Overnight Health: HHS Moving Quickly on Key Regulations

The Hill, by Sam Baker and Elise Viebeck –

November 12, 2012:

The new waiting game in healthcare isn’t about the political future of the Affordable Care Act, but rather the huge amount of work that still has to be done to implement it. As expected, the Health and Human Services Department is moving ahead quickly on several key regulations that had been held until after the election.

Since Election Day, HHS has submitted regulations to the Office of Management and Budget on essential health benefits, insurance regulations, wellness programs and quality initiatives.

Essential benefits — the 10 categories of procedures that health plans will have to cover — will be one of the most highly anticipated rules of the entire implementation process, with major implications for states as well as the insurance industry. HHS doesn’t appear to have sent over a rule yet on the federal exchange, another big-ticket item for states as well as industry stakeholders.

With the healthcare law’s political future now assured, the focus over the next few months will be on the states and the rule-making process, and all signs indicate that a new flood of regulations is about to begin.

Doc fix, again: With the end of the year fast approaching, it’s time once again for Congress to deal with the dreaded “doc fix.” Doctors will see a 27.5 percent cut in their Medicare payments unless Congress comes up with a plan to eliminate or, more realistically, postpone the cut. AARP, the powerful seniors’ lobby, weighed in last week with a letter urging Congress to permanently repeal Medicare’s sustainable growth rate (SGR) formula. Congress should pay for repeal with savings from the wars in Iraq and Afghanistan, AARP said.

“We urge you to pass the longest possible SGR fix this year, in order to allow for the development of a long-term and sustainable solution. New payment methods are needed that maintain access and encourage the delivery of high-quality care,” AARP said.

Its letter was also signed by the American Academy of Family Physicians, the American College of Physicians, the American Geriatrics Society, the Center for Medicare Advocacy and the Medicare Rights Center.

Speaking of cuts: Is the ACA still on the defunding block, despite President Obama’s reelection and the even larger Democratic majority in the Senate? Possibly. Lobbyists and Republicans have raised the idea of tapping into the law’s premium subsidies as part of an end-of-year fiscal agreement that will require deep cuts somewhere in the budget.

Supporters of the health law say there’s no way Obama would risk compromising his signature domestic achievement, arguing that any cut to the subsidies would affect enrollment and affordability. What gives the idea some weight, however, is the fact that the subsidies won’t take effect until 2014, meaning Congress could cut the money now without directly taking it out of anyone’s pocket.

Hospitals up, insurers down: President Obama’s reelection is good news for hospitals and bad news for insurance companies, according to the latest analysis from Moody’s. The Affordable Care Act “will have negative credit implications for insurers based mainly on the additional regulations and restrictions it imposes on insurers,” Moody’s wrote. The credit outlook for pharmaceutical companies is also negative because of rebates and taxes they have to pay, though those policies were part of an agreement that the industry proposed.

Hospitals will do better because of the ACA, Moody’s said, mostly because they’ll have more paying customers thanks to the individual mandate.

Mind the cuts: Nursing homes have launched an ad campaign urging Congress to stop the automatic cuts to Medicare contained in the sequester. The American Health Care Association (AHCA) is out with its second ad buy in Beltway publications and the major cable networks. The ads emphasize the importance of Medicare funds for its member nursing homes and other skilled nursing facilities by featuring stories from patients.

“Any potential deal struck to address the ‘fiscal cliff’ must consider the impact on our residents and the much-needed access to quality care that we provide,” said AHCA President and CEO Mark Parkinson in a statement. Read more from Healthwatch.

In tobacco news: More than 175 states have agreed to fight cigarette smuggling with a new World Health Organization (WHO) pact. The agreement, announced in Seoul, came after more than five years of negotiations and will mandate that signatories require tobacco manufacturers be licensed and that all products be trackable.

“The protocol gives the world an orderly, rules-based instrument for countering and eventually eliminating a very sophisticated international criminal activity,” said WHO chief Margaret Chan. “Illicit trade is bad for health because it circumvents measures like taxes and price increases that are known to reduce demand.” Healthwatch has the rest of the story.

Source: John & Rusty Report via Choice Admin