Weekly Washington Healthcare Update - May 13, 2013

  1. CONGRESS

    House of Representatives

    Ways and Means Hearing on Physician Payments

    On Tuesday, the Ways and Means Health Subcommittee held a hearing to examine options in the development of a viable Medicare physician payment policy. Members focused on building upon a framework proposal established by the Ways and Means Committee in conjunction with the Energy and Commerce Committee. Witnesses urged Congress to adopt a new Medicare physician payment system that includes a five-year transition from the current payment formula and provides positive payment updates during that time while financially rewarding doctors for providing high-quality care. However, even with the Congressional Budget Office (CBO) recently scoring a 10-year freeze of physician payments, in lieu of drastic cuts called for by the sustainable growth rate (SGR) formula, offsetting the cost of a permanent fix to Medicare physician payments remains a significant obstacle.

    Witness List:

    David Hoyt, M.D. Executive Director American College of Surgeons

    Kim Allan Williams, M.D. Past President American Society of Nuclear Cardiology

    Charles Cutler, M.D. Chair, Board of Regents American College of Physicians

    Frank G. Opelka, M.D. Vice-Chair, Consensus Standards Approval Committee National Quality Forum

    Patrick Courneya, M.D. Medical Director HealthPartners Health Plan

    For more information: waysandmeans.house.gov

    Energy and Commerce Rx Security Markup Scheduled

    The Energy and Commerce Committee has scheduled a full committee markup in order to consider, among other legislation, a bill introduced by Rep. Latta (R-OH) to establish a national regulatory framework to enhance the safety and integrity of the nation's pharmaceutical distribution system. The legislation was reported out of the Health Subcommittee by voice vote on Wednesday, despite opposition from some Democrats, who largely fear that the legislation doesn't provide enough certainty that unit-level tracing will be achieved, and that it could hamper ongoing efforts to implement similar policies.

    GOP Not Interested in IPAB Nominations

    Last week, House Speaker Boehner (R-OH) and Senate Minority Leader McConnell (R-KY) sent a letter to President Obama confirming that they would not be nominating any potential appointees to the Independent Payment Advisory Board (IPAB) established under the ACA as a cost control mechanism for Medicare. The board would make binding spending reduction proposals when Medicare spending exceeds an indexed threshold. Congress would have to replace the recommendations with equal or greater cuts if it disagreed with the panel's recommendations. Though the CMS Actuary recently affirmed that Medicare spending growth was not sufficient in recent years to trigger such action on the part of IPAB, Republicans have consistently criticized the board as unelected bureaucrats who would interfere with beneficiary access to care. "We believe Congress should repeal IPAB," Boehner and McConnell wrote, "just as we believe we ought to repeal the entire health care law."

    Small Business Committee Hearing on Health Insurance Tax

    Last week, the Small Business Subcommittee on Health and Technology held a hearing titled "The Health Insurance Fee: Impact on Small Businesses," in which members explored a fee on fully insured health insurance that starts in 2014 under ACA, with concern over whether the fee will hurt small businesses more than large companies. According to a study conducted by the National Federation of Independent Business (NFIB) the fee will raise premiums of employer-sponsored insurance by as much as 3 percent, costing nearly $5,000 per family over a decade. The fee and other ACA taxes on businesses that will benefit from health reform are levied to pay for expanding coverage under the law to an estimated 27 million people.

    Witnesses:

    Mr. William Dennis, Jr. Senior Research Fellow NFIB Foundation

    Mr. Ryan P. Thorn Ryan P. Thorn Insurance Planning Testifying on behalf of the National Association of Health Underwriters

    Mr. Paul N. Van de Water Senior Fellow Center on Budget and Policy Priorities

    Mr. Dean Norton President New York Farm Bureau

    For more information, or to view the hearing, please visit: smallbusiness.house.gov

    Senate

    HELP Hearing on Pharmaceutical Compounding

    On Thursday, the Senate HELP Committee held a hearing to explore efforts on the part of the FDA and industry groups to oversee the operation of pharmaceutical compounders, such as the New England Compounding Center, which was responsible for more than 50 deaths as a result of contaminated drugs. Chairman Harkin (D-IA) has circulated a draft of legislation that would require compounding pharmacies that produce drugs without a prescription and then sell them across state lines to be licensed under a newly created category of compounding manufacturers. Compounding pharmacies have long been the subject of regulatory confusion between the FDA and state authorities as a result of the unique space in which they operate, it often being difficult to distinguish whether the compounder is operating as a bulk manufacturer or serving specific patients in response to a prescription. Chairman Harkin expects to formally mark up his draft legislation before the Memorial Day recess.

    Witnesses:

    Panel I Dr. Janet Woodcock Director, Center for Drug Evaluation and Research Food and Drug Administration, U.S. Department of Health and Human Services

    Panel II Carmen S. Catizone Executive Director National Association of Boards of Pharmacy, Mount Prospect, IL

    Allan Coukell Director, Medical Programs The Pew Charitable Trusts

    David G. Miller Executive Vice President and CEO International Academy of Compounding Pharmacy

    Dr. Kasey K. Thompson Vice President, Office of Policy, Planning and Communications American Society of Health-System Pharmacists

    For more information, or to view the hearing, please visit: help.senate.gov

    Tavenner Confirmation Vote Scheduled

    After repeated threats from senators on both sides of the aisle, including a hold proposed by HELP Chairman Harkin (D-IA) as a result of HHS's decision to tap into funds Harkin championed for prevention activities in the ACA, CMS Acting Administrator Tavenner seems to have cleared the final hurdles remaining before a final confirmation vote by the full Senate. The Finance Committee approved her nomination earlier this year by voice vote. Tavenner would become the first confirmed administrator since 2006.

    Finance Committee Asks Docs for Medicare Payment Reform Ideas

    On Friday...

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