| HEALTH REFORM |
SUPREME COURT: DOJ To File First Brief in Health Reform Case; Observers Say Administration's Argument Has a Weakness
Story Highlights:
* The Department of Justice today will file its first brief to the Supreme Court in the case against the federal health reform law.
* The brief is expected to focus on whether Congress has the constitutional power to mandate that U.S. residents purchase health insurance.
* Several observers have noted a weakness in the Obama administration's defense in that it has not yet defined a so-called "limiting principle," which outlines where that constitutional power would end.
The Department of Justice on Friday will file its first brief to the Supreme Court in the case focusing on the constitutionality of the federal health reform law, The Hill's "Healthwatch" reports. The first brief is expected to center on whether it is within Congress' constitutional power to require U.S. residents to purchase health insurance through the individual mandate.
[Ed. Note: For background on the Supreme Court's review of the overhaul, click here.]
According to "Healthwatch," some observers have said that the issue of congressional power is a weakness of the Obama administration's defense of the overhaul. Some opponents of the reform law have argued that if Congress can require U.S. residents to purchase health coverage, it also can compel them to purchase other products or services. The administration argues that upholding the requirement would not lead to other mandates because the health care market is unique, in that providers are legally required to treat patients who cannot pay while insured residents and the government cover the costs.
However, observers note that the administration has not yet delineated the so-called "limiting principle" for the individual mandate, which states where Congress' power to compel U.S. residents to act ends. In the past, when courts have evaluated new applications of Congress' power, they typically have asked where the limits to those powers end, according to "Healthwatch." For example, in its ruling -- which declared the overhaul unconstitutional -- the 11th Circuit Court of Appeals stated, "Ultimately, the government's struggle to articulate ... limiting principles only reiterates the conclusion we reach today: There are none."
Ilya Shapiro, a legal scholar at the Cato Institute, said, "DOJ has to do a better job of answering, 'What goes beyond your theory of federal power?' They've been asked this in every court, and they've never satisfied the court" (Baker, "Healthwatch," The Hill, 1/5).
-- compiled by Lindsey Underwood |
|
|
IRS: Agency Should Formally Prepare for Influx of Appeals Over Health Reform Law, Treasury Audit Warns
Story Highlights:
* IRS should prepare for heavier caseloads in 2014, when major provisions of the federal health reform law take effect, according to a report from the Inspector General for Tax Administration in the Treasury Department.
* The IRS will collect penalties and issue tax credits related to the overhaul.
* The report notes that the agency has begun preparations by creating an internal website, assigning an analyst to manage health reform law-related appeals and dispatching staff members to monitor preparations.
IRS should prepare for an influx of taxpayer appeals in 2014, involving several new credits and penalties under the federal health reform law, according to an audit released Thursday by the Treasury Department's inspector general for tax administration, the Washington Times reports.
According to the audit, the IRS appeals division has begun preparing by assigning an analyst to manage appeals related to the overhaul, creating an internal website to help staff members address specific issues, and dispatching staff throughout the rest of the agency to monitor the preparations. However, the audit suggests that IRS take a more formal approach to prepare for heavier caseloads in 2014, when the agency will be responsible for ensuring U.S. residents purchase health coverage and businesses offer health plans to their workers. The agency also will pay tax credits to insurers participating in the state health insurance exchanges and to small businesses that provide health coverage for their employees.
The audit notes that the agency also has received a larger number of taxpayer appeals unrelated to the overhaul. It states, "As a consequence, the [federal health reform law] has the potential to significantly impact appeals operations with new case receipts in addition to an already growing workload" (Winfield Cunningham, Washington Times, 1/5).
-- compiled by Lindsey Underwood |
|
|
HEALTH REFORM: Wis. Gov. Says States Should Halt Implementation Until After Supreme Court Rules
Wisconsin Gov. Scott Walker (R) on Thursday said that states working to implement the federal health reform law before the Supreme Court rules on the law's constitutionality are making a "poor decision," CQ HealthBeat reports. Walker in December said he would halt all work on his state's health insurance exchange and would not use any federal funds the state has already received until the high court reviews the case in March.
[Ed. Note: For background on the case against the health reform law, click here.]
"I think for any state to move forward on that without knowing what the impact will be ... particularly any state involved in the [multistate] lawsuit, is a poor decision," Walker said (Norman, CQ HealthBeat, 1/5).
