WASHINGTON WIRE
July 16, 2009
Issue 208
SENATE HELP COMMITTE PASSES HEALTH BILL; OBAMA PUSHES FOR VOTES BY RECESS
HOUSE COMMITTEES BEGIN MARK UP OF REVISED HEALTHCARE REFORM BILL
HELP COMMITTEE PASSES AMENDMENT TO PROVIDE DATA PROTECTIONS FOR DRUGMAKERS
IOM ADDRESSES NURSE WORKFORCE SHORTAGE
HOUSE COMMITTEE CONTINUES WORK ON SPENDING BILL
OIG REPORT QUESTIONS ULTRASOUND BILLING PROCEDURES
OBAMA ANNOUNCES PICK FOR SURGEON GENERAL NOMINATION
Top Story
SENATE HELP COMMITTE PASSES HEALTH BILL; OBAMA PUSHES FOR VOTES BY RECESS
In a very busy week for healthcare reform in Congress, the Senate HELP Committee July 15 passed their portion of a healthcare reform bill along a party line vote, 13-10. But advocates for reform still face a tough battle, as the Senate Finance Committee continues to delay release of their version while they attempt to negotiate a bipartisan compromise. The Affordable Health Choices Act includes an employer mandate and public insurance option, both of which cause consternation among Republican members. While Democratic members of the Committee believe the bill dramatically expands coverage for the uninsured, Republicans worry that the cost of the reforms could further cripple the healthcare system.
Also this week, President Obama met with Democratic Congressional leaders to reiterate his commitment to passing a bill this year, and to pressure the lawmakers to vote on the bills before the August recess. Although Obama has not said that waiting for September would be a signal of defeat for Democrats, President Obama would much prefer the House and Senate pass a healthcare reform bill before August recess. Obama's goal is to sign a healthcare reform bill in October. He told a group of reporters in Italy that passing healthcare reform would be his highest priority over the next month.
However, it appears more and more unlikely that the Senate will hold a floor vote before their scheduled departure, August 8. The Administration is asking Congress to stay longer into August if necessary to finish a healthcare reform package. In the meantime, the White House said that it met on Wednesday afternoon with three Republican Senators – Senators Lisa Murkowski (AK) Saxby Chambliss (GA) and Bob Corker (TN) — to discuss health care reform.
Health Care News
HOUSE COMMITTEES BEGIN MARK UP OF REVISED HEALTHCARE REFORM BILL
The House Tuesday, July 14, released a revised healthcare bill, HR 3200, which the committees of jurisdiction will be begin marking up immediately, even as moderate Democrats in the House and Senate raise doubts about many of the revenue provisions in the House legislation. The bill, which is over one thousand pages, creates a public health care plan option, includes individual and employer mandates and reforms Medicare payment policies.
The most controversial means for paying for the reforms HR 3200 include a surcharge on high-income individuals of 1 percent for those with income exceeding $350 thousand, 1.5 percent after $500 thousand and 5.4 percent after $1 million. Also included is a tax on businesses making over $400 thousand that fail to provide health insurance to their employees.
House Democratic leaders have faced some resistance from moderate Democrats, forty-two of whom sent House Speaker Pelosi a letter raising concerns about the cost of the first draft of the House bill. Those concerns were reinforced when the CBO released a score for the bill that priced it over $1 trillion. The CBO analysis also said it would dramatically decrease the number of Americans without healthcare insurance coverage. But it is in that expansion of coverage and entitlements which could lead to increased health costs, instead of cutting costs, a CBO official warned the Senate Budget Committee this week.
The three House Committees of jurisdiction begin marking up the bills this week, indicating that a House vote on the bill by the August recess is possible. President Obama continues to push for a vote on the bill by the August recess.
HELP COMMITTEE PASSES AMENDMENT TO PROVIDE DATA PROTECTIONS FOR DRUGMAKERS
During the mark up of their healthcare reform bill, the Senate HELP Committee passed an amendment to give biologic drug developers more protections from competition with generic manufacturers. The committee voted 16-7 to give companies 12 years of data exclusivity. During the 12-year period, a generic company would be prohibited from using the brand company's data to seek approval of a bio-generic. The amendment was sponsored by Republican Senators Michael Enzi (R-WY) and Orrin Hatch (UT), as well as Democratic Senator Kay Hagan (D-NC). A number of HELP Committee members that opposed the amendment favored a similar proposal that would have granted data exclusivity for 7 years. This amendment failed 5-17.
IOM ADDRESSES NURSE WORKFORCE SHORTAGE
This week, the Institute of Medicine (IOM), and the Robert Wood Johnson Foundation (RWJF) initiated a new study on the future of nurses in health care. RWJF predicts that in 2025, the nation will face a nursing shortage of half a million. Former HHS Secretary Donna Shalala and Cedars-Sinai Medical Center Director of Nursing Research Linda Burnes Bolton will lead a study committee in reviewing nursing care and education models. The committee’s report will offer ideas about nurses’ role in healthcare reform, including by increasing quality and decreasing costs.
HOUSE COMMITTEE CONTINUES WORK ON SPENDING BILL
The full House Appropriations Committee is scheduled to mark up the FY 2010 Labor, Health and Human Services and Education bill this Friday, July 17. Last week, the Appropriations Subcommittee approved the draft spending bill, worth a total of $730.5 billion. The bill allocates $64.7 billion for the Department of Education - $7.8 million less than requested. If enacted, HHS would receive a $6 billion increase from last year, to reach a total of $73.7 billion. The draft bill gives the Department of Labor $13.3 billion, an $845 million increase from 2009 and about $23 million less than requested.
OIG REPORT QUESTIONS ULTRASOUND BILLING PROCEDURES
In its July 10 report, the HHS Office of Inspector General determined there is questionable spending on national Medicare ultrasound billing. The report, Medicare Part B Billing for Ultrasound, stated that only 20 counties are accountable for 16 percent of the national total for ultrasound billing. The costs for ultrasounds in those counties were over three times higher than in lower-use counties. The OIG recommended that CMS provide closer oversight of ultrasound billing expenses.
The report shows that there are discrepancies in the billing process. For example, the report found that the same beneficiary could receive over five ultrasound services in one day from one doctor and that proper identifying information for doctors in the claims field was sometimes lacking. The most common billing process discrepancy involved doctors ordering ultrasounds prior to making service claims.
OBAMA ANNOUNCES PICK FOR SURGEON GENERAL NOMINATION
On Monday, July 13, President Obama announced he will nominate the founder and chief executive officer of a rural health clinic, Regina Benjamin, as the next U.S. surgeon general. Benjamin is a recipient of the Nelson Mandela Award for Health and Human Rights in 1998 and of the MacArthur Foundation Genius Award. The date is yet to be set for Benjamin's Senate confirmation hearing.
Upcoming Events
Hearings
Monday, June 20
H.R. 3200, The America's Affordable Health Choices Act Of 2009 Markup, Day 3
House Energy and Commerce Committee
2123 Rayburn House Office Building
Tuesday, June 21
H.R. 3200, The America's Affordable Health Choices Act Of 2009 Markup, Day 4
House Energy and Commerce Committee
2123 Rayburn House Office Building
Wednesday, June 22
H.R. 3200, The America's Affordable Health Choices Act Of 2009 Markup, Day 5
House Energy and Commerce Committee
2123 Rayburn House Office Building
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