Simpson-Bowles offer new deficit plan   02/19/2013
The former chairmen of the president's bipartisan National Commission on Fiscal Responsibility and Reform today offered an updated deficit reduction plan calling for $2.4 trillion in savings through a combination of spending cuts and tax changes. "There is no perfect solution to our fiscal problems," former Sen. Alan Simpson (R-WY) and Erskine Bowles, President Clinton's former chief of staff, said. "However, we believe strongly and sincerely that an agreement on a comprehensive plan to bring our debt under control is possible if both sides are able to put their sacred cows on the table in the spirit of principled compromise. We understand that there will be disagreements among policymakers and experts about the exact approach and specific policies necessary to achieve deficit reduction, and we welcome their commentary." The 10-year plan would reduce Medicare and Medicaid spending by about $600 billion by "improving provider and beneficiary incentives throughout the health care system, reducing provider payments, reforming cost-sharing, increasing premiums for higher earners, adjusting benefits to account for population aging, reducing drug costs, and getting better value for our health care dollars." Click here to view the proposal.
AHA video urges Congress to reject arbitrary cuts that hurt patient care   02/19/2013
As it works to reduce the deficit, Congress should pursue real reform that improves patient care - not arbitrary cuts that could hurt access to quality hospital care for all Americans, according to a video message to the nation's hospital family released today by the AHA. "Tell your members of Congress to oppose additional cuts to hospital care and to protect patient care," the video urges. For more information and to share the video via Twitter, Facebook and other social media, go to www.aha.org/protectcare.
Supreme Court reverses ruling on Georgia hospital acquisition   02/19/2013
The U.S. Supreme Court today reversed a lower court decision allowing the Hospital Authority of Albany-Dougherty County, which owns Phoebe Putney Memorial Hospital in Albany, GA, to acquire a competing hospital under the state action doctrine, which provides an exemption from federal antitrust laws. Phoebe Putney Health System said in a statement, "We are disappointed because the lower court rulings were clear in the applicability of state action immunity in accordance with long-standing precedent. This does not alter our resolve or the commitment Phoebe has to meeting the growing needs of this community and the region we serve." The Federal Trade Commission had challenged the acquisition (Federal Trade Commission v. Phoebe Putney Health System), maintaining the state action doctrine did not apply. The Court agreed, finding that there was "no evidence the State affirmatively contemplated that hospital authorities would displace competition by consolidating hospital ownership." In a friend-of-the-court brief, AHA and the Georgia Hospital Association had urged the Court to consider the impact of its ruling on state hospital authorities, which are tasked "with ensuring that their communities have needed health care and a proper safety net."
CMS issues proposed MLR rule, payment changes for MA plans   02/19/2013
The Centers for Medicare & Medicaid Services Friday issued a proposed rule implementing medical loss ratio requirements for Medicare Advantage and Medicare prescription drug plans under the Patient Protection and Affordable Care Act. Beginning in 2014, the law requires Medicare health and drug plans to spend at least 85% of revenue on clinical services, prescription drugs, quality improvements or direct benefits or face financial and other penalties. CMS will accept comments on the proposed rule for 60 days. The agency also issued for public comment through March 1 an advance notice of proposed MA payment and policy updates for 2014.
CMS suspends enrollment in ACA high-risk pools   02/19/2013
The Centers for Medicare & Medicaid Services Saturday suspended new applications to the federally-run Pre-existing Condition Insurance Plan until further notice, and said state-based PCIPs also will suspend new applications after March 2. In a notice at healthcare.gov, CMS said the suspension will help ensure that funds are available through 2013 to continuously cover the more than 100,000 people currently enrolled in the program. The Patient Protection and Affordable Care Act created the temporary program as a bridge to 2014, when the law prohibits insurance companies from discriminating against Americans because of a pre-existing condition.
7 states seek to operate insurance marketplaces with HHS   02/19/2013
Four more states have applied to operate health insurance marketplaces in partnership with the Department of Health and Human Services, HHS Secretary Kathleen Sebelius said in a blog post today. Friday was the deadline for states to apply for a partnership exchange. According to HHS, Arkansas, Delaware and Illinois have received conditional approval to operate a partnership marketplace; Iowa, Michigan, New Hampshire and West Virginia have applied to operate a partnership marketplace; and several states have suggested other approaches to contributing toward health plan management in their marketplace. Another 17 states and the District of Columbia have received conditional approval to operate a state-based exchange. For more information, visit cciio.cms.gov.