REID, MCCONNELL, BAUCUS, GRASSLEY HAIL SENATE PASSAGE OF BILL TO ENSURE SENIORS, MILITARY FAMILIES CONTINUE ACCESS TO HIGH-QUALITY DOCTORS

Senate Leaders' Bill Would Fix Medicare Physician Payment Formula to Ensure Doctors Can Continue Seeing Medicare, Tricare Patients

Washington, DC - Senate Majority Leader Harry Reid (D-Nev.), Minority Leader Mitch McConnell (R-Ky.), Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa) today applauded Senate passage of legislation extending through 2011 a fix to the Medicare physician payment formula to ensure seniors and military families can be confident they will be able to continue seeing their doctors.  The legislation would ensure Medicare and Tricare, the health care program for active-duty service members, National Guard and Reserve members, retirees and their families, will continue to pay physicians who participate in those programs at current levels.

"This bipartisan agreement gives peace of mind to seniors and military families in Nevada and across the nation," said Senator Reid. "We ensured that our seniors and veterans can continue seeing their doctors and getting the treatment they need.  I appreciate the leadership of Chairman Baucus and Ranking Member Grassley for leading the effort to work across the aisle and reach this common-sense solution."

"I'm encouraged that we were able to work together in a bipartisan way and protect access to care for America's 45 million Medicare beneficiaries in a fiscally responsible manner," said Senator McConnell. "This bipartisan accomplishment will help ensure that Kentucky's seniors and military personnel and their families won't be denied access to their doctors as a result of inaction in Washington. I'm pleased that the White House is supportive and I hope our colleagues in the House will take up this measure and pass it promptly. "

"We worked together on this longer-term solution to give seniors and military families in Montana and across the country the peace of mind of knowing they still will be able to see their doctors and get the medicine they need," said Senator Baucus. "This bill provides the security patients deserve and the certainty doctors need, ensuring seniors and military families have access to the doctors they know and trust."

"With a double-digit payment cut, some doctors would stop seeing Medicare and Tricare patients," Senator Grassley said. "This bipartisan legislation will help to ensure that older Americans and military families can continue to get quality health care."

The bill, the Medicare and Medicaid Extenders Act of 2010, would avoid a 25-percent cut to Medicare physician payments under the Sustainable Growth Rate (SGR) formula that would otherwise go into effect on January 1, 2011.  The proposal also includes extensions of other expiring health care provisions, including protections for rural hospitals and doctors, Transitional Medical Assistance and the Special Diabetes Program.  The legislation would be paid for by modifying the policy regarding overpayments of the health care affordability tax credit.  This policy does not change the tax credits for which people are eligible based on their income.  Instead, the proposal would change the way people pay back overpayments when they have received more credit than they are eligible for because, for example, they earned more money than expected in a given year.

Under current law there is a flat cap of $250 for individuals and $400 for families on the amount of the health care affordability tax credit people are required to pay back when they received an overpayment.  This payback cap is the same for people earning 160 percent of the federal poverty level and 360 percent of the federal poverty level.  Under this proposal for correcting overpayments, the cap on the payback amount would be on a sliding scale based on the income of the recipient of the tax credit, making the policy fairer to both recipients and all taxpayers.

The Finance Committee has jurisdiction over the Medicare program and the physician payment formula, which also sets payment levels for the Tricare program.  A summary and legislative text of the Medicare and Medicaid Extenders Act of 2010 can be found on the Finance Committee website http://finance.senate.gov/legislation/.  The legislation must now be passed by the House and signed into law by the President.

 

 

###

Some have suggested piecemeal repeal of the most obnoxious features of the Affordable Care Act (ACA). The risk of this approach is comparable to that in cancer surgery: you might not get it all. In 906 pages of arcane statutory language, a lot can be hidden.

I suggest instead that we wipe the slate clean with a total repeal, and then consider reenacting any features that most agree are good. This would be the most efficient method because the list of items is shorter. Much shorter.

The most popular part is probably the elimination of "pre-existings." You can't eliminate the uninsurable condition of course, only the insurance company's ability to deny coverage to people who have it. How would such an isolated law work?

In a free market, coverage for people with pre-existings might well be available, without any law?if insurers could simply charge a premium reflecting their risk, or limit the potential pay-out. The premium, naturally, could be very high. That would be a strong incentive to buy insurance when young and healthy, and resist temptations to spend the premium money on iPods and new cars instead. But for many it is already too late.