-- compiled by Lindsey Underwood |
|
|
| ACCESS, QUALITY & COST |
HHS OIG: Report Highlights Unreported Cases of Medical Errors, Other Events in Hospitals
Story Highlights:
* Hospital workers report only one of seven errors, accidents or other "adverse events" that harm hospitalized Medicare beneficiaries, according to a new report from the HHS Office of the Inspector General.
* HHS Inspector General Daniel Levinson estimated that more than 130,000 Medicare beneficiaries are affected by one or more adverse events in a single month.
* Levinson said hospital workers often did not recognize "what constitutes patient harm" or they did not realize that certain events negatively affected patient health and needed to be reported.
Just one out of every seven medical errors, mishaps and other preventable events involving Medicare beneficiaries in hospitals is reported to the appropriate authorities by workers, according to a new report from the HHS Office of the Inspector General, the New York Times reports. Such events include medication errors, overuse of painkillers and other drugs, hospital-acquired infections and severe bedsores, the study found.
HHS Inspector General Daniel Levinson said hospitals receiving Medicare reimbursements are required to "track medical errors and adverse patient events, analyze their causes" and improve care. However, the federal investigation -- which included comprehensive reviews of 293 cases where patients experienced adverse events -- found that many hospital workers are not aware of "what constitutes patient harm" or realize that particular events that harmed patients should have been reported, he noted.
According to Levinson, workers in many cases either assumed that someone else would report the problem, thought the events were so common that they did not need to be reported or "suspected that the events were isolated incidents unlikely to recur." He added that some of the most serious problems that resulted in patient deaths were not reported. He estimated that more than 130,000 Medicare beneficiaries experienced some type of adverse event in hospitals in a single month.
Meanwhile, the investigation -- which involved independent physicians who reviewed patients' records -- found that when workers reported the events, hospitals rarely changed their policies or practices to prevent recurrences. Of the 40 cases that were reported to hospital managers, 28 were investigated and just five led to changes in policies or practices.
Medicare officials said they plan to establish a list of "reportable events" that hospitals and their workers must consult. In addition, hospitals will be directed to provide workers with "detailed, unambiguous instructions on the type of events that should be reported," according to CMS (Pear, New York Times, 1/6).
-- compiled by Matthew Wayt |
|
|
| POLITICS & POLICY |
PAYROLL TAX/'DOC FIX': House Democrats on Newly Formed Committee Meet
House Democrats met on Wednesday to discuss strategies to extend payroll tax cuts for the rest of the year and fix scheduled cuts to physicians' Medicare reimbursements, MedPage Today reports. The lawmakers are members of a committee that was formed under legislation (HR 3765) that extended the payroll tax cuts and blocked Medicare pay cuts for two months, which the House and Senate passed before Christmas (Walker, MedPage Today, 1/5).
-- compiled by Matthew Wayt |
|
|
NIH: Announces Two New Divisions Under Its General Medical Sciences Institute
NIH officials on Wednesday announced the creation of two new divisions under the National Institutes of General Medical Sciences, which supports basic research and research training, CQ HealthBeat reports.
The new Division of Training, Workforce Development and Diversity and the Division of Biomedical Technology, Bioinformatics and Computational Biology will oversee programs from the former National Center for Research Resources. Officials said the new divisions each will receive the same amount of funding and most of the grants will be administered by existing staff (CQ HealthBeat, 1/4).
-- compiled by Lindsey Underwood |
|
|
RX SHORTAGES: Schumer To Introduce Legislation That Targets Price Gouging
Sen. Charles Schumer (D-N.Y.) on Thursday announced that he is introducing new legislation that would address the ongoing shortage of essential and lifesaving pharmaceutical drugs, Buffalo Business First reports (Drury, Buffalo Business First, 1/5).
[Ed. Note: For background on the drug shortages, click here.]
Schumer's bill would make drug price gouging a federal crime during drug shortages and federal emergencies, and it would create an early warning system to prevent drug shortages.
Schumer also called for a federal investigation into the so-called gray market, where drugs that are affected by shortages are sold for marked up prices (Caya, WNED, 1/5).
