POLICY BRIEFINGS


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.


THIS WEEK'S BRIEFING - FEBRUARY 9, 2015


President Releases FY 2016 Budget


On February 2, 2015, President Obama released his Fiscal Year (FY) 2016 Budget, featuring an ambitious public works program, a one-time tax on foreign profits kept overseas by corporations, tax credits for middle-class Americans, and a 1.3 percent pay raise for federal employees and troops. The President’s fiscal blueprint, for the budget year that begins Oct. 1, 2015, proposes spending $4 trillion and projects revenues of $3.53 trillion, leaving a deficit of $474 billion. The budget request exceeds the spending caps established in 2010 by $74 billion spread evenly between military and non-military discretionary spending. While the Administration is proposing offsets to cover some of the expanded spending ($1.8 trillion over a 10-year period), it also argued strongly for the elimination of the limits that trigger wide cuts known as sequestration. The Budget includes the following health provisions:


  • $31.3 billion for biomedical research at the National Institutes of Health (NIH), providing about 10,000 new NIH grants
  • $215 million to launch a Precision Medicine Initiative that will accelerate the ability to improve health outcomes and better treat diseases
  • New funding to implement innovative policies to train new health care providers, investing $810 million in 2016 and $2.1 billion from 2017-2020 in the National Health Service Corps and proposing $5.25 billion over 10 years to support 13,000 new medical school graduate residents through a new competitive graduate medical education (GME) program and extends increased payments for primary care services.
  • Assumes repeal of the Medicare sustainable growth rate (SGR) formula and reforming Medicare physicians payments in a manner consistent with the reforms included in last Congress’ bipartisan, bicameral legislation.
  • Increases funding for programs across the Centers for Disease Control and Prevention (CDC), the Substance Abuse and Mental Health Services Administration (SAMHSA), the Agency for Healthcare Research and Quality (AHRQ), and the Office of the National Coordinator for Health Information Technology (ONC) to decrease the rates of inappropriate prescription drug abuse, including funding for every State to expand existing Prescription Drug Monitoring Programs,
    and supports increased dissemination of naloxone by first responders.
  • Increase of more than $550 million above 2015 enacted levels across the Federal Government to prevent, detect, and control illness and death related to infections caused by antibiotic-resistant (AR) bacteria.
  • $522 million to enhance the advanced development of next generation medical  countermeasures against chemical, biological, radiological, and nuclear threats and includes $110 million to respond to unanticipated public health emergencies.
  • $2.3 billion for the Ryan White HIV/AIDS Program and $900 million for the AIDS Drug Assistance Program.
  • $2.6 billion in budget authority and $4.7 billion in total resources for the Food and Drug Administration (FDA), investing in strengthening the oversight of compounding pharmacies.
  • Seeks to create a single (bundled) payment for some post-acute providers, and would enhance the ability of Accountable Care Organizations (ACOs) to increase quality and reduce costs.
  • Establishes quality bonuses for the highest rated Medicare Part D plans and modifies incentives in the Medicare prescription drug program. Also expands Medicare data sharing with qualified entities.
  • $30 million for a new project to develop evidence about how changes in health insurance benefit packages impact health care utilization, costs and outcomes.
  • Proposes to extend funding through 2019 for the Children’s Health Insurance Program (CHIP), which currently expires in 2015, and gives States the option to streamline eligibility determinations for children in Medicaid and CHIP.
  • Expands and simplifies eligibility for Medicaid home and community-based services (HCBS).
  • Proposes to implement streamlined processes for beneficiary appeals and joint Federal-State review of marketing materials for managed care plans that integrate Medicare and Medicaid payment and services and service Medicare-Medicaid enrollees.

The Budget also includes $400 billion in health care savings.


  • Proposes to exclude certain services from the in-office ancillary services exception (IOASE). (savings = $6.02 billion over 10 years)
  • Cuts to Medicare providers (savings = $222 billion over 10 years.
  • Reduces the Federal subsidy of Medicare costs for certain beneficiaries. (savings = $84 billion over 10 years)
  • Includes proposals to lower Medicare drug costs, including authority for HHS to negotiate drug prices in Medicare Part D (savings = $126 billion over 10 years)
  • Seeks to reduce the period of exclusivity for biologicals from the current 12 years to seven years. (savings = $16 billion over 10 years)
  • Changes to the Medicaid drug rebate program. (savings = 6.3 billion over 10 years)
  • Policies to target waste, fraud, and abuse, including prior authorization for services such as advanced imaging. (savings = nearly $3 billion over 10 years)
  • Lowers the threshold to trigger recommendations by the Independent Payment Advisory Board (IPAB). (savings = $20.88 billion over 10 years)

HHS Secretary Sylvia Matthews Burwell testified last Wednesday before the Senate Finance Committee on the HHS budget. However, many Committee members shifted their focus to the King v Burwell Supreme Court case. Secretary Burwell was criticized for avoiding members’ questions on whether the Administration has a contingency plan in the case that the Supreme Court invalidates health care law subsidies in states that use the federal exchange. Secretary Burwell maintained that she is focused on implementation of the law.




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SERVICES




BRIEFING ARCHIVE


 -  2017


 +  2016


 +  2015


 +  2014


 +  2013


 +  2012


 +  2011