The U.S. already has the equivalent of fire insurance for those whose house is burning down. It is called Medicaid. Roll into the emergency room desperately ill, and the hospital will treat you, and probably enroll you in Medicaid?likely after you have spent through any assets and lost your SUV and your home.

To prevent such personal tragedies, how about a law that simply said: "Insurance companies must take all comers, without price discrimination for pre-existing conditions." This is called "guaranteed issue" and "community rating" (GI/CR).

GI/CR would work well, if insurance were a magical money multiplier (MMM): put $100 in the slot machine, pull the lever, and watch $6 million in medical services pour out. The problem is that if a lot of healthy people who don't expect to need medical services decline to feed in their premiums, knowing they can always do so as soon as they get sick, premiums will have to escalate rapidly. This is called adverse selection (only sick people sign up), or the death spiral. It has happened every time GI/CR has been tried.

This popular part of ACA is impossible without the hated and unconstitutional individual and employer mandates.

What about doing away with limits on lifetime coverage? Limiting out-of-pocket expenditures? Doing away with copayments? All of these have the same problem: lack of an MMM, such as a money tree or the Philosopher's Stone that turns base metal into gold. The more we require insurance to pay out, the more money has to be poured in, with the inevitable loss to administrative overhead.

How about "giving doctors incentives to be more efficient"? In a free market, that is called the profit motive. In the ACA, the "incentives" are sticks painted to look like carrots, involving vast new reporting systems, with payments funneled through managed-care mechanisms. The choice is freedom?or ACA bureaucracies. Which of the some 159 new bureaucracies do we want to keep?

What about "affordability" provisions? Since prices are going up, in ACA "affordable" means forcing someone else to pay. It's a matter of redistributing money from those who earn more than 400% of the federal poverty level (around $88,000) to those who earn less. Americans are divided into winners and losers, guaranteeing constant fights over one's share of a shrinking pie.

One part everyone might favor is the one about allowing people to keep their insurance plan and their doctor if they like them.

Oh, that's not in the bill. That was just a Presidential promise. The ACA has rules for "grandfathering" some plans?a good term since they are not expected to have a long life expectancy. ACA also appears to be designed to drive independent doctors out of practice, and it virtually outlaws new doctor-owned hospitals.

If we continue to scour through the ACA looking for isolated good points that will make things better or less costly, rather than worse and more expensive, I predict that our thought experiment will lead to what in mathematics is called the "null set."

So far I have found no such provisions, zero. Nought, nada, nichts, zilch.

http://www.aapsonline.org/

Davenport, Iowa - Mississippi Valley Regional Blood Center will begin welcoming blood donors to its new Donor Center in Moline with a ribbon-cutting ceremony scheduled for 12:30 p.m. on Monday, November 15. The new Donor Center is located at 3600 16th Street in Moline (at the southeast corner of 16th St. and 36th Ave.). Blood donors will join MVRBC staff and officials from the Quad Cities Chamber of Commerce in officially opening the site.

Previously, the Blood Center operated Donor Centers that were located about four miles apart along Hwy. 5 (John Deere Road / Blackhawk Road) Moline and Rock Island. The new site is located about halfway between those locations, which are now closed. "Our new site has more space, more donor beds and more appointment slots," said Kirby Winn, Director of Public Relations. "It all adds up to more opportunities for blood donors to help patients at local hospitals."

Donors may schedule appointments by contacting MVRBC at (563) 359-5401 or online at www.bloodcenter.org. Hours of operation at the new location are:

Mondays & Thursdays: 10:30 a.m.-7 p.m.

Tuesdays & Wednesdays: 7 a.m.-7 p.m.

Fridays & Saturdays: 7-11:30 a.m.

The community is invited to attend an Open House at the new location from 8:30 - 11 a.m. on Saturday, December 4. Coffee, hot chocolate and bagels will be provided during the Open House, which will give current and prospective blood donors an opportunity to tour the location and learn about blood donation and the Blood Center's role in the community.

MVRBC is the provider of blood and blood components used for transfusion at all Quad City Area Hospitals. Working together with volunteer donors, MVRBC provides more than 25,000 units of blood and components each year to Genesis Medical Center hospitals in Davenport, DeWitt and Silvis; Hammond-Henry Hospital in Geneseo; Mercy Medical Center in Clinton; Select Specialty Hospital in Davenport and Trinity Regional Health System hospitals in Bettendorf, Moline, Muscatine and Rock Island. From its headquarters in Davenport, MVRBC serves a total of 75 hospitals in Illinois, Iowa, Missouri and Wisconsin. For additional information, see www.bloodcenter.org.