-- compiled by Lindsey Underwood |
|
|
INDUSTRY FUNDS: HHS Rule Aims To Streamline Electronic Transfers
HHS on Thursday released an interim final rule detailing standards for the electronic transfer of funds in the health care industry, Modern Healthcare reports. The rule, which was mandated by the federal health reform law, comes after HHS issued an interim final rule in July 2011 outlining transaction standards for checking patients' health plan eligibility and claims status (McKinney, Modern Healthcare, 1/5).
The new rule outlines the standards for the format and content of the data that a health insurer sends to its bank when it seeks to pay a claim to a health care provider electronically (Manos, Healthcare IT News, 1/5). The rule also requires the use of a trace number to automatically link medical bills from health care providers with payments from health plans (Modern Healthcare, 1/5).
Health plans also would need to use the trace number when issuing a remittance advice -- or a notice of payment -- to link the remittance advice to the corresponding medical bill. HHS estimated that the new standards would reduce administrative costs in the health care industry by $4.5 billion over the next 10 years. The department noted that the interim final rule became effective Jan. 1, and all HIPAA-covered health insurers must comply with the regulations by Jan. 1, 2014 (Healthcare IT News, 1/5).
-- compiled by Ashley Marchand |
|
|
DEMOCRATS: Criticize House GOP Majority for Health Care Focus in First Year
The Democratic Congressional Campaign Committee on Thursday criticized House Republicans for spending much of the previous year on efforts to undermine the federal health reform law and other health care-related issues, The Hill's "Healthwatch" reports.
In a statement, DCCC argued that Republicans have not been focused on job creation, highlighting 21 floor votes on various health care measures. DCCC also criticized House Republicans for "nearly shutting down the government so they could defund Planned Parenthood [and] ending Medicare so they could protect tax breaks for Big Oil" (Baker, "Healthwatch," The Hill, 1/5).
-- compiled by Santosh Rao |
|
|
| REGULATORY NEWS |
FDA: Order Surgical Mesh Manufacturers To Conduct Risk Assessments
FDA on Wednesday ordered manufacturers of implantable surgical mesh for use in women with urinary incontinence to conduct studies examining the safety risks of the devices, the New York Times reports.
Surgical mesh is included in a class of implantable devices that does not require manufacturer-administered clinical trials before being sold on the market or monitoring once they have been implanted. In 2008, FDA warned of a link between surgical mesh and certain types of complications, but the agency indicated that those instances were rare. However, complication rates increased fivefold over the following two years, the Times reports.
The new order follows a recommendation by an FDA advisory panel in September that the agency mandate safety studies for surgical mesh (Meier, New York Times, 1/4).
-- compiled by Hanna Dubansky |
|
|
| ELECTION WATCH |
SANTORUM: Says He Supports Privatizing Medicare, Eliminating CMS
| Republican presidential candidate and former Sen. Rick Santorum (Pa.) in an interview with CNN host John King said that he supports privatizing Medicare and eliminating CMS, which oversees the program, The Hill's "Healthwatch" reports. He said that CMS is where "government basically micromanages all health care through Medicare and Medicaid" (Baker, "Healthwatch," The Hill, 1/5). |
| Santorum Had Active Role in Passing Medicare Drug Benefit |
| Some conservatives are criticizing Santorum for his role in passing a 2003 law that created the Medicare prescription drug benefit, The Hill's "Ballot Box" reports. Although Santorum claims he "held his nose" while voting for the bill, "Ballot Box" reports that he urged his colleagues to vote for the program expansion, which he says was crucial to winning the support of independent voters (Cusack, "Ballot Box," The Hill, 1/6). |
| Santorum Criticizes Health Reform |
Santorum also recently criticized the federal health reform law, saying it is a scheme to keep people dependent on the federal government so that they will vote for Democrats, The Hill's "Ballot Box" reports. He added that he "wouldn't be in this race if it wasn't for ObamaCare," saying that if elected, "One of the first things I'm going to do is repeal" the overhaul (Easley, "Ballot Box," The Hill, 1/5).
-- compiled by Matthew Wayt |
|
|
| HOSPITALS & HEALTH SYSTEMS |
MASS LAYOFFS: Slowed in Final Months of 2011, Labor Data Show
The rate at which hospitals laid off 50 or more employees at one time decline in the final months of 2011, according to the latest data from the Bureau of Labor Statistics, American Medical News reports.
