WASHINGTON WIRE
October 5, 2007
Issue 148
In this issue, you'll find:
President Vetoes Children’s Health Bill
Study Reports Economic Impact of Chronic Disease
CMS Issues Proposed Rule to Redefine Medicaid Outpatient Services
Top Story
President Vetoes Children's Health Bill
On Wednesday, with little fanfare, President Bush vetoed legislation to reauthorize the State Children's Health Insurance Program (SCHIP) and invest an additional $35 billion into the program.
A Democratic priority this year, the SCHIP bill has received wide national support. The bill would provide health coverage to 10 million children, 4 million of whom are not already covered by the program, by increasing SCHIP spending from $25 billion to $60 billion over five years. (The additional spending would be fully paid for by a 61-cent increase in the tobacco tax.) The President has staunchly opposed such an increase, stating that it represents a step toward government-run healthcare and that many children who currently have, or are eligible for, private insurance will instead opt for SCHIP coverage.
The veto came as no surprise to SCHIP supporters, who had been lobbying the President for weeks to change his position on the legislation, and the bill now heads back to Congress for an override vote. The Senate originally approved the children's health bill by a vote of 67-29 - a veto-proof margin. However, the House voted 265-159 last week in favor of the bill, 19 votes short of a veto override.
The House is schedule to vote on October 18th and Democratic leaders will work hard over the next few weeks to garner additional favorable votes. However, Republican leaders remain confident that they will be able to sustain the veto.
Health Care News
Study Reports Economic Impact of Chronic Disease
In a study released Tuesday by the Milken Institute, researchers found that chronic disease cost Americans $1.1 trillion in lost productivity and $277 billion in treatment costs annually.
The study, titled An Unhealthy America: The Economic Burden of Chronic Disease, found that more than 109 million Americans report having at least one of the seven most common chronic diseases (cancer, stroke, hypertension, diabetes, pulmonary conditions, heart disease, and mental illness), for a total of 162 million cases in 2003.
According to the study, failure to invest in disease prevention could increase the number of cases from 162 million in 2003 to 230.7 million in 2013. However, researchers estimate that modest improvements in prevention and treatment could avert 40 million cases of chronic disease and reduce the related economic impact by 27% or $1.1 trillion annually by 2023.
CMS Issues Proposed Rule to Redefine Medicaid Outpatient Service
In the September 28th Federal Register, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that would amend the regulatory definition of outpatient hospital services under the Medicaid program in order to bring it more in-line with the Medicare program's definition.
The agency is proposing to establish Medicaid payment rates for its outpatient hospital services benefit based on what Medicare pays for the same services.
Under the proposed rule, CMS would also limit coverage under the Medicaid outpatient hospital services benefit to those facility services that are included under Medicare's outpatient definition. This change would eliminate coverage under the Medicaid outpatient hospital services for non-facility physician and professional services and non-traditional outpatient hospital services such as school-based and rehabilitative services. (Medicare pays for facility services under other payment methods.)
Medicaid state plans may cover prosthetic devices, prosthetics, supplies, and orthotic devices, durable medical equipment, and clinical diagnostic laboratory services as outpatient hospital services.
The proposed rule would also require that a provider reimbursed under the Medicaid outpatient hospital services benefit have a "legal relationship" with a main provider that meets the Medicare provider requirements.
CMS states that the proposed rule is a proactive attempt to clarify and clearly define currently vague regulatory language and would not significantly alter current practices in most States. It is unclear whether States and providers will agree with the agency.
CMS is accepting public comments on the proposed regulation until October 29, 2007. The proposed rule can be found here.
Upcoming Events
Hearings
Tuesday, October 9, 2007
AIDS Relief Plan and Nutrition
House Foreign Affairs - Subcommittee on Africa and Global Health
2 p.m., 2172 Rayburn
Wednesday, October 10, 2007
Disability Benefits Report
House Veterans' Affairs Committee
10 a.m., 334 Cannon
Thursday, October 11, 2007
Safety of Food Supply
House Energy and Commerce - Subcommittee on Oversight and Investigations
9:30 a.m., 2123 Rayburn
Tax Code and Health Coverage
House Budget Committee
10 a.m., 210 Cannon
Private Insurance and Medicare Drug Coverage
House Oversight and Government Reform Committee
10 a.m., 2154 Rayburn
Restrictions on International Reproductive Health Funds
House Foreign Affairs Committee
10 a.m., 2172 Rayburn
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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