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SAMHSA222s Weekly Financing News Pulse: National Edition October 16, 2009 10/16 /09 1 SAMHSA222s Weekly Financing New Pulse: National Edition National News Finance Committee Approves Health Care Reform Legislation; Legislature Moves Towards Floor Debates Congress Passes Bill Allowing Advance VA Health Care Appropriations Sen. Stabenow Introduces Bill to 223Fix224 Medicare Physician Payments; GOP to Add Cost Offse ts Sen. Reid Testifies Against Health Insurers222 Antitrust Exemption, Lawmakers Consider Adding to Health Reform Legislation Sick College Students Can Keep Parents222 Health Insurance Proposed Federal Rules Would Limit HRAs and Wellness Programs SAMHSA Awards $38.2 Million to Expand Drug Courts SAMHSA Grants Fund Jail Diversion and Trauma Recovery, Target Veterans CMS Pilots Medicare Quality and Cost Program in CO, NM, OK, and TX HHS OIG to Increased Medicare and Medicaid Auditing in 2010 U.S. Army Pilots Voluntary Private Substance Abuse Program Scattered Reports of H1N1 Vaccine Shortages Despite Ample CDC Supply; Public Still Weary Studies Released AHIP Releases Report Outlining Potential Effects of Health Care Reform and Meets Significant Resistance Rockefeller Institute on Government Report Finds State Revenues Show Record Drop SAMHSA Releases TEDS Report on Criminal Justice System Referrals to Substance Abuse Treatment Urban Institute Brief Analyzes Census Bureau222s Health Care Coverage Data Consumer Reports Survey Analyzes Health Plans, Finds Moderate Satisfaction HealthGrades Report Shows Gap in Hospital Care TriNet Survey Finds Businesses Fear Cost Increases from Health Reform Center for Economic Policy and Research Report Suggests Advantages of Globalizing Medicare and Medicaid Around the Hill: Hearings on Health Financing For quest ions or comment s, please contact Kevin Hennessy ( kevin.hennessy@samhsa.hhs. gov ). SAMHSA222s Weekly Financing News Pulse: National Edition October 16, 2009 10/16 /09 2 National News Finance Committee Approves Health Care Reform Legislation; Legislature Moves Towards Floor Debates : After receiving the Congressional Budget Office222s (CBO) score on October 7, the Senate Finance Committee approved the amended America222s Health Future Act of 2009 on October 13 in a 14 - 9 vote . Senator Olympia Snowe (R- ME) joined the committee Democrats in voting for the bill, a result of months of bipartisan negotiations led by Senate Finance Committee Chair Max Baucus (D - MT). H owever, Sen. Snowe emphasized that she was not entirely satisfied with the current bill and that she could not guarantee voting for the bill on the Senate floor after its is merged with the more liberal Senate Health, Education, Labor and Pensions (HELP) Committee bill ( Kaiser Health News, 10/13 ; CQ Politics, 10/13 ). After the bill cleared committee, Senate Majority Leader Harry Reid (D - NV), Sen. Baucus, Senator Chris Dodd (D - CT), White House Chief of Staff Rahm Emanuel, U.S. Department of Health and Human Services Secretary ( HHS) Kathleen Sebelius, Director of the White House Office of Health Reform Nancy - Ann DeParle, and Director of the Office of Management and Budget (OMB) Peter Orszag met to discuss creating a merged bill that would unify Congressional Democrats and maintain Sen. Snowe222s vote ( Kaiser Health News, 10/ 15 ). In other Senate news, the CBO scored Senator Orrin G. Hatch222s (R-U T) medical malpractice tort reform proposal last week, finding that it would save $54 billion over 10 years ( Kaiser Health News, 10/9 ). In the House, the CBO preliminarily scored two of the three versions of health care reform legislation that House Speaker Nancy Pelosi (D - CA) sent for review. According to documents obtained by the Washington Post , t he CBO determined that one version of the bill that includes a public plan with negotiated rates shift s more people onto Medicaid and offers fewer federal subsidies to purchase private coverage , cost ing an estimated $859 billion over 10 years. The second version of the legislation, which the CBO estimated would cost $905 billion over a decade, contains a public plan with reimbursement rates tied to Medicare payment rates and offers more government subsid i es rather than state Medicaid coverage ( Washington Post, 10/16 ). Rep . Pelosi also announced this week that the House bill will include a provision allowing children to remain on their parents222 health plans until age 26 ( Kaiser Health News, 10/14 ). Meanwhile, the House Ways and Means Committee approved a measure on October 15 setting in motion a process that would allow the Se nate to pass health care reform under reconciliation, requiring only a 51 - vote majority rather