Health reform implementation

OVERNIGHT HEALTH: GOP takes aim at CLASS repeal

Timid Romney? GOP presidential front-runner Mitt Romney stepped short of endorsing a referendum forbidding a health insurance mandate during his visit to Ohio on Tuesday, CNN reported, despite earlier assurances from Ohio Republican officials that that was his intention. Part of the reason for his reluctance, which was immediately panned by conservatives, could be the fact that he imposed a similar mandate himself when he was governor in 2006.

Perry plan: Romney’s chief rival, Texas Gov. Rick Perry, released an economic plan Tuesday that calls for major changes to Medicare and Medicaid but doesn’t offer many specific proposals. It says Medicare recipients should have more control over their benefits, but stops short of fully endorsing Rep. Paul Ryan’s (R-Wis.) plan to convert Medicare into a sort of voucher system. It also says states need more flexibility over Medicaid, but doesn’t say with much detail how to provide that flexibility. Healthwatch has more on the proposals.

{mosads}Fraud fail? Senate Republicans say HHS needs to be more aggressive with authority it gained from President Obama’s healthcare law. 

Yes, really.

Republicans on the Senate Finance Committee charged that HHS isn’t using a new tool to prevent Medicare fraud. The healthcare reform law allows the Centers for Medicare and Medicaid Services (CMS) to issue a temporary moratorium on new suppliers when there’s a high risk of waste, fraud or abuse. But HHS hasn’t used that power, Sens. Orrin Hatch (R-Utah) and Chuck Grassley (R-Iowa) said.

A CMS spokesman said the agency is already hard at work cracking down on fraud.

“We agree the Affordable Care Act gives CMS powerful and effective new tools to fight fraud in the Medicare and Medicaid program,” the spokesman said. “We are currently evaluating a number of potential opportunities to use this new Affordable Care Act tool and look forward to bolstering the success we have already had in cutting down waste, fraud and abuse thanks to the new law.”

Glitch fix: The House is slated to vote this week on Rep. Diane Black’s (R-Tenn.) bill to fix a glitch in the healthcare law’s Medicaid expansion. The White House endorsed the measure Tuesday. The White House said in a Statement of Administration Policy that it “looks forward to working with the House to ensure the bill achieves the intended result.”

The intended result is to change the way income is calculated when determining whether people are eligible for Medicaid and subsidies for private insurance. The way it’s calculated under the healthcare law could make 1 million middle-income families eligible for Medicaid.

Not a competition: Four out of five metropolitan areas don’t have a competitive insurance market, according to the American Medical Association. The AMA released a new report Tuesday that says the market for health plans is “highly concentrated” in 83 percent of U.S. metro areas. One company controls at least 50 percent of the market in half the areas studied.

Competitive markets give customers more plans to choose from and also give doctors more bargaining power over their rates. In areas with only one insurer, that insurer can essentially decide what it will pay doctors. But when potential patients are covered by an array of plans, doctors can afford not to take a rate they believe is too low.

Another abortion injunction: A federal judge in North Carolina on Tuesday blocked enforcement of a state law that requires abortion providers to show their patients an ultrasound and describe the fetus. Although women could turn away, doctors would be required to put the images in front of them. Planned Parenthood, the American Civil Liberties Union and the Center for Reproductive Rights filed the suit to block the new rules.


Wednesday’s agenda

The National Value-Based Insurance Design Summit starts at the Grand Hyatt. The agenda is here.

Budget Committee Chairman Paul Ryan (R-Wis.) is at the Heritage Foundation for a “major address” on the economy.

A coalition of local advocacy groups is releasing an analysis of possible supercommittee cuts to Medicare, Medicaid and Social Security.

National Journal is sponsoring a “Healthy Food, Healthy Planet” event at D.C.’s Newseum.


Fraud fight

Three drugmakers will pay the state of Mississippi more than $6 million for overcharging Medicaid.

Missouri reached an almost $600,000 settlement with an in-home personal care company charged with billing Medicaid for services rendered by workers ineligible for reimbursement. The Show-Me State also reached a $130,000 settlement with a similar company charged with billing Medicaid for services that were never provided.

Four Floridians were arrested for defrauding Medicaid in two separate incidents.


Lobbying registrations

Seward Square Group / Fluro Water

Barbour Griffith & Rogers / Partnership for America


Reading list

Reuters breaks down the issues facing the Supreme Court as it decides how to proceed on suits over the healthcare law.

One of the largest insurers in New York state has agreed to release rate information, the AP reports.

The costs of long-term care rose by 5.6 percent this year, according to Bloomberg.


What you might have missed on Healthwatch:

Federal panel says young boys should receive HPV vaccine

House Dems push hearing on HGH testing delay in pro football

White House prods health centers to hire more vets

Rehberg introduces healthcare law repeal legislation

News bites: Taxpayer funding for anti-abortion groups, CLASS Act’s void, and more 

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

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

Follow us on Twitter @hillhealthwatch

Correction: The White House supports passage of Rep. Diane Black’s Medicaid eligibility bill.