WASHINGTON WIRE
September 14, 2007
Issue 145
In this issue, you'll find:
Weems Vows Greater Transparency at CMS
CMS Issues Third and Final Part of Self Referral Regulations
Top Story
SCHIP Negotiations Continue
Unofficial negotiations between House and Senate leadership continued this week in an effort to reach a compromise on a State Children's Health Insurance Program (SCHIP) reauthorization bill.
The House and Senate approved two vastly different SCHIP bills. The Senate's $35 billion SCHIP reauthorization bill is funded entirely by a 61-cent increase in tobacco taxes and contains no provisions impacting Medicare or Medicaid programs. However, the House bill would reauthorize the SCHIP program at approximately $47 billion over five years through a 45-cent tobacco tax increase and cuts to the Medicare Advantage program. The House bill also contains several other Medicare and Medicaid provisions including a 2-year Medicare physician payment fix.
Negotiations between House and Senate leaders are centered on differing funding levels for SCHIP and the inclusion of Medicare provisions in the final bill. House Democrats do not want to lower their SCHIP funding level to get closer to the Senate's level and cannot fund their bill without cuts to Medicare Advantage and other Medicare provisions. Senate leaders want to pass a "clean" SCHIP bill and state that they will loose their bipartisan support should they make cuts to the popular Medicare managed care program. Some House members are indicating that they are considering separating their SCHIP and Medicare packages in order to reach a compromise with the Senate, but no official statements have been made.
The Bush Administration has issued a formal veto threat on both the Senate and House legislation on philosophical grounds, categorizing such expansions of children's health insurance as a move toward government-run healthcare. The President has sought a modest $5 billion SCHIP reauthorization.
Without a consensus this week and the SCHIP program set to expire on September 30th, it appears possible that Congress will have to pass a shot-term extension of the SCHIP program, potentially as part of a larger continuing resolution (CR) to fund the government prior to completion of the annual spending bills. However, there are indications that a breakthrough between the House and Senate negotiators is possible as well, which could result in a final bill that more closely resembles the Senate bill, rather than the House bill. This would allow for completion on a reauthorization bill before the end of the month.
Health Care News
Weems Vows Greater Transparency at CMS
During a press conference on Tuesday, new Acting Administrator for the Centers for Medicare and Medicaid Services (CMS), Kerry Weems, made it clear that he plans to conduct business "in the daylight" and keep an "arms-length" from CMS contractors.
Weems was appointed as Acting Administrator to the agency last week and his nomination is currently pending before the Senate Finance Committee.
Weems stated that they agency will not be issuing "cocktail hour press releases," targeting the recent Friday-evening-release of a letter to states regarding controversial changes to the State Children's Health Insurance Program (SCHIP). In contrast, the Acting Administrator pointed to a letter he sent last Friday prior to 9:00am denying a New York State SCHIP expansion.
He also pointed to other CMS Medicare priorities including changes to the Medicare Advantage program, competitive bidding for durable medical equipment, and quality of care.
CMS Issues Third and Final Part of Self Referral Regulations
On September 5, 2007, the Centers for Medicare and Medicaid Services (CMS) published Phase III of its regulations interpreting the Stark law's prohibition on physician self-referrals in the Federal Register.
The regulation was long awaited, with Phase II having been published more than three years ago, and further clarifies and modifies various exceptions under the self-referral rule.
PPSV has compiled a summary of the regulation which can be found at http://www.ppsv.com/assets/attachments/26.PDF.
Please contact Mark Fitzgerald for more information at 202.466.6550 or mark.fitzgerald@ppsv.com.
Upcoming Events
Hearings
Tuesday, September 18, 2007
9/11 Health Effects
House Energy and Commerce - Subcommittee on Health
10 a.m., 2322 Rayburn
Family and Medical Leave for Military Families
House Education and Labor - Subcommittee on Workforce Protections
2 p.m., 2175 Rayburn
Wednesday, September 19, 2007
Report on Care for Returning Wounded Soldiers
House Veterans' Affairs Committee
10 a.m., 334 Cannon
Thursday, September 20, 2007
First Responder Health and Safety
House Homeland Security Committee
10 a.m., 311 Cannon
For More Information
For further information on any topics discussed or publications listed, or to get copies of anything mentioned in this alert, please call 202.466.6550 and ask for the Legislative Practice Group.
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