WeeklyFinancingNewsPulseNationalEditionfinal20100122.pdf (PDF | 243.67 kb)
SAMHSA222s Weekly Financing News Pulse: National Edition January 22, 2010 1/22/10 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News Democrats Reconsider Strategy on Health Care Reform Following MA Loss MedPAC Issues 2011 Medicare Provider Payment Recommendations, Recommends Some Hospital Payment Increases DOJ Charges J&J with Providing Illegal Kickbacks to Omnicare Poll Finds Americans Less Supportive of Health Care Reform Studies Released PWC Survey Finds Employers Less Satisfied with Insurers Hay Group Estimate Health Care Premiums Will Rise 9 Percent in 2010 Urban Institute Considers Eligibility, Enrollment, and Retention Policies to Maximize Coverage Under Health Reform KFF Examines High Risk Insurance Pools Commonwealth Fund Examines the Effects of Health Care Reform Provisions Around the Hill: Hearings on Health Financing To Subscribe to SAMHSA222s Weekly Financing News Pulse, please go to the following link and choose 223Health Care Financing224: https://service.govdelivery.com/service/multi_subscr ibe.html?code=USSAMHSA&origin=http://www.samhsa.go v/enetwork/success.aspx For questions or comments, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs.gov ). SAMHSA222s Weekly Financing News Pulse: National Edition January 22, 2010 1/22/10 2 National News Democrats Reconsider Strategy on Health Care Reform Following MA Loss: After Senator Elect Scott Brown222s (R MA) victory in the Massachusetts special election to fill the late Senator Edward 223Ted224 Kennedy222s (D MA) seat, Democratic leaders are rethinking their health care reform strategy. Interim Massachusetts Senator Paul G. Kirk Jr. (DMA) will continue to serve until Senator Elect Brown is seated; however, President Barack Obama and Senate Majority Leader Harry Reid (D NV) said that the Senate will not hold any health care votes while Sen. Kirk is still serving ( Kaiser Health News, 1/21 ; Kaiser Health News, 1/20 ). Meanwhile, with President Obama set to deliver the State of the Union address on January 27 and transmit his 2011 budget to Congress by February 1, Democrats are considering numerous legislative options for health care reform and have yet to reach a decision. House Speaker Nancy Pelosi (D CA) has rejected the notion that the House could pass the Senate222s bill ( HR 3590 ) without modifications. Under such a plan, Congress would then pass a separate 223corrections224 bill to address House members222 concerns, likely using the budget reconciliation process ( Washington Post, 1/22 ; Kaiser Health News, 1/19 ). Senior Democrats are also considering breaking the large bill into several smaller bills, isolating areas of bipartisan agreement that could pass in both houses ( New York Times, 1/21 ; Kaiser Health News, 1/21 ). Finally, though possibly moot given the status of the current legislation, news outlets report that lawmakers in 30 states are pressing for constitutional amendments to exempt residents from individual health care mandates, with legislation already filed in at least 19 states ( Wall Street Journal, 1/20 ; Washington Times, 1/19 ). MedPAC Issues 2011 Medicare Provider Payment Recommendations, Recommends Some Hospital Payment Increases: On January 15, the Medicare Payment Advisory Commission (MedPAC) issued its recommendations for 2011 Medicare provider payment updates. Among other recommendations, MedPAC called for increasing inpatient and outpatient hospital reimbursements at the full rate of inflation and implementing a quality incentives program. MedPAC also recommended further adjusting hospital inpatient payments over three years to recover overpayments resulting from recent code changes ( MedPAC, 1/15 ; Kaiser Health News, 1/15 ). DOJ Charges J&J with Providing Illegal Kickbacks to Omnicare: The U.S. Department of Justice (DOJ) charged Johnson & Johnson (J&J) with illegally paying tens of millions of dollars to Omnicare Inc. between 1999 and 2004 to promote increased use of J&J pharmaceuticals. DOJ alleges that, under the arrangements, the nursing home pharmacy company222s annual purchases of J&J medications tripled to nearly $280 million. The DOJ also claims that the kickbacks incentivized 223off label224 use of the antipsychotic Risperdal. A spokesperson for J&J said that the company222s conduct was lawful and appropriate ( Wall Street Journal, 1/16 ). Poll Finds Americans Less Supportive of Health Care Reform: A Wall Street Journal/NBC News poll conducted January 10 to 14 found that 33 percent of respondents believe