Boehner
The New York Times ran a quietly subversive news story Wednesday about how members of Congress and their aides will receive health coverage under the Office of Personnel Management's new proposed rule interpreting a controversial Obamacare provision.
During the drafting of the Patient Protection and Affordable Care Act, Sen. Charles Grassley (R-Iowa), an opponent of the legislation, insisted that members of Congress and their staffers should have to buy their coverage from the state health insurance exchanges the same way millions of other Americans would get it—rather than getting it through the Federal Employees Health Benefit Program as they do now. It was a commendable idea that few members of Congress probably thought through.
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It's Christmas in July for Medicare-participating physicians—though the gift is far from being delivered. On Wednesday, the House Energy and Commerce Committee unanimously passed bipartisan legislation to repeal Medicare's sustainable growth-rate formula and replace it with a stable system of payments to the nation's physicians.
For years, Congress has waited until the end of the calendar year to stave off a steep Medicare payment cut to physicians with a temporary fix.
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A bipartisan House bill has been introduced that would require disclosure of Medicare payment information on individual physicians and other healthcare providers and suppliers, to enable the public to compare providers of services.
A companion bill has been pending in the Senate since June, and one Senate spokesperson says the final proposal may be added to the upcoming “doc fix” legislation to come later this year that would change how Medicare doctors are paid under the sustainable growth-rate formula.
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Republican and Democratic leaders on the House Energy and Commerce Committee released the latest version of a draft bill to repeal Medicare's sustainable growth-rate formula calling for a five-year period of stable payment increases as physicians transition into new payment models. But lawmakers still offered no way to offset the cost of the repeal.
Totaling 70 pages, the bill is a work in progress, as the panel's health subcommittee will mark up the legislation next week. Committee members—along with members of the House Ways and Means Committee—have worked throughout the year to craft a bill incorporating comments from more than 80 stakeholders. As before, this version of the bill gives providers the option of leaving traditional Medicare fee-for-service to try new payment models that emphasize better quality and lower costs.
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Technology industry association leaders who testified Thursday before a House subcommittee hearing on whether legislation is needed for data breach reporting called for Congress to pre-empt state laws on data breaches. But at least one witness opposed such preemption.
“There is a growing and exceptionally strong case to be made for the creation of a national data breach notification framework that supersedes state data breach laws,” said Dan Liutikas, chief legal officer of Washington- based Computing Technology Industry Association, a trade group for the computer hardware manufacturers, software developers and other information technology specialists.
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Veteran investigative journalist Kurt Eichenwald has an important and scathing commentary in the new issue of Vanity Fair on the issue of how new state restrictions in Texas and other states on centers providing abortion and other women's health services are likely to affect diagnosis and treatment of breast cancer patients.
What prompted Eichenwald to write the piece was that his wife, Theresa, a physician, recently was diagnosed with the disease, just a few weeks after discovering a breast lump. Eichenwald contrasts his wife's speedy diagnosis and treatment with the long delays faced by low-income and uninsured women associated with greater likelihood of death. He names and blames anti-abortion lawmakers in his home state of Texas for passing legislation that will shut down a number of centers where low-income and uninsured women receive screening and referrals for breast cancer.
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Delays in key provisions of the Patient Protection and Affordable Care Act last week last week are spawning congressional actions this week.
The Obama administration's surprise July 2 announcement that it will delay for one year the requirement that large employers provide qualifying insurance coverage for their workers or face tax penalties spurred told-you-sos from Republicans in Congress.
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Dr. Peter Bach, an oncologist at Memorial Sloan-Kettering Cancer Center in New York, is calling for a radical revamp of Medicare's cancer drug payment program. "The current financing method for physician-administered oncology drugs is unsustainable," he writes in an online Viewpoint on the Journal of the American Medical Association website.
Oncology practices currently operate by charging a mark-up on the retail sales price of chemotherapy drugs. Previously set at 6%, the federal budget sequester dropped that to 4.2%, and the CMS is talking about further lowering it to 3% to hold down costs as the price of the latest cancer drugs soars. The average sales price system provides oncologists with bigger margins if they choose the most expensive drugs, which they are under increasing pressure to do because of the cuts. Responding to oncologists' protests, at least 91 sponsors in the U.S. House of Representatives have signed onto legislation restoring the 6% mark-up.
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McDermott
Rep. Jim McDermott (D-Wash.) wants to reduce organized medicine's role in setting Medicare fees. But such legislation is likely to face stiff resistance from the American Medical Association and subspecialist physician groups, who are heavily represented in the fee-setting process.
McDermott has introduced legislation that he said will address “the lack of transparency and fairness” in setting the Medicare fee schedule and lessen the CMS' reliance on guidance from the AMA's Specialty Society Relative Value Scale Update Committee—commonly referred to as “the RUC.”
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