WASHINGTON WIRE
February 13, 2009
Issue 190
House Passes Economic Recovery Package; Senate Expected to Vote before Recess
Court Reverses Decision to Release Medicare Claims Data
Senate Budget Committee Holds Healthcare Reform Hearing
Top Story
House Passes Economic Recovery Package; Senate Expected to Vote Before Recess
On Friday, February 13, the House voted to pass the final version of the American Recovery and Reinvestment Act (ARRA), with no Republicans voting in favor of the bill. At time of publication Friday evening, the Senate was holding the vote open for Senators returning from out of town. Just two votes shy of 60 with two Democrats left to cast their votes, the Senate was fully expected to pass the stimulus and send the conference bill to the President for signature.
The final version of the stimulus package would provide funding for infrastructure and for state programs, including over $80 billion for Medicaid. The Conferees distributed 65 percent of the increased Federal Medical Assistance Percentage (FMAP) funds across all states and 35 percent of the funds towards states with higher unemployment rates. The conference report also required states to comply with prompt pay requirements upon acceptance of the FMAP funds.
The final bill would also extend the moratoria on four controversial Medicaid regulations while urging HHS to refrain from finalizing three other proposed rules, including one on rehabilitation services.
In addition, the bill would provide $10 billion in increased funding for NIH. ARRA would also provide funding for comparative effectiveness research, implementation of health information technology and COBRA subsidies for individuals who lose their job in the recession.
Health Care News
Court Reverses Decision to Release Medicare Claims Data
The U.S. Court of Appeals for the District of Columbia recently found that the Medicare program properly rejected a Freedom of Information Act (FOIA) request for physician claims data that would have resulted in public disclosure of Medicare reimbursement amounts received by individual physicians. On January 30, 2009, the court reversed a 2007 decision by a lower court that would have required the U.S. Department of Health and Human Services (HHS) to release Medicare claims data on individual physicians. PPSV attorneys Rob Portman, Ron Connelly, and Hilton Marcus represented a group of sixteen medical professional societies, which submitted an amicus (friend of the court) brief in support of the government's refusal to release the data.
The plaintiff, Consumers' Checkbook, a D.C.-based consumer group, hoped to access the data to determine the number of times physicians perform certain procedures which the group claimed would allow the public to better assess the quality of physician services. The data, when used with the widely available Medicare physician fee schedule, would have revealed information about individual physicians' Medicare reimbursement.
The appeals court held that the government was justified in protecting the requested data from disclosure under a FOIA exception that permitted such denials if disclosure would result "in a clearly unwarranted invasion of personal privacy." In this case, the court found that physicians, as private citizens, have a substantial right to privacy in their financial information, including claims that are paid by Medicare. In addition, the majority of the court did not accept Consumers' Checkbook's assertion that the volume of procedures conducted by an individual physician was an indicator of quality of care.
A similar lawsuit between Real Time Medical Data, a company that supplies Medicare claims data to hospitals and other healthcare organizations, and HHS over the release of physicians' outpatient Medicare claims data in five Southern states is currently under appeal in the U.S. Eleventh Circuit Court of Appeals, located in Atlanta, Georgia.
Senate Budget Committee Holds Healthcare Reform Hearing
On Tuesday, February 10, the Senate Budget Committee discussed healthcare reform with Congressional Budget Office Director Douglas W. Elmendorf. Repeating what is becoming a common theme in healthcare reform conversations, Chairman Kent Conrad (D-ND) said that lawmakers need to prioritize initiatives that cut costs while improving quality.
Private and public health care spending are on track to reach 37 percent of the gross domestic product in 2050, Conrad said. For his part, Elmendorf discussed cost-cutting options such as capping the tax exclusion for employer based health care and broadening coverage through an individual mandate. Elmendorf told Senators that they would need to shift more of the healthcare costs to the patient and suggested hiking cost-sharing by Medicare beneficiaries, as well as linking Medicare reimbursements to value instead of procedures.
Upcoming Events
Hearings
Currently, no hearings are scheduled for this week.
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