that President Obama222s health care reform initiative is a 223good idea224 while 46 percent think it is a 223bad idea224. The pollsters noted that, though largely unchanged since December, public criticism of health care reform has increased 20 percent since April. In addition, the poll found that 48 percent of respondents believe that health care reform will be 223a step backwards224, while 42 percent believe it will be a step forward ( Kaiser Health News, 1/20 ; Wall Street Journal, 1/20 ). Studies Released SAMHSA222s Weekly Financing News Pulse: National Edition January 22, 2010 1/22/10 3 PWC Survey Finds Employers Less Satisfied with Insurers: A PricewaterhouseCoopers222 (PWC) Health Research Institute survey polled 100 large companies and 130 small companies, finding that 59 percent of large employers were satisfied with their health insurer in 2009, down 5 percent from 2008. The survey found that small employers222 satisfaction remained constant at 52 percent. In addition, the survey found that over 60 percent of employers said they plan to increase employees222 share of health care costs in the coming year. The report also provides information about services employers would like added to health plans, including personal health records, help with wellness programs and cost controls, and debit card interfaces ( Kaiser Health News, 1/19 ; PWC via PRNewswire, 1/19 ). Hay Group Estimate Health Care Premiums Will Rise 9 Percent in 2010: A report by the Hay Group , outlining the results from its annual Health Benefits Prevalence Report, estimates that employer sponsored health care premiums will increase an average of 9 percent in 2010 excluding the effects of changes to plan design, medical management, or plan administration. The projections are based on 30 years of trends in employer sponsored coverage and data from the Federal Employee Health Benefits Program (FEHBP), which Hay says is a leading indicator for other employer sponsored plans. The report notes that though the annual premium increase in 2009 was the lowest since 2000, FEHBP data indicates the decline may have bottomed out ( Hay Group via Business Wire, 1/19 ). Urban Institute Considers Eligibility, Enrollment, and Retention Policies to Maximize Coverage Under Health Reform: A report by the Urban Institute notes that both the House ( HR 3962 ) and Senate ( HR 3590 ) health care reform bills create multiple subsidy systems that may present barriers to coverage. The report recommends creating a single application for Children222s Health Insurance Program (CHIP), Medicaid and exchange subsidies under the Senate bill, applying the same streamlining measures to exchange subsidies and Medicaid, and establishing annual subsidy eligibility with exceptions for certain midyear corrections ( Urban Institute, 1/13 ; Kaiser Health News, 1/15 ). KFF Examines High Risk Insurance Pools: The Kaiser Family Foundation (KFF) released a brief examining the structure of high risk insurance pools and their implications for health care reform. Under both the House and Senate bills ( HR 3962 , HR 3590 ), a high risk insurance pool would be one of the first provisions implemented to create a safety net before other provision take effect. KFF examines the role of the high risk pools in the health care safety net and explores key issues for national implementation ( KFF, 1/7 ; Kaiser Health News, 1/15 ). Commonwealth Fund Examines the Effects of Health Care Reform Provisions: On January 7, the Commonwealth Fund released a report analyzing the House and Senate222s health care reform legislation (HR 3962, HR 3590). The report focuses on the number of newly insured residents and the program or plan under which they would be covered; the consequences of federal financing; estimated insurance costs for families; consequences for employers; and the extent to which changes to the insurance market can stimulate competition and lower cost ( Commonwealth, 1/7 ; Kaiser Health News, 1/15 ). Around the Hill: Hearings on Health FinancingHouse Veterans222 Affairs Committee : Health Care Needs of Rural Veterans January 27, 10:00 a.m., 345 Cannon SAMHSA222s Weekly Financing News Pulse: National Edition January 22, 2010 1/22/10 4 House Veterans222 Affairs Subcommittee on Health: Project Hero February 3, 10:00 a.m., 334 Cannon House Veterans222 Affairs Subcommittee on Disability Assistance and Memorial Affairs: Veterans222 Benefits Improvement Act February 3, 2:00 p.m., 334 Cannon House Veterans Affairs Committee : Fiscal 2011 and 2012 Budget: VA February 4, 10:00 a.m., 334 Cannon
