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.


It's the Law For Only This Year

Last week President Obama signed H.R. 3630, the Middle Class Tax Relief and Job Creation Act of 2012, into law (P.L. 112-96).  As previously described, the law would extend current Medicare physician payment levels until only year-end, thus setting up another contentious debate over their further extension in a lame-duck legislative session after the November elections.

House Committee Meetings

On Tuesday the House Energy and Commerce Committee will markup legislation (H.R. 452, the Medicare Decisions Accountability Act) designed to repeal the PPACA Independent Payment Advisory Board (IPAB).  Also, on the same day the House Ways and Means Committee will take testimony from HHS Secretary Kathleen Sebelius on the President’s FY 2013 budget recommendations.
Senate to Consider Blunt

PPACA Amendment

This week the Senate returns to consider S. 1813, a transportation reauthorization bill, which could highlight a fight over a PPACA-related amendment to be offered by Senator Roy Blunt.  The Blunt amendment would overturn the HHS rule requiring religious-based organizations to provide certain women’s contraceptive coverage under their fully-insured and self-insured health plans.  They proposed exception to the PPACA coverage mandate would allow such organizations to avoid such coverage if it violates their "moral beliefs."

Non-Grandfathered Health Plan Actuarial Value Defined

The CMS Center for Consumer Information and Insurance Oversight (CCIIO) has issued a guidance bulletin requesting comment on a proposed framework for defining how health insurers can conform their individual and small group plan offerings to the PPACA’s “essential health benefits” requirement.  The several options proposed by the CCIIO for calculating the “actuarial value” of covered benefits, which include standardized data and an actuarial value calculator, aims to produce comparisons across plans within a state that focus on cost-sharing differences rather than other differences between plans, such as different provider payment rates and utilization patterns.  The PPACA tiers of benefit types must meet the following percentages of the actuarial value of essential plan benefits: Bronze plans must cover 60%; Silver plans must cover 70%; Gold plans must cover 80%; and Platinum plans must cover 90%.  The CCIIO also provided a FAQ on its website stating that states will have to defray the costs of any state-mandated health benefits that exceed the PPACA mandated “essential health benefits” under the so-called “benchmark” plans they choose to offer under their state-based health insurance exchanges in 2014 and 2015.

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