OVERNIGHT HEALTH: Congress ponders Medicare rates

Now that’s entitlement reform: Rep. Bill Pascrell (D-N.J.) used Hackbarth’s testimony before Ways and Means’s Health subcommittee to push back on allegations that Democrats aren’t serious about tackling entitlement reform. Pascrell said the healthcare reform law contains several MedPAC recommendations to restructure Medicare so it pays for quality rather quantity of care through medical homes and accountable care organizations, for example.

“They miss the point about healthcare legislation because one-third of it dealt with Medicare and Medicaid,” Pascrell said. “This is entitlement reform.”

Replied Hackbarth: “We think that they are promising steps.”

Medicaid finally gets some attention, too: March 15 is also the date lawmakers chose for the annual report to Congress from the new advisory commission on Medicaid and the Children’s Health Insurance Program. Created by the 2009 CHIP reauthorization and funded by the healthcare reform law, the Medicaid and CHIP Payment and Access Commission has 17 commissioners appointed by the U.S. Comptroller General.

Rather than specific recommendations, the 244-page report recaps the history, structure and issues facing Medicaid and CHIP and lays the groundwork for future advice to Congress.

Focus on exchanges, Tea Party candidate says: Jamie Radtke, chairwoman of the Federation of Virginia Tea Party Patriots and a candidate for the state’s open Senate seat in 2012, said Monday night that Tea Party groups must put pressure on state lawmakers to block funding of state health exchanges, opening in 2014. The idea is that if enough states refuse to build the exchanges, the federal government wouldn’t have the ability to implement and operate exchanges in all of them.

“That’s one place where it can be very effective and targeted, going after the state legislatures and state governors and saying, ‘Why in the world are you taking federal ObamaCare money?'” Radtke told opponents of the reform law during a “pizza, beer and policy” event late Monday night.

Are the waivers legal? Republicans on the House Oversight Health subpanel questioned whether HHS has the authority to grant temporary waivers to the annual limits requirement included in the healthcare reform law. Republicans argued the law’s annual limits provision never explicitly mentions waivers, but Democrats said the law’s language makes a solid case for waiver authority.

More to come?: Rep. Trey Gowdy (R-S.C.), chairman of the Oversight subpanel, said he wasn’t sure whether his committee will further pursue the issue. “I think it’s interesting that expressed grants of waivers are provided in other pieces of the legislation, and then there’s a little bit of legislative footwork or statutory interpretive footwork that has to be done to reach the conclusion with respect to this piece of legislation,” Gowdy told The Hill. “Is it a fair question to ask? Yes, it is.”

Bye-bye bidding? A bipartisan pair of Pennsylvania lawmakers trying to eliminate the Medicare competitive bidding program for durable medical equipment (DME) thinks they have the momentum to get the repeal through this Congress. Legislation from Reps. Glenn Thompson (R) and Jason Altmire (D) failed in the last Congress, despite having 259 co-sponsors. The competitive bidding program, widely panned by the DME and long-term care industries, went into place in January in nine metro regions, with 91 more opening up this year. 

Medicare said the first round of bidding saved an average of 32 percent, but the program’s opponents say its payment rates will push the small suppliers out of the market and result in lower-quality medical equipment. Tyler Wilson, who heads the American Association for Homecare, said his group has been swarmed with complaints since competitive bidding opened.

“Now that it has happened, we have a demonstrable negative impact to this and I think that’s going to help the case for repeal,” Altmire said Tuesday during a press conference announcing the bill (H.R. 1041). 

Health reform tracking made easy: The National Conference of State Legislatures has just launched a searchable database of what states are doing with regard to healthcare reform. Medicaid, exchanges, insurance reforms and opt-out bills — it’s all there.

No emergency? The American College of Emergency Physicians is taking umbrage with reports out of Massachusetts and South Carolina that blame emergency-room patients for the nation’s high healthcare costs. The association is particularly worried about legislation in the Palmetto State that could keep “abusers” out of the emergency room.

“We are disturbed by reports coming from Massachusetts and South Carolina that suggest emergency patients are responsible for the high cost of health care,” said ACEP President Sandra Schneider. “Emergency care amounts to only 3 percent of all the health care spending each year in the United States. Focusing on emergency care as a source of waste in the health care system is counterproductive, as are efforts to keep a small subset of emergency patients out of the ER.”

Warning seniors:  HHS launched a nationwide radio and TV campaign Tuesday to educate consumers about Medicare fraud. 

GOP defends anti-ObamaCare record: Any disagreement among Republicans on repealing healthcare reform “involves tactics, not substance and principle,” says a new memo from the office of Majority Whip Kevin McCarthy (R-Calif.). The three-page memo outlines the House repeal vote, proposed healthcare reform cuts in the continuing resolutions and the slew of hearings held so far.

Wednesday’s agenda:

Happy birthday: Senate Finance Democrats invite HHS Secretary Kathleen Sebelius to talk to the committee about implementation of the healthcare reform law almost a year after it was enacted.

Not a happy birthday: Senate Finance Committee Republicans on Wednesday will hold a press conference to discuss the “cost and impact” of the law.

Abortion back in focus: A Ways and Means subcommittee holds a hearing on H.R. 3, which would end tax breaks for health plans that offer abortion services.

Brain safety: Sen. Tom Udall (D-N.M.) and Rep. Bill Pascrell (D-N.J.) are unveiling new legislation aimed at protecting children from sports-related traumatic brain injuries. 

Reading list:

Georgia will apply for a MLR waiver, The Associated Press reports. 

Health Net is facing a second investigation over lost patient data, the Los Angeles Times reports.

States are putting their own spin on healthcare reform, The Associated Press reports.

Lobbying registrations (since Friday):

Alston & Bird / American College of Emergency Physicians (Healthcare reform and Medicare reimbursements)

What you might have missed on Healthwatch: 

There is ‘no persuasive reason’ to fast-track Supreme Court legal challenges to healthcare reform, the Obama administration argued.

Energy and Commerce Republicans are demanding to know why and how end-of-life provisions were tucked into a Medicare regulation. 

Liberals hate proposed changes to the medical-loss ratio that would protect brokers.

Comments / complaints / suggestions?  Please let us know:

Julian Pecquet: jpecquet@digital-staging.thehill.com / 202-628-8527

Jason Millman: jmillman@digital-staging.thehill.com / 202-628-8351