OVERNIGHT HEALTH: Rate review rules expected

Rate review news coming: The Health and Human Services Department will make an announcement Thursday morning about bringing “accountability and transparency to health insurance premium increases.” 

Consumer advocates have been expecting HHS to finalize rules on rate review by the end of the month, and both sides had their complaints about the department’s initial proposal. Insurers took issue with HHS’s decision to review rate increases of 10 percent or more — a benchmark that department officials acknowledge was arbitrary.

But the healthcare law doesn’t give HHS any tools beyond the bully pulpit to block rate hikes from taking effect. Consumer advocates and some Democratic lawmakers want to give the federal government that power and have also pushed states to establish their own rate review authorities.

HHS is also accepting applications for about $150 million in grants to help states bolster their rate review programs. 

Medicare politics: House Minority Leader Nancy Pelosi (D-Calif.) on Thursday will head to Wisconsin for a speech about Medicare. She’ll be in Rep. Tammy Baldwin’s district, but more importantly in the backyard of Rep. Paul Ryan (R-Wis.), who wrote House Republicans’ plan to convert Medicare into subsidies for private insurance. The Hill’s Mike Lillis has the details.

{mosads}GOP leadership hasn’t embraced Ryan’s plan to the point of coming up with a bill, and Republicans have taken heat over the recess for supporting it. But the party apparently isn’t brooking any opposition from within its own ranks. Democrats are reveling in the furor over presidential candidate Newt Gingrich’s take on the Ryan plan. After calling it “right-wing” social engineering on Sunday, Gingrich apologized Tuesday to Ryan and said he would have voted for the plan if he was still in the House.

Healthwatch has the story on Gingrich saying it would be dishonest for Democratic ads to quote his remarks on the Ryan proposal. And The Hill also has more details on Sen. Chuck Schumer’s (D-N.Y.) enthusiasm for the Republican infighting.

Rising health costs: 

U.S. employers can expect an 8.5 percent increase in their medical costs next year due in some part to the healthcare reform law, the consulting firm PwC said in a report Wednesday.

The widely read annual report on cost trends points to three main drivers of healthcare costs, two of which are exacerbated by the new law.

At the same time, PwC said the law will have a “minimal effect” on 2012 prices because the provisions that go into effect before 2014 are “small changes for which employers already have fully accounted.” Read the Healthwatch story.

The PwC report comes as Healthcare Finance News reports that Texas-based LifeCare Holdings has entered into a definitive agreement to acquire all of HealthSouth Corporation’s long-term acute care hospitals for $120 million.

Mandate defense: The Justice Department stepped up the tone in its latest defense of the healthcare law’s coverage mandate. Although its arguments are fundamentally unchanged, the latest brief presents a sharpened defense of the policy and blunt attacks on the states that have filed suit over the requirement. Under their proposed healthcare system, the federal government wrote, the uninsured would be “left on the street after a car accident.”

Healthwatch’s Sam Baker has the story.

More state pushback: A separate, less realistic challenge from the states also advanced Wednesday. Oklahoma Gov. Mary Fallin signed a multi-state “compact” that would transfer almost all authority over healthcare programs to the states, and the same compact passed the state Senate in Tennessee. Read the Healthwatch story.

Home health hassle: Fifty senators of both parties sent a letter Wednesday to Medicare chief Don Berwick asking him to ease regulations of the healthcare reform law requiring physicians to documents patients’ qualification for Medicare-covered home health services.

Health IT: HHS on Wednesday sent state Medicaid directors a letter laying out the conditions for them to receive financial incentives to adopt electronic medical records, as called for in the 2009 economic stimulus package. The letter urges states to seek legal agreements with private insurers and other partners regarding the scope, budget and timing of their contributions. Healthwatch’s Julian Pecquet has more.

IMF fallout: Advocates for patients with HIV and AIDS condemned speculation about whether the woman accusing International Monetary Fund Director Dominique Strauss-Kahn of sexual assault might have the disease. The New York Post raised the issue Wednesday morning. The National Minority AIDS Council called the speculation “disturbing” and said victims of sexual abuse shouldn’t be subjected to “pointless conjecture.” Read the Healthwatch story.

Alzheimer’s drug: Public Citizen launched a petition for the FDA to ban the 23 mg dose of Aricept to treat Alzheimer’s.

9/11 compensation: Sheila Birnbaum was appointed to be the Special Master for the September 11 Victim Compensation Fund created by last year’s James Zadroga 9/11 Health and Compensation Act.

“It’s welcome news that the Justice Department has finally named a special master — but now the hard work really begins,” the bill’s authors, Reps. Carolyn Maloney (D-N.Y.), Jerrold Nadler (D-N.Y.), and Peter King (R-N.Y.), said in a joint statement. “In a matter of weeks, the program is supposed to start and the special master will need to draft and release for public comment regulations on which individuals and injuries are eligible for compensation. This is vitally important work, and much is at stake.”

The open letter comes after the Federal Trade Commission last month proposed new guidelines on food marketing to children. The guidelines wouldn’t go into effect until 2016.

Thursday’s agenda:

Medicare spending: The Heritage Foundation debates how Washington should control Medicare spending.

Affordable insurance: The Commonwealth Fund will release a new report recommending ways to ensure access to affordable insurance is maintained through job and income changes. The report will be available here. 

Rheumatology day: Rheumatologists and rheumatology health professionals visit Capitol Hill to meet with lawmakers. Recent statistics show arthritis and other rheumatic diseases cost the United States $127.8 billion a year. That’s more than the $104 billion in costs for cancer care.

Lobbying registrations:

Barbour Griffith & Rogers DBA BGR Holding / Eisai (pharmaceutical company)

Gephardt Group Government Affairs / Healiance Pharmaceuticals

National Policy Group / Budco Health Service Solutions (dependent eligibility verification services)

Patton Boggs / Children’s Medical Center of Dallas

Reading list: 

North Carolina leaders have reached a compromise on saving the state health plan, the News and Observer reports.

Separately, the state House postponed a vote on legislation to ban lawsuits against pharmaceuticals approved by the Food and Drug Administration, says the AP.

The federal government will issue the first Medicare electronic record incentive payments this week, writes ModernHealthcare (subscription requested). 

Health Affairs reviews the healthcare law’s CLASS Act in its latest policy brief.

Pharmalot looks at the global outlook for drug spending.

U.S. adults are abusing all kinds of pharmaceuticals, reports the Baltimore Sun.

The companies that own Circle K, Dairymart and On The Run have agreed to a multi-state effort to curb tobacco sales to minors, Reuters reports.

An FDA panel is recommending lower doses for children’s Tylenol, The Associated Press reports.

Comments / complaints / suggestions?

Please let us know:

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

Sam Baker: sbaker@digital-staging.thehill.com / 202-628-8351

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