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SAMHSA222s Weekly Financing News Pulse: National Edition July 9, 2010 7/9/10 1 SAMHSA222s Weekly Financing News Pulse: National Edition National News NTAS Warns IRS Will Face Difficulty Implementing National Health Care Reform Law; GOP Continues Challenging Reform; Missouri Lieutenant Governor Files New Lawsuit Rasmussen Reports Poll Finds Strong Support for Repealing National Health Care Reform MHPAEA Takes Effect, Federal Officials Issue Guidance on Implementation Rep. Matsui Introduces Bill to Improve Medicaid Funding for Community - Based Behavioral Health Services VA to Issue New Rule s on Disability Compensation for PTSD States Request Funds From BP for Mental Health Services Related to Gulf Oil Spill Update: Obama Appoints Berwick as CMS Administrator in Recess Appointment Studies Rele ased RWJF and Health Affairs Brief Examines Options for Medicare Reimbursement Reform Health Affairs Study Offers Payment and Service Delivery Lessons for CMI KFF Updates Health Ref orm Subsidy Calculator Urban Institute Brief Outlines National Health Care Reform Lessons From Massachusetts222 Experiences Commonwealth Fund Finds U.S. Residents Have Fewer Hospital Visits Than in Other Industr ial Nations, Spend More Per Visit 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_subscribe.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 July 9, 2010 7/9/10 2 National News NTAS Warns IRS Will Face Difficulty Implementing National Health Care Reform Law; GOP Continues Challenging Reform; Missouri Lieutenant Governor Files New Lawsuit: On July 7, the National Taxpayer Advocate Service (NTAS), an independent ombudsman organization within the Internal Revenue Service (IRS), questioned the IRS222 ability to fulfill its duties under the national health care reform law. In a statement accompanying the NTAS222 mid - year report to Congress, National Taxpayer Advocate Nina E. Olson said that the IRS is neither structured nor funded to effectively oversee social programs and that the new tax reporting measures in the law 223may impose significant burdens on businesses, chariti es, and government agencies.224 Under the reform law, the IRS will administer insurance premium subsidies, small business tax credits, and assessments on employers who do not cover their employees. The IRS will also enforce the law222s individual insurance mandate. Beginning in 2012, the law requires businesses and tax - exempt organizations to follow new procedures to report purchases to the IRS. The measure was created to raise funds to pay for the health care reform law by reducing the underreporting of bus iness income. The NTAS222 report projects it would raise $13.7 billion over 10 years ( Kaiser Health News, 7/8 ; The Washington Post, 7/7 ). In other health care reform news, on July 7, Senators Tom Coburn (R- OK) and John Barasso (R - WY) released a report critical of the national health care reform law, asserting that it will not reduce health care costs or improve access to care. The report comes as two GOP Congressmen, Rep. Steve K ing (R- IA) and Rep. Wally Herger (R- CA), are circulating petitions that would force Congressional votes to repeal the reform law ( The Hill, 7/7 ; Kaiser Health News, 7/2 ; The Washington Times, 7/2 ). Finally, on July 7, Missouri Lieutenant Governor Peter Kinder (R) and three private citizens filed suit over the health care reform law in U.S. District Court in Cape Girardeau, Missouri. The plaintiffs conten d that the law222s individual insurance mandate is unconstitutional, the law222s expansion of Medicaid could force Missouri to raise state taxes, and the law improperly alters state officials222 compensation by changing their health care plan. The suit names U. S. Department of the Treasury Secretary Timothy Geithner , U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius , U.S. Attorney General Eric Holder , and U.S. Department of Labor Secretary Hilda Solis as defendants. Lieutenant Gover nor Kinder filed the suit in both his personal and official capacities and is raising private funding to pay for the suit ( Kaiser Health News, 7/8 ; AP, 7/8 ; St. Louis Post - Dispatch, 7/8 ). Rasmussen Reports Poll Finds Strong Support for Repealing National Health Care Reform: A July 1 Rasmussen Reports poll found that 60 percent of voters favor repealing the national health care reform law. However, only 41 percent of voters believe it is 223somewhat likely224 that Congress will repeal the law and 45 percent believe repeal is 223unlikely224. Overall, the poll found that 36 percent of voters believe the law will be 223good for the nation,224 while 53 percent believe it will be 223bad for the nation224 ( Rasmussen Reports, 7/5 ). M HPAEA Takes Effect, Federal Officials Issue Guidance on Implementation: On July 1, the interim final rule (IFR) on th e Mental Health Parity and Addiction Equity Act (MHPAEA) took effect. The IFR