Healthcare policy keeps nation’s capital busy
While the first part of the year in Washington focuses almost exclusively on passing a health reform bill, the rest of 2010 sees some of those reforms taking shape in the ongoing implementation phase. The year also brings with it a new CMS administrator in Donald Berwick. And in the last month of year, Congress passes—and the president signs—the Physician Payment and Therapy Relief Act of 2010, which delayed for one month a 23% cut to Medicare payments to physicians that was scheduled to take effect the same day President Barack Obama signed the legislation.
In July, during a congressional recess, Obama names physician Berwick, a Harvard-trained pediatrician and patient-safety expert, to lead the CMS. The recess appointment angers some congressional Republicans, who contended Berwick favors healthcare rationing and were unable to question Berwick during hearings and vote on his confirmation. Some of those GOP leaders remind Berwick of this when he appears for the first time before the powerful Senate Finance Committee on Nov. 17.
In October, HHS announces it will allocate $30 million in federal funding from the Affordable Care Act to 35 states, four territories and Washington, D.C., to either establish or strengthen programs that provide direct services designed to help patients with their health insurance. These services include helping consumers enroll in health coverage, file complaints and appeals against health plans, and educate them about their rights.
Republicans win back control of the U.S. House of Representatives on Nov. 2, vowing to “repeal and reform” the Affordable Care Act. Healthcare experts and political pundits say that while a repeal is unlikely—given that Democrats still control the Senate and the White House—House leaders could use methods to defund parts of the massive legislation.
The CMS launches its Innovation Center in mid-November. Led by physician and former Geisinger Health Plan CEO Richard “Rick” Gilfillan, the center was established in the Affordable Care Act to study new ways of delivering care and paying providers that improve quality and save money.
At a news conference Nov. 22, HHS Secretary Kathleen Sebelius announces the muchanticipated medical loss ratio regulations, which require insurers to spend at least 80% of consumers’ premium costs on patient care. Anticipating disruptions and market destabilization, some states request adjustments to this provision, which takes effect Jan. 1.
In early December, the Senate Democratic and Republican leaders and the Senate Finance Committee chiefs introduce legislation that would extend a fix to the Medicare physician payment formula through 2011.
Senate Majority Leader Harry Reid, Senate Minority Leader Mitch McConnell and Finance Committee leaders Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa) introduce the Medicare and Medicaid Extenders Act of 2010, which would avert the 25% Medicare payment cut to physicians scheduled for Jan. 1, 2011. One provision would reverse that reduction and extend the current Medicare payment rates through Dec. 31, 2011. The estimated cost of the provision is $14.9 billion over 10 years. It is passed and signed into law in mid-December.