than the usual 60 votes needed to block a filibuster. Reconciliation applies only to bills affecting the country222s budget and, according to Constitutional rules, the full House must approve the legislation before the Senate may vote on it . In addition, only those elements of health care reform that affect the budget would be eligible for passage under reconciliation ( Kaiser Health News, 10/15 ). Finally, as health care reform works through Congress, Democratic leaders in both houses say they expect to remain in session through mid - December rather than delay health care reform until 2010 ( Kaiser Health News, 10/15 ; CQ Politics , 10/14 ). Co ngress Passes Bill Allowing Advance VA Health Care Appropriations: On October 14, Congress passed the Veterans Health Care Budget Reform and Transparency Act ( HR 1016 ) authorizing Congress to appropriate funds for the Department of Veterans Affairs222 (VA) medical programs one year in advance of each fiscal year. In 19 of the past 22 years Congress has approved the VA budget late, forcing the VA to operate on the previous year222s budget that often lacks funding for new programs slated for inclusion in the new budget (Financing News Pulse 6/29 edition). The legislation now awaits President Obama 222s signature ( PRNewswire via Reuters, 10/15 ; PRNewswire via Reuters, 10/14 ). SAMHSA222s Weekly Financing News Pulse: National Edition October 16, 2009 10/16 /09 3 Sen. Stabenow Introduces Bill to 223Fix224 Medicare Physician Payments ; GOP to Add Cost Offsets : O n October 13, Senator Debbie Stabenow (D - MI) introduced a bill ( SB 1776 ) to alter the Medicare physician reimbursement payment formula, which has required Congress to pass one year 223fixes224 to avoid sig nificant cuts to physician reimbursements. If some reform is not passed, the current formula will reduce physician reimbursements by 21 percent in January. The Democratic legislation would authorize $247 billion in additional payments to physicians over a decade , altering the formula going forward, without offsetting the expense and therefore adding to the federal deficit. Senate Majority Leader Harry Reid (D - NV) took procedural action on October 14 to bypass committee hearings and hold a cloture vote as early as next week, requiring a 60- vote majority to advance the legislation. Senate Democrats decided to pursue the reimbursement change outside of health care reform legislation in consultation with the White House and House Democrats ( AP, 10/15 ; The Hill, 10/14 ; Kaiser Health News, 10/15 ). Senate Minority Leader Mitch McConnell (R- KY) said that Republicans will offer amendments to the bill to offset the cost, possibly allocating unused American Recovery and Rein vestment Act (ARRA) funds ( Kaiser Health News, 10/15 ). Sen. Reid Testifies Against Health Insurers222 Antitrust Exemption , Lawmakers Consider Adding to Health Reform Legislation: On October 14, Senate Majority Leader Harry Reid (D - NV) testified as a witness at a Senate Judiciary Hearing, calling for an end to the 1945 McCarran- Ferguson Act , which exempted health insurers from antitrust laws. Senate Judic iary Committee Chair Patrick Leahy (D - VT) introduced the Health Insurance Industry Antitrust Enforcement Act in September (Financing News Pulse 9/18 edition); however, senior Democrats including Senator Charles Schumer (D - NY) are calling for the bill222s inclusion in the health care reform legislation currently moving through Congress ( New York Times, 10/14 ; Kaiser Health News, 10/14 ). S ick College Students Can Ke ep Parents222 Health Insurance : A new federal law known as 223Mic h elle222s Law224 took effect October 9, allowing medically ill or injured college students to take a year off school while maintain ing health coverage under their parents222 insurance plans. The law is modeled after a New Hampshire law passed in 2006 ( Kaiser Health News, 10/9 ; AP, 10/10 ). Pro posed Federal Rules W ould Limit HRAs and Wellness Programs : On October 7, the federal government proposed new rules prohibiting health plans and employers from offering financial incentives to employees participating in health risk assessments (HRAs) that request information about their family medical history. Set to kick - in for insurance plans with plan years beginni ng on or after December 7, the new regulations bring HRAs into compliance with the Genetic Information Non - Discrimination Act of 2008 , which prohibits the collection of genetic information for insurance underwriting. Violations would result in fines up to $500,000 and would expose employers and health plans to discrimination lawsuits. The comment period for the proposed rules ends January 5 ( Kaiser Health News, 10/14 ; Wall Street Journal, 10/15 ). SA MHSA Awards $ 38.2 Million to Expand Drug Courts : On October 2 , Substance Abuse and Mental Health Services Administration (SAMHSA) announced 44 grants totaling $ 38.2 million over three years to expand or enhance substance abuse treatment services in drug courts. The courts will receive up to $300,000 annually for up to three years ( SAMHSA, 1 0/2 ; Desert Sun, 10/14 ). S AMHSA Grants Fund Jail Diversion and Trauma Recovery, Target Veterans : SAMHSA awarded six grants totaling more than $10 million over five years to support local and statewide expansion s of jail SAMHSA222s Weekly Financing News Pulse: National Edition October 16, 2009 10/16 /09 4 diversion programs for people with post traumatic stress and other trauma- related disorders. The program, which will provide grantees up to $394,000 annually for five years, will give priority to veterans returning from Iraq and Afghanistan. SAMHSA award ed grants to the Governor222s Offices in Florida, New Mexico, North Carolina, Ohio, Rhode Island, and Texas ( SAMHSA, 9/29 ). C MS Pilots Medicare Quality and Cost Program in CO, NM, OK, and TX: A Centers for Medicare & Medicaid (CMS) pilot project currently underway in select hospitals in Colorado, New Mexico, Oklahoma and Texas is designed to share health care cost savings between CMS, hospitals, doctors, and Medicare patients. Under the pilot, hospitals and Medicare negotiated reduced prices for Medicare Parts A and B enrollees undergoing any of nine orthopedic or 28 cardiovascular procedures to be paid in 223bundle s224 to doctors and hospitals . Hospitals, in turn, share those bundled payments with doctors as incentives for achieving certain cost and quality benchmarks. In addition, cost savings are passed on to the patients, who receive checks for a share of CMS222 savings. However, only Medicare and patients are guaranteed to save money under the pilot, if hospitals and doctors are unable to provide more efficient care without quality reductions they will be forced to absorb the loss ( Kaiser Health News, 10/13 ; San Antonio Express - News, 10/13 ). H HS OIG to Increased Medicare and Medicaid Auditing in 2010 : On October 1, the HHS Office of the Inspector General (OIG) released its FY2010 work plan outlining increased oversight of Medicare and Medicaid auditing programs. Under the work plan, the OIG will continue reviewing CMS222 Recovery Audit Contractor (RAC) Program, including the number of cases referred, the programs222 handling of those cases, and the training and guidance provided to national RACs. In addition, the OIG will review the Medicaid Integrity Program (MIP) and CMS222 oversight of the Medicare and Medicaid Data Match Project (Medi - Medi) ( Health Leaders Med ia, 10/7 ; Fierce Health Finance, 10/14 ). U .S. Army Pilots Voluntary Private Substance Abuse Program : The U.S. Army is piloting a volu ntary substance abuse counseling program for six months at bases i n Alaska, Hawaii, and Washington. T he Army Confidential Alcohol Treatment and Education Pilot allows soldiers with no history of substance abuse to seek alcohol and substance treatment anonymously and without affecting their permanent records. Enrollment in the pilot program does not require soldiers to inform their commanding officers and will not delay promotions or re - enlistments. After six months, army officials will determine whether to expand the program ( Stars and Stripes, 10/10 ). S cattered Reports of H1N1 Vaccine Shortages Despite Ample CDC Supply; Public Still Weary : Centers for Disease Control and Prevention (CDC) officials report that the agency has 6.8 million doses of H1N1 (swine flu) vaccine on hand; however, states have only placed orders for 3.7 million doses. Despite the CDC222s supply, spot shortages have been reported across the country while a CBS News poll finds that only 46 percent of Americans say they are likely to get the vaccine, though 59 percent report that they are likely to vaccinate their children ( Kaiser Health News, 10/12 ; CBS News, 10/11 ; CBS News, 10/10 ). In addition, the U.S. military plans to use its health care databases to monitor potential adverse reactions, supplementing the effort from the Vaccine Advers e Events Report System (VAERS), which is jointly run by the CDC and the Food and Drug Administration (FDA) ( Kaiser Health News, 10/15 ). Studies Released AHIP Releases Report Outlining Potential Effects of Health Care Reform and Meets Significant Resistance : A report , conducted by PricewaterhouseCoopers (PWC) and released by America222s Health Insurance Plans (AHIP) October 12, estimates that the Senate Finance Committee 222s SAMHSA222s Weekly Financing News Pulse: National Edition