Hart Health Strategies provides a comprehensive policy briefing on a weekly basis. This in-depth health policy briefing is sent out at the beginning of each week. The health policy briefing recaps the previous week and previews the week ahead. It alerts clients to upcoming congressional hearings, newly introduced bills, regulatory announcements, and implementation activity related to the Patient Protection and Affordable Care Act (PPACA) and other health laws.


Second Presidential Debate Yields Little Information on Obama Post-Election Fiscal Plans

Last week’s debate between President Obama and GOP challenger Mitt Romney revealed little about the tax, health and other fiscal policies the current Administration will attempt to persuade the lame-duck Congress to pass.  The CEOs of several major financial institutions alerted Congress and the Administration to their concern that the credit rating of the United States could be downgraded and interest rates could spike if an agreement on fiscal matters cannot be achieved after the election.  In this regard, at least one negotiating position seems to be clear, given statements by a White House spokesman declaring that the President will veto any legislation that extends the Bush-era tax cuts for upper income individuals. 

    Without an agreement to delay or modify the upcoming sequestration cuts mandated by the Budget Control Act, discretionary health spending would be cut by about 8.2% and Medicare providers would see payments decrease by about $11.1 billion in this fiscal year. 

    Whether Congress will tackle appropriations for the period remaining after the March 27th cut-off date set under the current CR also remains to be seen. 

    Also, with Medicare Part B physicians facing a 27% cut in payments in January, even a temporary revenue neutral “doc fix” may be difficult for Congress to craft, absent a more comprehensive agreement on spending and taxes.  Nonetheless, the AMA and 100+ medical societies sent a letter to the Senate Finance Committee urging a longer-term solution to the Medicare Part B payment problem.  They said a first step would be to eliminate the current sustainable growth rate (SGR) formula and make subsequent changes such as stable payment updates, delivery system reform and rewards for physicians who achieve savings in delivering health care.

Republicans Criticize MedMal Research Grants

Senators Chuck Grassley and Orrin Hatch and Rep. Lamar Smith sent a letter to HHS Secretary Kathleen Sebelius requesting an explanation of how the $23.2 million HHS has granted for medical malpractice reform research relates to “traditional” medical malpractice reforms aimed at reducing frivolous lawsuits, inflated jury awards and high attorney fees.  They said that the President clearly implied in a speech that such reforms would be considered when the Agency for Healthcare Research and Quality (AHRQ) makes such awards.  They also asked for information on whether Congress expressly approved the demonstration, planning and evaluation projects and the authority for using appropriated funds for such research.

House Oversight Committee Threatens to Subpoena MA DEMO Documents

In a letter sent last week to HHS Secretary Kathleen Sebelius, the Chairman of the House Oversight and Government Reform Committee, Darrell Issa, said the committee would begin proceedings to compel HHS to provide certain previously requested documents related to the 10-year $8.3 billion Medicare Advantage Quality Bonus Payment Demonstration unless the information is released by October 18th.  In general, Republicans maintain the program is but an election year ploy to cover up the cuts to Medicare Advantage insurers which are mandated under the PPACA.

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