-end-

WASHINGTON -- Sen. Chuck Grassley and Sen. Herb Kohl are asking the federal government to move forward in implementing new physician payment sunshine provisions.  The senators said some drug and medical device makers are preparing to meet the new requirements but in the absence of clear guidance from the federal government, are preparing payment data in non-uniform ways, causing the material to be difficult for the public to use.

Kohl is chairman of the Senate Special Committee on Aging and Grassley is ranking member of the Senate Committee on Finance.  They sponsored the Physician Payment Sunshine Act, which became law as part of the health care overhaul enacted this year.  The new provisions require drug and medical device manufacturers to disclose to the Department of Health and Human Services anything of value given to physicians, such as payments, gifts, honoraria or travel above certain minimum thresholds.  The goal is to inform consumers in case they want to consider the role such payments or gifts play in the provision of medical care.  The senators said the information will be collected in 2012 but some companies are preparing now, and greater guidance from the agency would help the utility of the information for the public.

The text of the senators' letter is available here.

Friday, November 05, 2010

Sen. Chuck Grassley, ranking member of the Finance Committee, with jurisdiction over key federal health care programs, made the following comment on a news report that health care costs will go up for AARP employees.

"AARP supported a partisan health care overhaul that cut Medicare by almost $500 billion. That will result in less choice, fewer benefits and decreased access to care for millions of its members. But now we hear that AARP's members aren't the only ones who will bear the brunt of the new health care law. Like companies across the country, AARP is shifting more costs onto employees in reaction to the health care overhaul. Despite their employer's support, AARP employees are learning that the health care law is not going to address the top priority of making health care coverage less expensive.  Supporters of the law tend to have tunnel vision and focus on how it will affect narrow groups of people, rather than recognizing that most people will just end up paying more.  But the big picture is clear.  Employers and employees nationwide will pay more for health care because of the new law."

A news article from the Associated Press follows.

Citing health overhaul, AARP hikes employee costs

By RICARDO ALONSO-ZALDIVAR, Associated Press Ricardo Alonso-zaldivar, Associated Press 2 hrs 52 mins ago

WASHINGTON - AARP's endorsement helped secure passage of President Barack Obama's health care overhaul. Now the seniors' lobby is telling its employees their insurance costs will rise partly as a result of the law.

In an e-mail to employees, AARP says health care premiums will increase by 8 percent to 13 percent next year because of rapidly rising medical costs.

And AARP adds that it's changing copayments and deductibles to avoid a 40 percent tax on high-cost health plans that takes effect in 2018 under the law. Aerospace giant Boeing also has cited the tax in asking its workers to pay more. Shifting costs to employees lowers the value of a health care plan and acts like an escape hatch from the tax.

"Most plan co-pays and deductibles have been modified," Jennifer Hodges, AARP's director of compensation and benefits, wrote employees in an Oct. 25 e-mail. "Plan value changes were necessary not only from a cost management standpoint but also to ensure that AARP's plans fall below the threshold for high-cost group plans under health care reform."

AARP officials said medical inflation is the main reason employee costs will be going up. The health care law is "a small part," said David Certner, legislative affairs director.

Although the tax on so-called "Cadillac" health care plans doesn't take effect for years, employers are already beginning to assess their potential exposure because it is hefty: at 40 percent of the value above $10,200 for individual coverage and $27,500 for a family plan. The tax is intended as a savings measure, to prod employers and workers into more cost-efficient plans.

Certner said AARP's plans are currently under the threshold for the tax. "We intend to stay below those thresholds," he said. "It's not in anybody's interest to move above those thresholds, not the employees' nor the employer's."

AARP officials say the organization's public policy recommendations are made independently of other considerations, including its range of business ventures, from travel, to insurance, to publishing.

The 40 million-strong AARP represents people 50 and older, including retirees on Medicare and Social Security. Its endorsement of health care overhaul came at a critical time last year, days before a close vote on the House floor.

"The impact on AARP employees is not a factor at all in our policy making, which is directed at the impact on our membership and on all older Americans," said Certner.

About 4,500 people are covered by AARP's plans, including employees, dependents and retirees.

"We supported the (health care) package because it contained incredibly important protections for our younger members, who often have problems getting access to care," said spokesman Jim Dau. "And because it helps our older members in Medicare with important new benefits."

Starting in 2014, the overhaul law prohibits insurance companies from turning down people with medical problems, and limits what they can charge older customers. It gradually closes the coverage gap in the Medicare prescription benefit, and improves coverage for preventive care.

