GOP Backing Away From Plans To Repeal ACA, Overhaul Safety-Net Programs.
The Wall Street Journal (1/9, Peterson, Armour, Subscription Publication) reports that GOP lawmakers are scaling back plans to reform safety-net programs and repeal the ACA after President Trump and party leaders participated in a retreat over the weekend. The article says they are now focusing on a smaller agenda which will emphasize the basics, such as funding the government, increasing the debt limit, and reaching a compromise on immigration.
Legislation and Policy
Sen. Alexander Says Trump Supports ACA Stabilization Bill.
The Hill (1/9, Sullivan) reports that on Tuesday, Sen. Lamar Alexander (R-TN) said “he spoke to President Trump on Monday about a bipartisan bill aimed at stabilizing ObamaCare markets and that Trump again expressed his support for the measure.” Advocates of the measure, called “Alexander-Murray, had planned to attach it to a government funding bill last month but had to punt after Congress opted for a slimmed-down, short-term spending measure instead.” Now, they hope “to pass the bill when Congress acts on a long-term funding package in the coming weeks, but they still face opposition from House conservatives who say the measure is simply throwing more money at ObamaCare.”
Two Maryland State Legislators Propose State-Level Individual Mandate.
The Washington Post (1/9, Hicks) reports two Maryland state legislators, state Sen. Brian J. Feldman (D) and Del. Joseline Peña-Melnyk, said they will introduce a bill that would impose a state-level individual mandate. The article says state Sen. Jim Rosapepe (D), the Maryland NAACP, Baltimore City Health Commissioner Leana Wen, and the Maryland Citizens Health Initiative support the measure.
The AP (1/9, Witte) reports advocates of the measure said “it could also work in other states to help keep insurance premiums from skyrocketing.”
Public Health and Private Healthcare Systems
CBO Cuts Cost Estimate For Reauthorization Of CHIP.
The AP (1/9, Fram) reports that the Congressional Budget Office says the Senate’s bill to reauthorize the Children’s Health Insurance Program for five years would cost $800 million. The CBO had previously estimated that the funding would cost $8.2 billion. The AP adds, “The budget analysts say extending the children’s insurance program will encourage some parents to use that program and not the marketplaces,” which “would save the government money.”
The Hill (1/9, Greenwood) reports that the CBO “drastically lowered its estimate” of the costs to renew CHIP, “likely making it easier for lawmakers to agree on a plan for extending the program.” Funding for CHIP expired in the fall, then Congress provided temporary funding that “was supposed to last through March, but states could run out of money for the program well before then.” CBO Director Keith Hall explained the estimate in a letter to Senate Finance Committee Chairman Orrin Hatch (R-UT), and said the new amount was “because of a provision in the recently signed tax bill eliminating the Affordable Care Act’s individual mandate requiring people to purchase health insurance.”
Georgia Owes Federal Government $665,000 Due To Duplicate Medicaid Payments, OIG Says.
The Atlanta Journal-Constitution (1/9, Norder) reports that the Georgia Department of Community Health mistakenly issued multiple Medicaid ID numbers to hundreds of patients, resulting in duplicate payments that will cost the state $665,000 to refund to the federal government, according to an audit by the Office of Inspector General for the US Department of Health & Human Services. The OIG sampled monthly payments to managed care for Medicaid recipients and found that of the 100, the state had made duplicate payments for 72 of them. Georgia officials said that they “may have already recovered and refunded the federal portion of some over-payments.”
Illinois Lawmakers Consider Revamping Hospital Assessment Program That Pays For Medicaid.
Modern Healthcare (1/9, Schorsch, Subscription Publication) reports that Illinois lawmakers, Gov. Bruce Rauner’s (R) Administration, and lobbyists are pushing to reform the state’s hospital assessment program. Currently, the assessment dollars from hospitals are sent to CMS “for a match,” and then the state “redistributes funds based on claims data for Medicaid services provided in the hospital in 2005 and on an outpatient basis in 2009,” which some say is outdated and “doesn’t reflect where Medicaid patients seek treatment” now. The article explains that the “revamp could drastically alter the hospital landscape in Illinois” and it is “causing major anxiety among hospital executives.” A public hearing on the changes is scheduled for January 11.
CMS Expands Medicare Coverage Of Insulin Pumps.
Modern Healthcare (1/9, Dickson, Subscription Publication) reports that on January 5, the Centers for Medicare and Medicaid Services expanded coverage for innovative insulin pumps for Medicare beneficiaries with diabetes. In an “under-the-radar-notice,” CMS “alerted Part D sponsors that they can cover new products on the market that deliver insulin,” such as those that deliver through the skin directly rather than through a tube. CMS does not mandate that Part D sponsors cover the new products, however. Sen. Susan Collins (R-ME), who sent a letter to CMS Administrator Seema Verma last year urging the move, said in a statement, “Most private insurers already cover these proven devices, and it defied common sense that Americans with diabetes would lose this coverage when they qualified for Medicare.”
CMS Announces New Voluntary Bundled Payment Model.
Modern Healthcare (1/9, Castellucci, Subscription Publication) reports that the Centers for Medicare and Medicaid Services announced Tuesday “a new voluntary bundled-payment model that will be considered an advanced alternative payment model under MACRA.” The new model, called the Bundled Payments for Care Improvement-Advanced Model, “includes 32 clinical-care episodes that providers can choose from, 29 of which are in the inpatient setting and three in the outpatient setting.”