applies to all plan years beginning on or after July 1. The law does not mandate M H /SU D coverage but requires all employer-sponsored group health plans with 51 or more employee s offering MH /SU D coverage to do so on an equal basis with general health care. The Employee Benefits Security Administration (EBSA) issued guidance on the classification of outpatient benefits s tating that federal agencies will not take enforcement action against any plan or insurer that distinguishes between office visits and all other outpatient services while they complete final regulations on the law . Under the law, insurers may not place financial requirements or treatment limits on MH/SUD benefits within either SAMHSA222s Weekly Financing News Pulse: National Edition July 9, 2010 7/9/10 3 sub - classification that are more restrictive than those for general health care ( Medical News Today, 7/8 ; Life and Health Insurance News, 7/1 ; The Hill, 7/1 ). Rep. Matsui Introduces Bill to Improve Medicaid Funding for Community -Based Behavioral Health Services: On June 29, Rep. Doris Matsui (D - CA) introduced a bill ( H.R. 5636 ) that would increase Medicaid funding for facilities providing community - based behavioral health services to low - income residents. The Community Mental Health and Addiction Safety Net Equity Act of 2010 would establish a national network of Federally Qualified Behavioral Health Centers (FQBHCs). Medicaid provides Federally Qualified Health Centers (FQHCs) with higher, cost - based, reimbursements, rather than flat - fee reimbursements . Proponents of the bill say that the higher reimbursements will improve access to behavioral health services in underserved areas. The bill was referred to the House Energy and Commerce Committee ( California Healthline, 7/7 ; Sacramento Business Journal, 7/7 ). V A to Issue New Rules on Disability Compensation for PTSD: The U.S. Department of Veterans Affairs (VA) plans to issue new rules making it easier for veterans with post - traumatic stress disorder (PTSD) to receive disability compensation. The new rules will eliminate the current requirement that veterans document specific events that caused their PTSD. Instead, the VA would grant disability compensation to veterans proving that they served in a war zone working a job consistent with the events they say triggered their condition. Veterans who did not experience traumatic events but had good reason to fear them would also be eligible for disability compensation. The rules could take effect as soon as July 12 and Congressional analysts estimate they will cost $5 billion ( Kaiser Health News, 7/8 ; The New York Times, 7/7 ). S tates Request Funds From BP for Mental Health Services Related to Gulf Oil Spill: State officials in Alabama, Florida, Louisiana, and Mississippi are requesting a combined minimum of $27 million from BP PLC for mental health services and outreach related to the Deepwater Horizon oil spill in the Gulf of Mexico. Alabama Department of Mental Health officials requested $5.7 million to establish a call center assisting individuals with mental health issues related to the spill and an additional $20 million annually for up to five years. State officials in Florida requested $1.7 million for 90 days of mental health services in eight coastal counties and Louisiana Department of Health and Hospitals Secretary Alan Levine requested $10 million to fund six months of outreach and behavioral health services in Louisiana. Finally, the Mississippi Department of Mental Health requested $10 million to create a fund available to public and private mental health clinics and may request an additional $10 million. BP officials say they are developing a comprehensive plan to provide the Gulf Coast with community out reach and non- profit support and that they hope to make an announcement on the subject in the near future ( AP via MSNBC, 7/2 ; My Fox Memphis, 7/2 ). U pdate: Obama Appoints Berwick as CMS Administrator in Recess Appointment: In a recess appointment on July 7, President Barack Obama appointed Dr. Donald Berwick as Centers for Medica re & Medicaid Services (CMS) Administrator , avoiding the Congressional confirmation process. Because Dr. Berwick was not confirmed by Congress, the appointment will expire at the end of the next session of Congress in late 2011. President Obama no minated Dr. Berwick on April 19 but, as of July 7, t he Senate Finance Committee had yet to schedule his confirmation hearings. Dr. Berwick was the President and CEO of the Institute for Healthcare Improvement , a non - profit organization seeking to improve health care quality worldwide. Dr. Berwick also served as a professor at the Harvard School of SAMHSA222s Weekly Financing News Pulse: National Edition July 9, 2010 7/9/10 4 Public Health and Harvard Medical School . CMS has roughly 4,500 employees, 102 million beneficiaries, and an ann ual budget of $780 billion ( Kaiser