The Obama administration says changes required by the law so far have only had a minimal, single-digit impact on premiums. Many benefits experts agree with that assessment but point out that the increases come on top of untamed health care inflation.

AARP warned its employees that more cost-shifting could be in store. "AARP intends to make similar changes, as necessary, in the future to avoid the (health plan) tax," said Hodges' e-mail.

Current forecasts are that the overhaul will only have a small impact on job-based coverage, slightly reducing the number of people who would otherwise be covered by employer plans. Those workers would have access to taxpayer-subsidized coverage through new insurance markets.

 

Reply

Forward




WASHINGTON, D.C. - November 4, 2010 - Senator Tom Harkin (D-IA) today announced that $1,771,228.41 will be coming to Iowa in tax credits and grants to promote biomedical research.  The funds will help small biotechnology companies to produce new and cost-saving therapies, support good jobs and increase U.S. competitiveness.  The funds are provided under the new therapeutic discovery project program and are administered by the U.S. Department of Health and Human Services (HHS).  The program was created under The Affordable Care Act, the historic health reform law.  As Chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, Harkin played a pivotal role in the Senate passage of that law.

"Iowa's biotechnology companies are helping to lead the way in new research that will one day improve and save lives," said Harkin.  "With these funds, we not only support the search for medical cures, which will one day help lower health care costs, we are also keeping Iowa competitive in the global biomedical industry and creating good jobs in our state.  This is truly a double win for Iowa."

According to HHS, the therapeutic discovery project program is targeted to projects that show significant potential to produce new therapies, address unmet medical needs, reduce the long-term growth of health care costs, or advance the goal of curing cancer within the next 30 years.  The allocation of the credit also reflects projects that show the greatest potential to create and sustain high-quality, high-paying jobs in the United States and to advance our competitiveness in the fields of life, biological, and medical sciences.  Today, the biotechnology industry employs 1.3 million workers, and the industry continues to be a key growth engine for our economy.  The credit covers up to 50 percent of the cost of qualifying biomedical research and is only available to firms with fewer than 250 employees.  To provide an immediate boost to U.S. biomedical research and the small businesses that conduct it, the credit is effective for investments made in 2009 and 2010.  Firms could opt to receive a grant instead of a tax credit, so start-ups that are not yet profitable can benefit as well.

Details of the Iowa projects can be found here.

October 28, 2010

Contact: Public Information Officer at 563-326-8618

Since July 2010, there have been 103 cases of Pertussis (Whooping Cough) reported in Scott County and the number of cases continues to grow. As a result, the Iowa Department of Public Health has declared Scott County a Pertussis (Whooping Cough) Outbreak Area.

During a Pertussis Outbreak, anyone who has had a cough for more than two weeks, without another known reason (asthma, bronchitis, pneumonia, etc) and has either coughing "spells or fits", or a whoop with their cough, or vomits after coughing is considered to be a case of Pertussis and needs to see their doctor for testing and treatment.

Pertussis is easily spread to others when someone who has it coughs germs into the air and other people breathe them in. School age children and healthy adults who have Pertussis may not look very sick, but can still spread the disease to other people when they cough.

It is very important for people who have Pertussis to stay at home the entire time they are taking their medicine. That means no school, no work, no grocery shopping, no church, etc. Pertussis can cause babies, people with weak immune systems and older people to get very sick or even die.

For more information call the Scott County Health Department at 563-326-8618 or visit www.scottcountyiowa.com/health.

WASHINGTON - Tuesday, October 26, 2010 - Sen. Chuck Grassley is expressing concern over whether the National Cancer Institute unfairly disciplined its ethics director for trying to make sure agency travel complies with federal law and procedures, including those set by the institute's parent agency, the National Institutes of Health.  The travel at issue is sponsored by non-government sources, such as corporations and other private entities.

"Some government agencies have more travel than others.  They should be used to transparency and scrutiny to make sure they follow the rules," Grassley said.  "National Cancer Institute executives appear to have taken issue with the scrutiny to sponsored travel given by their then-chief ethics officer.  It's important to get to the bottom of whether the ethics officer was retaliated against just for doing her job."

 Grassley wrote to the director of the National Institutes of Health and the director of the National Cancer Institute, seeking details of National Cancer Institute employees' sponsored travel.  He asked the National Cancer Institute to conduct an internal review of whether it has furnished all required information to the Office of Government Ethics and copied the Office of Government Ethics.  Grassley also reminded the National Cancer Institute that interfering with federal employees' rights to furnish information to Congress is a violation of federal law.

