MLA Weekly Health Care Wrap-Up: 9.9.11

September 9, 2011

Federal Health Care Update

President Obama Addresses Joint Session of Congress

On Thursday, President Obama addressed a joint session of Congress to lay out his $447 billion plan to spur job growth in the U.S. The plan includes approximately $253 billion in payroll tax cuts and small business tax credits and $194 billion in new spending, including an extension of unemployment benefits. The president indicated he would be releasing additional details on his deficit reduction plan early next week and suggested that the roughly $450 billion plan outlined on Thursday evening could be financed through the work of the congressional "Super Committee" charged with deficit reduction. In his remarks, the president pointed specifically to Medicare as an area of possible focus saying, "We have to reform Medicare to strengthen it."

Super Committee Holds First Public Meeting

The Joint Committee on Deficit Reduction, also known as the "Super Committee," held its first organizational meeting on Thursday. Most of the meeting was focused on members' opening statements as well as approving the Committee rules. Common themes from members on both sides of the aisle included the link between job creation and deficit reduction, the need for transparency and the desire to look toward other bipartisan efforts, including Bowles-Simpson, Rivlin-Domenici and the Senate Gang of 6, for possible solutions. The next hearing will be September 13, when CBO Budget Director Doug Elmendorf will testify. All hearings will be announced at least one week in advance.

Also this week, the Committee named Sarah Kuehl its Deputy Director. Sarah is currently a member of the staff of Senate Budget Committee Chairman Kent Conrad, where she served as one of the Senator's lead staffers during the health care reform debate. Her current policy portfolio includes Medicare, health insurance and Social Security.

HHS Announces $11.9 million To Implement Health IT In Rural Areas

On September 2, the Department of Health and Human Services (HHS) announced $11.9 million to support health information technology (HIT) in rural areas. Each of the 40 grantee organizations will receive approximately $300,000 to purchase equipment, install broadband networks and provide staff training. The funding is made available through the Health Resources and Services Administration (HRSA), a division of HHS.

Senate Committee Approves Children's GME, Autism Bills

On Wednesday, a bill reauthorizing the Children's Hospital Graduate Medical Education (CHGME) Program moved one step closer to passage after obtaining unanimous support in the Senate Health, Education, Labor and Pensions (HELP) Committee. The bill would reauthorize the program at the current funding level for five years, providing up to $330 million in annual discretionary funding to hospitals that train the nation's pediatric workforce. The program, which President Obama proposed terminating in the FY12 budget, provides funding to freestanding children's hospitals for direct and indirect expenses associated with operating their medical residency programs.

Also on Wednesday, the Senate HELP Committee unanimously approved the Combating Autism Reauthorization Act (CARA), which would extend the programs authorized under the original Combating Autism Act (CAA) an additional three years. CAA provides for autism surveillance programs at the Centers for Disease Control and Prevention, as well as intervention and training programs at the Health Resources and Services Administration, among other programs. The CAA will lapse on September 30 without reauthorization.

Medicare Fraud Strike Force Charges Individuals For False Billing

On Wednesday, U.S. Attorney General Eric Holder and HHS Secretary Kathleen Sebelius announced charges against 91 individuals, including doctors, nurses, and other medical professionals, for their alleged participation in Medicare fraud schemes involving approximately $295 million in false billing. The investigation was carried out by Medicare Fraud Strike Force operations in eight U.S. cities. The Strike Force, which is part of the Health Care Fraud Prevention and Enforcement Action Team (HEAT), is a joint initiative launched in May 2009 between the Department of Justice and HHS designed to combat Medicare fraud through use of Medicare data analysis and an increased focus on community policing.

The defendants charged are accused of various health care fraud-related crimes, including conspiracy to defraud the Medicare program, health care fraud, violations of the anti-kickback statutes and money laundering. The charges are based on a variety of alleged fraud schemes involving various medical treatments and services such as home health care, physical and occupational therapy, mental health services, psychotherapy and durable medical equipment.

From The States

For full coverage of state exchange activities, check out this week's State of the States: Health Insurance Exchange Developments here.


On Wednesday, Louisiana District Judge Janice Clark issued a temporary restraining order blocking the state Department of Health and Hospitals from proceeding with its implementation of a plan to shift more than 800,000 Medicaid recipients to private insurers. The order was granted on behalf of Aetna, who is protesting the state's decision to award the managed care contracts to other carriers.


Commerce Secretary Mike Rothman announced Tuesday that he will appoint a task force to advise on the design and development of a health insurance exchange. The Minnesota Health Insurance Exchange Advisory Task Force will consist of 15 members. In addition, four legislators (2 Democrat, 2 Republican) representing the Minnesota House and Senate will be appointed to the task force to serve as ex-officio members. The announcement comes against the backdrop of Republican legislators' strong opposition to Minnesota's receipt of a $4 million Level One Establishment grant from the federal government in August to support their health insurance exchange evaluation and planning process.


On Thursday, the 4th Circuit Appeals Court of Virginia dismissed one of the highest profile challenges to the Affordable Care Act. The ruling stated that Virginia Attorney General Ken Cuccinelli did not have a legal right to sue over the law's requirement to purchase insurance because the state lacks "standing" in the matter. The 4th Circuit also dismissed the case brought against the law by Liberty University.

Calendar: Looking Ahead

Monday, September 12.

Tuesday, September 13.

Wednesday, September 14.

Thursday, September 15.

Around Town

Data collected by the Centers for Disease Control and Prevention and published on September 2 found that 25 percent of American adults reported having a mental illness the previous year. The report explores the increased costs associated with treating such patients and recognizes the need for greater access to mental health treatment.

On Thursday, AARP, the Commonwealth Fund and The Scan Foundation released a report ranking all 50 states as well as D.C. in 25 categories aiming to comprehensively measure the availability of accessible, affordable and quality long term care for the elderly and disabled, as well as support for caregivers. The results of the study can be found here.

The September issue of Health Affairs features several articles on the urgency to lower health care costs. To read the issue, click here.

A new report by the RAND Corporation explores consolidation among health plans nationally.

A new study released by the Commonwealth Fund on Thursday reveals that Affordable Care Act reforms could reduce the number of underinsured U.S. adults by 70 percent.

Quotes of the Week

 "Millions of Americans rely on Medicare in their retirement. And millions more will do so in the futureā€¦But with an aging population and rising health care costs, we are spending too fast to sustain the program. And if we don't gradually reform the system while protecting current beneficiaries, it won't be there when future retirees need it. We have to reform Medicare to strengthen it."

- President Obama addressing Medicare reform in his speech to a Joint Session of Congress on Thursday evening.

"In order to succeed, I know this committee must be primarily about the business of saving and reforming social safety-net programs that are not only failing many beneficiaries, but going broke at the same time."

- Representative Jeb Hensarling, (R-TX) and co-chairman of the deficit reduction committee upon the conclusion of the first meeting of the bipartisan Super Committee on Thursday.