Health News, 7/7 ; Politico, 7/7 ). Studies Released RWJF and Health Affairs Brief Examines Options for Medicare Reimbursement Reform: A brief published by the Robert Wood Johnson Foundation (RWJF) and Health Affairs examines problems with Medicare222s sustainable growth rate (SGR) formula. The brief comes after Congress recently acted to prevent a 21 percent cut to Medicare physician reimbursement rates. The brief outlines the impact of numerous versions of temporary and permanent physician rate adjustments. The authors project that freezing rates through 2020 would increase federal spending by $276 billion over ten years, while raising the rates to reflect annual inflation would increase federal spending by $330 billion over the same period. The authors also examine proposals for Medicare payment reform to curtail cost growth and encourage cost - effective care, including payment bundling and the development of accountable care organizations (ACOs) ( RWJF, 6/29 ). Health Affairs Study Offers Payment and Service Delivery Lessons for CMI: Based on the experiences of the Medicare Health Support Program, a chronic care pilot program that ran from 2005 to 2008, an article in Health Affairs examines lessons in payment and service delivery reform for the Center for Medicare & Medicaid Innovation (CMI). The national health care reform law created the CMI within CMS t o promote payment and service delivery reform. The report emphasizes the importance of collaboration, flexibility, leadership, the receptivity of beneficiaries to care management, and timely patient data. In addition, the authors warn against selecting flawed test populations when planning future pilot programs ( Kaiser Health News, 7/8 ). KFF Updates Health Reform Subsidy Calculator: On July 7, the Kaiser Family Foundation (KFF) released an updated version of its health reform subsidy calculator . The tool considers an individual222s age, income, family, and regional health care cost s to determi ne his or her likely health insurance premiums in the health insurance exchanges set to begin in 2014 under the national health care reform law. KFF222s calculator also projects an individual222s eligibility for government premium subsidies based on those cri teria ( KFF ) . Urban Institute Brief Outlines National Health Care Reform Lessons From Massachusetts222 Experiences: On June 21, the Urban Institute released a brief examining lessons learned from the experiences of Massachusetts222 2006 health care reform. The authors suggest that Massachusetts222 experiences are somewhat predictive because the national law is modeled after Massachusetts222 law. The brief asserts that Massachusetts experienced a substantial increase in insurance coverage, a limited reduction in employer - sponsored coverage, high compliance with the law222s individual insurance mandate, increased access to care, and a decrease in the financial burden of care. However, the authors note that Massachusetts also faces rising health costs and a shortage of providers. The brief examines Massachusetts222 response to these problems as possible models for addressing those i ssues nationally. T he authors suggest that only the federal government can fully address cost containment issues ( Urban Institute, 6/21 ). Commonwealth Fund Finds U.S. Residents Have Fewer Hospital Visits Than in Other Industrial Nations, Spend More Per Visit: On June 29, the Commonwealth Fund released a brief examining data on health spending in 30 industrialized nations collected by the Organization for SAMHSA222s Weekly Financing News Pulse: National Edition July 9, 2010 7/9/10 5 Economic Cooperation and Development (OECD). The brief found that, in 2008, U.S. residents had fewer hospital and doctor visits than did residents of most other countries but that U.S. residents had the highest spending per hospital visit, at $17,126. The Netherlands had the next highest spending per visit at $11,522. The authors also found that the U.S. is in the bottom quartile of the OECD na tions for life expectancy and that the U.S. has seen the smallest improvement in that measure over the past twenty years ( Commonwealt h Fund, 6/29 ). Around the Hill: Hearings on Health Financing Congress is out of session for the July 4th recess. The Senate will reconvene Monday, July 12 and the House will reconvene Tuesday, July 13. Senate Veterans222 Affairs Committee : Veterans222 Claims Processing July 14, 9:30 a.m., 418 Russell House Veterans222 Affairs Subcommittee on Oversight and Investigations : Veterans222 Suicide Prevention Outreach Efforts July 14, 10:00 a.m., 334 Cannon House Veterans222 Affairs Committee : Treatments for TBI and PTSD July 14, 10:00 a.m., 334 Cannon House Veterans222 Affairs Subcommittee on Health: Serving Rural Vets in Virginia July 19, 10:00 a.m., Site TBA House Veterans222 Affairs Subcommittee on Oversight and Investigations : Gulf War Illness July 27, 10:00 a.m., 334 C annon