 Grassley's letter is available here.

WASHINGTON - Tuesday, October 26, 2010 - Senator Chuck Grassley today said that the U.S. Department of Health and Human Services has awarded $1,143,168 to the Iowa Department of Public Health. 

According to the U.S. Department of Health and Human Services, the Iowa Department of Public Health will use the money to fund maternal and child health services.

Each year, thousands of local Iowa organizations, colleges and universities, individuals and state agencies apply for competitive grants from the federal government.  The funding is then awarded based on each local organization or individual's ability to meet criteria set by the federal entity administering the funds.

-30-

New Advisory Panel will Address Disparities in Breast Cancer Rates

CHICAGO - October 18, 2010. Governor Pat Quinn today announced a new initiative to fight breast cancer that will improve access to mammograms and treatment. The effort will be overseen by a new advisory panel charged with raising the quality of care for all women, focusing specifically on strategies to reduce the racial disparity in breast cancer mortality.

"Breast cancer is a deadly disease that affects women across Illinois," said Governor Quinn. "We are doing everything we can to make sure more women have access to lifesaving screenings and treatments. The Breast Cancer Quality Screening and Treatment Board consists of highly-qualified medical experts and health care advocates who will work hard to fight this disease."

The members of the newly formed Breast Cancer Quality Screening and Treatment Board include :

  • Dr. David Ansell, Vice President for Clinical Affairs and Chief Medical Officer for Rush University Medical Center and Associate Provost for Medical Affairs, Rush University.
  • Dr. Bechara Choucair, Commissioner, Chicago Department of Public Health
  • Sister Sheila Lyne, CEO and President, Mercy Hospital
  • Eileen Knightly, Director, Mercy Hospital Breast Care Center
  • Anne Marie Murphy, Executive Director, Metropolitan Chicago Breast Cancer Task Force
  • Dr. Pamela Ganschow, Director, John H. Stroger Hospital of Cook County Breast & Cervical Cancer Screening Program
  • Dr. Elizabeth Marcus, Chair, John H. Stroger Hospital of Cook County Division of Breast Oncology
  • Stephani Huston Cox, Director of Patient Services, Planned Parenthood Springfield Area
  • Linda Maricle, Executive Director, Susan G. Komen for the Cure Peoria
  • Donna Thompson, Chief Executive Officer, Access Community Health Network
  • Elizabeth S.A. Patton, Administrator, East Side Health District
  • Salim Al Nurridin, Chief Executive Officer, Healthcare Consortium of Illinois
  • Vicki Vaughn, Director, St. Mary's Hospital

The mission of the Breast Cancer Quality Screening and Treatment Board is to work with the Medicaid Program and IBCCP to identify gaps in screening and diagnostic mammogram services throughout the state; expand the use of digital mammography; recommend common quality standards; identify best practices for effective outreach to reduce racial disparities; and monitor the pilot projects.

The new initiative is a joint project by the Illinois Department of Healthcare and Family Services (HFS) and the Illinois Department of Public Health (IDPH). It will include an increase in the Medicaid reimbursement rate beginning in 2011 for screening providers who commit to high-quality service and data sharing on detection rates with the Chicago Breast Cancer Quality Consortium. Medicaid spending for the program will qualify for federal matching funds.

"I am very glad to be working with Governor Quinn, our partners at IDPH and our board of experts to improve access to-and the quality of-breast cancer screening and treatment for women throughout our state," said HFS Director Julie Hamos.

The initiative will include three new pilot projects to assist women who have breast cancer and are being treated through either the Medicaid Program for low-income women or the Illinois Breast and Cervical Cancer Program (IBCCP), which provides free breast and cervical cancer screenings and services to uninsured eligible women in Illinois. The pilot projects will test different approaches to best assist these women in navigating the complex system of breast cancer health care and treatment.

"Early detection can help save lives, and mammography remains the most effective means available to detect cancer in its earliest stages," said IDPH Director Dr. Damon T. Arnold. "We look forward to working with the new board to help ensure all women have access to quality mammography and other breast cancer services."

As part of the initiative, the state will ramp up its educational outreach programs about early detection and treatment of breast cancer. Women over the age of 40 will be informed of access to free annual mammograms - whether they are enrolled in Medicaid or Medicare, have private insurance coverage or are uninsured. Under the new federal Affordable Care Act all new and renewed private health insurance policies will offer free annual mammograms.

###

Pages