working on
a bill that would establish a health insurance exchange in Idaho." Although "Wood has had a bill ready for weeks, it probably won't be
introduced, Denney said Tuesday."
New Jersey Lawmakers Listen To Budget Testimony.
Newsworks
(3/8, Gregory) reports, "The New Jersey Assembly held the first legislative hearing Wednesday on Gov. Chris Christie's
proposed $32 billion budget," with a focus on "funding for health-care services." The budget allocated approximately $35 million for
programs to serve the mentally and developmentally disabled, pleasing those advocates. However, "the Health Care Association called for
increased reimbursement for nursing homes" and "officials with the ARC of New Jersey urged the state to give a 3 percent increase in aid
to service providers."
HHS: Lifetime Health-Benefit Caps Will No Longer Affect 374,000 Rhode Islanders.
The AP
(3/7) reported that officials from the US Department of Health and Human Services (HHS) "say that 374,000 Rhode Island
residents will no longer bump up against a lifetime limit on health care coverage because of a provision of the federal health care overhaul"
under which "lifetime limits on most benefits are prohibited in any policy issued or renewed on or after Sept. 23, 2010." HHS "estimated
this week that 105 million people nationwide had been on plans with the limits."
Public Health and Private Healthcare Systems
House GOP Revives Medicaid Block Grant Idea.
CQ
(3/8, Subscription Publication) reports that two Republicans, House Budget Committee member Tim Huelskamp and Paul Broun
of Georgia, are the co-sponsors "of a measure that would turn Medicaid into a state block grant program expect that the idea will be
incorporated into the forthcoming House GOP budget proposal." Democrats "and many provider groups oppose the idea, saying the
reduced federal payments would cause states to restrict enrollment and benefits." Meanwhile, "groups, including AARP and the American
Cancer Society Cancer Action Network, opposed the block grant idea when" Budget Chairman Paul Ryan "proposed it last year, and the
Democratic Senate rejected a motion to move to the House-passed budget proposal."
Audit Finds Problems In Awarding Of Illinois State Workers' Health Insurance.
The AP
(3/8) reports that officials at Health Alliance "say they're not surprised by an audit critical of the procurement process," which
found "serious problems with the way Illinois awarded $7 billion in contracts for state workers' health insurance. ... The audit comes as the
state is settling a lawsuit by Health Alliance over the contracts."
Lawmakers Warn Of Coming End Of Medicare Guarantee.
CQ
(3/8, Reichard, Subscription Publication) reports, "Look beyond the fall elections and it may seem sharply different, with
members of Congress free to discuss, as never before, the restructuring of the entitlement program," Rep. Peter Roskam (R-IL) and Sen.
Ron Wyden (D-OR) said at a conference sponsored by the Federation of American Hospitals. "Roskam...noted that his fellow House
Republicans have, in effect, said they are willing to be held politically accountable for big changes to the program." He added, "Without a
bipartisan effort to protect Medicare 'what the years ahead ensure is that senior citizens and health care providers will be getting a steady
diet of cost shifting and arbitrary cuts until the Medicare guarantee is kaput.'"
Maryland To Receive Part Of Federal Medicaid Fraud Claims Settlement.
The Baltimore Business Journal
(3/8, Gantz, Subscription Publication) reports, "Maryland will get a cut of a federal Medicaid fraud
claims settlement, Attorney General Douglas F. Gansler said Wednesday." The piece notes that "K-V Pharmaceutical Co. reached a $17
million settlement for allegations the company was responsible for false claims to Medicaid. ... K-V was the parent company of the former
Ethex Corp., which allegedly submitted false quarterly reports to the federal government and misrepresented the regulatory status for
Nitroglycerin ER and Hyoscyamine Sulfate ER," which are "two drugs the Food and Drug Administration had previously determined were
ineligible for Medicaid reimbursement."
The Washington Examiner
(3/8, Farmer) reports, "The District is part of nationwide settlement for $17 million with KV
Pharmaceutical Company."
New Medicare Summary Notice Redesigned.
CQ
(3/8, Subscription Publication) reports, "Federal officials have redesigned the notice that Medicare beneficiaries get every
quarter that explains their benefits and claims and enables them to appeal any decisions the agency has made. The new notice is
available online now, and starting next year the paper version will be mailed to beneficiaries each quarter." According to a statement by
"Marilyn Tavenner, acting administrator of the Centers for Medicare and Medicaid Services," the new Medicare Summary Notice "is easier
to understand and navigate" and "also makes it easier for people with Medicare to understand their benefits and file appeals if a claim is
denied."
Senior Market News
Prudential Will Stop Selling Individual Long-Term Care Policies.
Bloomberg News
(3/8, Frye) reports, "Prudential Financial Inc. (PRU), the second-biggest US life insurer, said it will halt the sale of
individual long-term care policies, joining rivals in retreating from the industry." In a statement issued yesterday, "the company will continue
to offer group long-term care insurance." According to Prudential, "existing contracts are guaranteed renewable and won't change."
Boustany Suggests Possible CLASS Act "Conspiracy Of Silence."
CQ
(3/8, Reichard, Subscription Publication) reports that Rep. Charles Boustany Jr. (R-LA), chairman of the House Ways and
Means Subcommittee on Oversight, is questioning HHS Secretary Kathleen Sebelius "on whether there was a 'conspiracy of silence'
involving administration officials and advocacy groups regarding 'secret' changes to the Community Living Assistance Services and
Supports (CLASS) program before the health care overhaul law passed." Boustany sent a letter
to Sebelius on March 6, requesting
that she "explain a 'yawning gap' between her testimony and an HHS report on the CLASS program." He argued that this "'at best
suggests your lack of familiarity with the details of your department's operations' and 'at worst is indicative of a distinct lack of candor, and
potentially a desire to mislead Congress.'"
Also in the News
Moody's Expects Hospital Consolidations To Continue.
The New York Times
(3/8, B5, Abelson, Subscription Publication) notes a new report from Moody's Investors Service predicting
"even more consolidation" among hospitals over the next few years. Lisa Goldstein, one of the report's authors, noted that "the difficult
business environment and the changes expected in how hospitals will be paid for delivering care are driving many smaller, stand-alone
hospital groups into the arms of larger and better-financed organizations." The report also cites health insurers among the potential buyers,
who "may be looking to join with hospitals as a way of improving their competitiveness, especially if they are expected to create networks
of hospitals and doctors that are responsible for delivering and coordinating care for large communities."
Bloomberg News
(3/8, Kaske) reports, "Smaller stand-alone hospitals that don't merge with other institutions may have
difficulty matching the operating performance and market access of larger multi-hospital systems and 'will face greater negative rating
pressure going forward,' according to the report."
Wednesday's Lead Stories
• House Committee Approves IPAB Repeal Legislation.
• HHS Officials Say Final Rule On Health Insurance Exchanges Coming Soon.
• Federal Officials Overhaul Medicare Billing Statements To More Easily Find Fraud.
• CDC Finds One In Five Americans Struggle With Paying Medical Bills.
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