According to the data, there were seven mass layoffs at hospitals in November that affected at least 464 employees. According to projections based on that rate, BLS said there likely would be a total of about 120 large-scale hospital layoffs in 2011 (Stagg Elliott, American Medical News, 1/5).
-- compiled by Hanna Dubansky |
|
|
| TRENDS & TIMELINES |
HEALTH COLLABORATIVES: Businesses, Health Systems, Insurers Team Up To Address Lacking Care Quality, Rising Costs
Several businesses, health systems and insurers across the U.S. are collaborating to reduce rising health costs and improve care quality, Kaiser Health News/USA Today reports. KHN/USA Today highlights a collaborative in Oregon that allows Intel employees to see a physical therapist within 48 hours of calling, compared with waiting weeks to see a provider before the program began. According to the company, the collaborative saved $2 million in administrative costs in 2011 (Meyer, Kaiser Health News/USA Today, 1/5).
-- compiled by Matthew Wayt |
|
|
PUBLIC HEALTH: More Research Needed on Shale Gas Drilling's Effect, CDC Expert Says
More research is needed to determine whether shale gas drilling poses a threat to public health, according to Christopher Portier, director of the National Center for Environmental Health at CDC, the AP/Sacramento Bee reports.
The issue of shale gas drilling has led to "angry debates," with some saying there are obvious public health risks and others insisting those concerns are overstated, according to the AP/Bee.
Although federal and state regulators currently are studying the effect of shale gas drilling on air and water, Portier said the research should also involve "soil, plants and animals," including "livestock on farmed lands" and "recreational fish" that have contact with "potentially impacted surface waters" (Begos, AP/Sacramento Bee, 1/14).
-- compiled by Matthew Wayt |
|
|
ON THIS DAY: Jan. 6, 1995 -- Gingrich Looks To Replace Medicare
American Health Line is celebrating its 20th anniversary in 2012. Since 1992, AHL has brought its subscribers coverage of all the health policy news they need to know. In honor of the anniversary, AHL on each day of 2012 will feature a story that was published on that date from the last two decades. Here is one of those stories.
POLITICS & POLICY - MEDICARE: GINGRICH PROPOSES REVAMPED SYSTEM
Testifying before the House Ways & Means Cmte. 1/5, House Spkr. Newt Gingrich (GA) "called for replacing" Medicare, "but stopped short of providing any specifics or a timetable." Gingrich: "I think we need to transform Medicare into another system. ... I believe we can design a Medicare program which gives every senior citizen greater choice of better health care at lower cost, and, as a consequence, saves a heck of a lot of money." He said the House Budget Cmte. would consider proposals after the first 100 days of the session, in which House GOPers want to enact the "Contract With America."
OUTLOOK: W.S. JOURNAL reports that his comments "made clear" that Medicare "would come under pressure for large savings" as GOPers seek to provide tax cuts while balancing the budget. Ways & Means Cmte. Chair Bill Archer (R-TX), said, however, that Gingrich was "talking about a long-range type of thing," and that any savings from Medicare should be used to finance health reform. JOURNAL notes that in '86, Gingrich "proposed legislation to eliminate the payroll tax that finances Social Security and Medicare, with incentives for taxpayers to replace them with private-sector options." Other House GOPers "have indicated Medicare would be a big source for savings as they try to offset the cost of tax cuts." For example, Archer has said he would support higher premiums for Medicare Part B.
PUTTING IT IN PERSPECTIVE: CBO estimates project that Medicare will cost $176B in '94, which would be 11.5% of all federal spending. With no policy changes, the program's cost will increase by more than 10% a year and "consume" 18% of the budget in 2005 (Calmes/Rogers, 1/6). |
|
|
| ODDS & ENDS |
BLOGGER VS. BLOGGER: Is 'Tough Love' an Effective Anti-Obesity Strategy?
A controversial anti-childhood obesity campaign by Children's Healthcare of Atlanta has sparked a fair amount of controversy on the blogosphere. The "Strong4Life" campaign is comprised of short TV ads and billboards, each featuring an obese child telling Georgia to stop "sugar-coating" the obesity problem.
Some of the ads contain captions such as "Chubby kids may not outlive their parents" and "It's hard to be a little girl if you're not," while others say "Fat kids become fat adults" and "Big bones didn't make me this way. Big meals did." In one TV ad, a girl talks about her fear of going to school because other children tease her.
MORE>> |
|
|