WASHINGTON WIRE
May 1, 2009
Issue 198
Senate Finance Leaders Release Healthcare Delivery Reform Options
CMS Proposes Payment Update for IRFs
IOM Recommends Ban on Gifts from Drug and Device Companies to Physicians
Congress Passes FY 2010 Budget Resolution
Obama Asks for Funding to Fight Possible Pandemic
Senate Confirms Sebelius for HHS Secretary
Top Story
Senate Finance Leaders Release Healthcare Delivery Reform Options
On April 28, Senate Finance Committee Chairman Max Baucus (D-MT) and Ranking Member Charles Grassley (R-IA) released policy options for healthcare delivery reform entitled "Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs." The release followed two sessions - one public, the other private - at which stakeholders and committee members discussed options for reforming the Medicare delivery system. The Committee will hold four more healthcare reform sessions, two each on coverage and financing (two public).
The Senate Finance Committee will accept public comments on the policy options presented in the document until May 15. The Senate Finance and HELP Committees plan to mark-up healthcare legislation in mid-June. The House is on a slower time track.
In the document (soon to be posted to our website), the Committee organizes the policy options into the following categories:
- Payment Reform - Improving Quality and Promoting Primary Care
- Payment Reform - Fostering Care Coordination and Provider Collaboration
- Health Care Infrastructure Investments - Tools to Support Delivery System Reform
- Medicare Advantage - Promoting Quality, Efficiency and Chronic Care Management
- Public Program Integrity - Combating Fraud, Waste and Abuse
Health Care News
CMS Proposes Payment Update for IRFs
On April 29, CMS released a proposed rule updating the FY 2010 prospective payment system (PPS) rates for inpatient rehabilitation facilities (IRFs). Comments on the proposed rule are due June 29 and CMS said it will finalize the rule on or before August 1.
CMS said the marketbasket update would increase payments by $140 million; the rule would also decrease the outlier threshold amount, adding another $10 million to payments. The proposed rule would also clarify requirements for preadmission screening for rehabilitation services in an IRF. The proposed rule would require that IRFs provide rehabilitation nursing, physical therapy, occupational therapy, speech language pathology, social services, psychological services, and prosthetic and orthotic services using qualified personnel.
IOM Recommends Ban on Gifts from Drug and Device Companies to Physicians
On April 28, the Institute of Medicine released a report recommending new regulations to ban gifts from drug and device companies to doctors and to expand disclosure of physicians' and scientists' relationships with industry. The IOM report suggests that there should be a focus on preventing conflicts of interest rather than addressing them after they occur. The report also concluded that disclosure of individual and institutional financial relationships is a critical because it is believed that greater disclosure requirements may help prevent practitioners from engaging in questionable practices.
The IOM committee developed a total of 16 recommendations, including that institutions should develop conflict of interest committees; institutions should disclose financial relationships with pharmaceutical, medical device, and biotechnology companies; relevant national organizations should establish a standard content, a standard format, and standard procedures for the disclosure of financial relationships with industry; and Congress should create a national program on disclosure.
Congress Passes FY 2010 Budget Resolution
On Monday, April 27, the Senate and House Budget Committees released details on a budget agreement for FY 2010 that in some areas tracks President Obama's budget requests, such as his healthcare agenda. On Wednesday, the House passed the $3.4 trillion budget resolution on a 233-193 party line vote. That evening, the Senate passed the resolution 53-43.
The budget resolution instructs Senate and House Committees with jurisdiction over healthcare programs to, if necessary, use a controversial procedural tactic known as "budget reconciliation" to overcome minority (Republican) objections to reduce the deficit over a five-year period. It also includes a deficit-neutral healthcare reserve fund to expand coverage, improve healthcare quality and outcomes and constrain costs, but the budget resolution does not indicate an amount - leaving it up to the committees of jurisdiction to determine the size of the reserve fund and offsets on existing spending. Though the budget resolution does not offer a permanent physician fee fix, it states that the future policy is yet to be determined and that reserve funds are meant to accommodate legislative improvements in Medicare's system for paying physicians.
Obama Asks for Funding to Fight Possible Pandemic
In the midst of growing fears over a swine flu pandemic, President Obama has asked Congress for over a $1 billion in funding to fight the spread of the virus. The U.S. Centers for Disease Control had confirmed 141 cases of the swine flu across 19 states in the U.S., including one death of a Mexican toddler in Texas. The alert level at the World Health Organization is now at 5 on its scale of 6, indicating that the probability of a pandemic is high.
Senate Confirms Sebelius for HHS Secretary
On Tuesday, April 28, the Senate confirmed 65-31 Governor Kathleen Sebelius as HHS secretary. Sebelius' nomination came March 2 on the heels of Secretary-designate Tom Daschle's withdrawal of his nomination because of tax issues.
Upcoming Events
Hearings
Tuesday, May 5
Health Care Overhaul
Senate Finance Committee
10 a.m., 106 Dirksen Bldg
Wednesday, May 6
'Health Reform in the 21st Century'
House Ways and Means Committee
Full Committee Hearing
10 a.m., 1100 Longworth Bldg.
Medicare and Medicaid Fraud
Senate Special Aging Committee
Full Committee Hearing
2 p.m., 216 Hart Bldg.
Thursday, May 7
Flu Virus Preparedness
House Education and Labor Committee
Full Committee Hearing
10 a.m., 2175 Rayburn Bldg.
VA's Health Infrastructure
House Veterans' Affairs - Subcommittee on Health
Subcommittee Hearing
10 a.m., 334 Cannon Bldg.
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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