October 16, 2009 10/16 /09 5 health care reform legislation could add $1,700 to family health insurance premiums by 2013 and could raise family premiums by over $4,000 by 2019. White House officials, Congressional Democrats, and health care reform advocates have refuted the report. In addition, numerous non - partisan policy analysts and PWC222 s official statement note that the analysis consider ed only a limited number of the legislation222s provisions rather than examining the legislation as a single entity ( Kaiser Health News, 10/12 ; Kaiser Health News, 10/12 ; Kaiser Health News, 10/13 ; Politico, 10/13 ; Washington Post, 10/15 ). The Blue Cross Blue Shield As sociation (BCBS) also released a report October 14 outlining possible effects of health care reform legislation, inclu ding estimating that the legislation would increase the price of average annual medical claims for individual policies by 50% in five years . The BCBS report considers some provisions of the bill omitted from the AHIP report as well as numerous caveats abo ut the estimations but is still dismissed by senior Democrats and health care reform advocates ( Kaiser Health News, 10/15 ; Wall Street Journal, 10/15 ). Rockefeller Institute on Government Report Finds State Revenues Show Record Drop: A report released by the Nelson A. Rockefeller Institute on Government on October 15 found that state tax collections for the second quarter showed a record drop of 16.6 percent. The report notes that every state but Vermont saw total tax revenue fall and that 36 states reported revenue declines of 10 percent or more . T he revenue shortages come as many states have already tapped their 223rainy day224 funds and relied heavily on ARRA funding in their most recent budgets , indicating that states will likely move to cut spending unless revenue increases ( AP, 10/15 ). S AMHSA Releases TEDS Repor t on Criminal Justice System Referrals to Subs tance Abuse Treatment : SAMHSA released the latest Treatment Episode Data Set (TEDS) report , finding that the criminal justice system was the single largest source of referrals to substance abuse treatment, accounting for 37 percent of admissions. The report found that criminal justice system referral admissions were less likely than all other referral admissions to drop out of treatment (22 vs.27 pe rcent). In addition, the most rapid area of growth within criminal justice system referrals has been among those younger than 18 years of age, increasing from 38 percent of adolescent admissions in 1992 to 47 percent in 2007 ( Media Newswire, 10/12 ; SAMHSA, 10/9 ). Urban Institute Brief Analyzes Census Bureau222s Health Care Coverage Data : Using data from the U.S. Census Bureau222s American Community Survey (Financing News Pulse 9/14 edition), the Urban Institute released a brief examining the variations in health care coverage by congressional district. The brief examines public and private coverage as well as uninsurance, finding that private coverage rates are lowest in districts with higher poverty rates and that uninsurance is highly correlated with low private coverage rates. The brief also identifies the districts that would benefit the most fr o m the increase d coverage currently proposed in national health care reform legislation ( Urban Institute, 10/5 ; Kaiser Health News, 10/12 ). Consumer Reports Survey Analyzes Health Plans, Finds Moderate Satisfaction: The Consumer Reports National Resource Center conducted a non - re presentative survey of HMO and preferred provider organization (PPO) enrollees, finding that 64 percent reported being 223very or completely224 satisfied with their plan, down 3 percent from 2007. The survey also found that, unlike in the recent past, H MO enrollees did report significantly greater difficulty accessing health care than PPO enrollees; however, HMO enrollees continued paying an average of $537 less in annual premiums. Consumer Reports222 data is available only to subscribers ( Washington Post, 10/12 ; Kaiser Health News, 10/13 ). SAMHSA222s Weekly Financing News Pulse: National Edition October 16, 2009 10/16 /09 7 Senate Homeland Security and Governmental Affairs Committee: Domestic Partner Benefits October 15, 10:00 a.m., 342 Dirksen House Veterans222 Affairs Subcommittee on Health: Inappropriate Billing Practices by the VA October 15, 10:00 a.m., 334 Cannon Senate HELP Committee: Equal Health Care Premiums for Women October 15, 10:30 a.m., 430 Dirksen House Energy and Commerce Subcommittee on Oversight and Inves tigations : Insured but not Covered October 15, 1:30 p.m., 2123 Rayburn House Foreign Affairs Subcommittee on Western Hemisphere: Western Hemisphere Drug Policy October 15, 2:00 p.m., 2172 Rayburn
