White House issues report on potential impact of sequestration   09/14/2012
President Obama today sent Congress a report on how his administration would implement the automatic spending cuts scheduled to take effect Jan. 2 under the Budget Control Act. Required by the Sequestration Transparency Act, the report includes a breakdown of exempt and non-exempt budget accounts and an estimate of the funding reductions that would be required across non-exempt accounts, including a 2% cut to Medicare estimated at $11.09 billion for the remainder of fiscal year 2013. Medicaid spending is exempt from the sequester. According to a report released this week by the AHA, American Medical Association and American Nurses Association, more than 766,000 health care and other jobs could be lost by 2021 as result of the 2% reduction in Medicare spending mandated by the BCA.
House approves six-month continuing resolution   09/14/2012
The U.S. House of Representatives last night voted 329-91 to approve a continuing resolution funding most federal programs at their current levels through March 27. If approved by the Senate, the six-month measure would eliminate the threat of a government shutdown when the fiscal year ends Sept. 30, as Congress has not yet approved all appropriations bills for next year. It also would clear the way for lawmakers to tackle more difficult issues in the post-election "lame duck" session, such as the $109 billion in automatic spending cuts scheduled to take effect Jan. 2 under the Budget Control Act, including a 2% reduction in Medicare spending.
House extends Conrad 30 program for three years   09/14/2012
The U.S. House of Representatives last night approved legislation extending through September 2015 the Conrad State 30 J-1 visa waiver program, an AHA-supported program that allows foreign-born physicians to remain in the U.S. on a J-1 visa for three years after medical school to serve in medically underserved areas. The legislation passed the House 412-3 as part of a broader immigration workforce bill (S. 3245) dealing with non-controversial programs, which now goes to the president to be signed into law. Under U.S. immigration law, foreign students admitted to the U.S. to attend medical school are granted J-1 visas, which require them to return home for two years after completing their education before they can apply for an immigrant visa, permanent U.S. residency or an additional nonimmigrant visa. The Conrad State 30 program enables these physicians to remain in the U.S. if they agree to provide 40 hours a week of primary care in a medically underserved area for three years. Their wages are required by law to match those of similarly skilled American colleagues. When they complete their obligation, they are allowed permanent legal residency and can pursue U.S. citizenship.
Federal court summarily dismisses state of Maine's Medicaid request    09/14/2012
The 1st U.S. Court of Appeals yesterday dismissed Maine's request for an order requiring the Department of Health and Human Services to consider or approve its proposal to decrease Medicaid coverage for three eligibility groups by Oct. 1. "As developed here, the facts do not warrant the mandamus-like relief of ordering Respondents to consider or approve the [State Plan Amendment] by Oct. 1, 2012," the judgment states. Maine officials asked the court to require HHS to approve the changes by Oct. 1 so the state can balance its budget, arguing in part that the Patient Protection and Affordable Care Act's Maintenance of Effort requirement is unconstitutional under the Supreme Court's ACA decision in June.
Appeals court limits issues for review in appeal of RAC decision    09/14/2012
When a Medicare Recovery Audit Contractor determines that an overpayment was made to a health care provider, the provider may not challenge whether the RAC has "good cause" under the Medicare rules to reopen the claim, the 9th Circuit Court of Appeals affirmed Tuesday in Palomar Medical Center v. Sebelius. "We are not unsympathetic to the interest of Palomar in finality of its medical services receipts," the opinion states. "But Congress created the RAC program and gave the Secretary discretion to set regulations that would govern reopening of Medicare claims. The Secretary in her 2005 regulations said that there would be no appeal of a reopening and that a decision to reopen was to be 'final.'…In these circumstances we agree with the district court that the question of good cause to reopen could not then be litigated after a claim determination was revised upon audit by a RAC." Providers may still challenge the merits of any denial or reduction in payment that may result. The AHA, Federation of American Hospitals and American Health Care Association had urged the court to reject the lower court ruling.
CMS planning outreach opportunities on hospital-wide readmissions measure   09/14/2012
Due to problems with the phone line during a recent Centers for Medicare & Medicaid Services conference call on the new hospital-wide readmissions measure, the agency is working on a way for interested hospitals to participate in the full presentation and ask questions. AHA will provide more information to hospitals as it becomes available. Hospitals have until Oct. 3 to download and review mock hospital-specific reports and other data from "dry runs" of the hospital-wide readmission measure and hip and knee replacement complications and readmissions measures to be added to the Hospital Compare website in 2013. AHA urges hospitals to review and provide feedback on the data to CMS as described in the dry run materials and to nfoster@aha.org.