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.


Senate to Rethink Budget Resolution

As Congress turns this week from a two week recess, the sparing over the House budget and the Senate’s insistence on the $1.047 trillion spending cap under the Budget Control Act will likely continue to impede a two-house compromise on the final spending targets for all twelve FY 2013 appropriations bills.  Although Senate Majority Leader Harry Reid has declared the House budget resolution all but dead in that body, Senate Budget Chairman Kent Conrad has indicated that his committee will, nonetheless, go ahead and try to garner enough votes to pass their own version of an FY 2013 spending plan.

Republicans Question IRS PPACA Funding

House Ways and Means Committee Chairman Dave Camp and Oversight Subcommittee Chairman Charles Boustany sent a letter last week to the IRS Commissioner Douglas Shulman asking the service to provide detailed information on IRS funding needs to implement the PPACA and to explain how many new employees are being hired to implement the law and which of the tax increases in the law they will be working on.  They also sought information on any requests for money from the Department of Health and Human Services Health Insurance Reform Implementation Fund since May 13, 2011 and explain whether the IRS intends to seek additional funds from HHS.  Apparently the Administration has transferred an additional $500 million to the IRS while the President’s FY 2012 budget requested $473 million and another $360 million for FY 2013.

No Plan for Adverse Supreme Court Decision

HHS Secretary Kathleen Sebelius said that while it is “probably” a good idea for the department to have a contingency plan for the PPACA in the event the Supreme Court strikes down some or all of the law’s provisions, she indicated that a backup plan is not “where conversations we are headed right now.”  The Administration also called into question Medicare Trustee Charles Blahous’ estimate of the real ten year costs of the PPACA.  His Mercatus Center paper, The Fiscal Consequences of the Affordable Care Act, said the law would add $346 billion to the federal deficit in 2012-2021 under an optimistic scenario and as much as $527 billion under a pessimistic scenario.  The White House responded that this was just “another attempt to refight the battles of the past” and that “one former Bush Administration official is wrongly claiming that some of the savings in the Affordable Care Act are ‘double-counted’ and that the law actually increases the deficit.  This claim is false.”

Report on Medicare Wage Index System

HHS transmitted to Congress the PPACA mandated report on how the Medicare inpatient prospective payment system (IPPS) should use a comprehensively reformed wage index system to better reflect geographic differences in the cost of labor.  Instead of using the current wage indices for general labor market areas, not for individual hospitals, the report suggests using a Commuting Based Wage Index (CBWI) that utilizes commuting data to establish a labor market area and wage index value for each hospital.  HHS said using the CBWI could accomplish the major goals of moving towards a wage index system that yields greater accuracy and less distortion.  Statutory and regulatory changes would be required to implement the proposed change.

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