Archive for January 2012
BACK AND FORTH: Free Birth Control vs. Freedom of Religion
Administrators at many Catholic universities are resisting new federal rules that will require health plans to cover contraceptive services for employees, while many of the schools’ students say current restrictions hinder access.
The new rules — which are part of a provision in the federal health reform law — require health plans to cover contraceptive services for employees without consumer cost-sharing. However, not-for-profit employers do not have to offer the coverage if they have the inculcation of religious values as their purpose, primarily employ individuals who hold certain religious beliefs and primarily serve a population with those religious tenets.
Catholic hospitals, universities and other organizations had pressured HHS to create an even broader exemption that would allow them to refuse to cover contraception for their employees, but the agency announced on Jan. 20 that it would not expand the exemption. HHS said it would give religiously affiliated employers an extra year to comply with the rule, meaning that they will have until Aug. 1, 2013, to begin providing the coverage. Read the rest of this entry »
AHL’S TOP STORY: Federal Judge Issues Temporary Injunction on California Medicare Payment Cuts
U.S. District Court Judge Christina Snyder yesterday temporarily blocked a 10% cut to physician reimbursements through Medi-Cal, California’s Medicaid program, saying the cuts would cause “irreparable harm” to beneficiaries, the AP/Sacramento Bee reports (AP/Sacramento Bee, 1/30).
The cuts, which California Gov. Jerry Brown (D) signed last year, were part of the state’s strategy to alleviate its budget constraints (Mieszkowski, Bay Citizen, 1/31). Several California health care organizations filed a lawsuit challenging the payment cuts.
POLL: Can the Health Reform Law Stand Without the Individual Mandate?
The Obama administration on Friday said that if the Supreme Court strikes down the federal health reform law’s individual mandate, most of the law can remain intact. Plaintiffs in the case have argued that the entire law must be voided if the mandate is struck down.
In a brief filed with the court, Department of Justice lawyers noted that just two provisions would need to be eliminated if justices deem the mandate unconstitutional.
However, Karen Harned of the National Federation of Independent Business, a plaintiff in the case, said that the mandate holds the reform law together. She added, “To argue otherwise would be like arguing a house can stand after its foundation has crumbled.”
AHL’S TOP STORY: DOJ Brief Argues Most of Reform Law Can Stand Without Individual Mandate
The Obama administration last week said that if the Supreme Court strikes down the federal health reform law’s individual mandate, most of the law can remain intact, Politico reports. Plaintiffs in the case have argued that the entire law must be voided if the mandate is struck down (Haberkorn, Politico, 1/27).
[Ed. Note: For background on the Supreme Court's review of the federal health reform law, click here.]
In a brief filed with the court, Department of Justice lawyers noted that just two provisions would need to be eliminated if justices deem the mandate unconstitutional: one requiring health insurers to accept individuals regardless of their health status and the other prohibiting insurers from charging higher premiums based on an individual’s medical history (Vicini, Reuters, 1/27). Read the rest of this entry »
THE FRIDAY RUNDOWN: If You Ignore It, Maybe It Won’t Go Away
As February looms, it’s becoming a matter of days, not months, before the Supreme Court begins hearing the case against the federal health reform law.
IT’S OH SO QUIET: Democrats, led by President Obama, have come to a collective hush on the federal health reform law. In his State of the Union address on Tuesday, Obama spent little time discussing the federal health reform law.
In fact, Obama’s speech included just 44 words on the overhaul, far fewer than in his previous addresses. During the address, he said that the makeup of the overhaul — which he noted relies on a “reformed private market, not a government program” — is a sign that he is willing to work with Republicans.
Obama also said he “will not go back to the days when health insurance companies had unchecked power to cancel your policy, deny you coverage or charge women differently from men.”
AHL’S TOP STORY: GAO Report Finds as Much as $3.1B in MA Overpayments in 2010
A new Government Accountability Office report found that Medicare Advantage plans in 2010 were overpaid by between $1.2 billion and $3.1 billion, The Hill‘s “Healthwatch” reports (Pecquet, “Healthwatch,” The Hill, 1/26).
[Ed. Note: For background on Medicare Advantage payment rates, click here.]
According to the report, the overpayments resulted from a faulty risk adjustment process that overstated beneficiaries’ sicknesses, which triggered the higher payment rates (Wayne, Bloomberg, 1/27). The report suggests that private insurers are more attentive about noting disease diagnoses that garner higher reimbursements (Sanger-Katz, National Journal, 1/26).
The report, which House Democrats requested, calls on CMS to improve the accuracy of the risk score adjustment by readjusting the diagnostic coding system (Daly, Modern Healthcare, 1/26). The report did not identify plans that received the overpayments, Bloomberg reports (Bloomberg, 1/27).
Read the rest of this entry »
Blogger vs. Blogger: Why Didn’t Obama Spend More Time on Health Reform?
President Obama in his State of the Union address on Tuesday spent little time discussing health care and the federal health reform law. Obama’s speech included just 44 words on health reform, far fewer than in his previous addresses.
Sarah Kliff of the Washington Post‘s “Wonkblog”and Forbes‘ Robert Book had different conclusions on why Obama said so little about the overhaul.
AHL’S TOP STORY: GOP Will Release Alternative Health Reform Plan After Supreme Court Rules on Overhaul
House Energy and Commerce Health Subcommittee Chair Joe Pitts (R-Pa.) yesterday said that the GOP will release an alternative to the federal health reform law after the Supreme Court rules on the law’s constitutionality, Politico reports (Haberkorn, Politico, 1/25).
Republicans last year unsuccessfully attempted to repeal the reform law, as well as some of its individual provisions (American Health Line, 7/6/11). However, the “replace” portion of their “repeal and replace” strategy never came to fruition (Baker, “Healthwatch,” The Hill, 1/25).
Pitts said, “We will be ready to respond to the Supreme Court decision, which is expected in June, with a replacement package.”
He said the plan likely will include proposals that Republicans have long supported, such as:
- Giving tax breaks for health insurance to workers instead of employers;
- Limiting medical malpractice suits;
- Allowing insurers to sell plans across state lines (Politico, 1/25); and
- Creating state-based high-risk pools funded by the government instead of requiring private insurers to cover people with pre-existing conditions (“Healthwatch,” The Hill, 1/25).
WHAT WE’RE READING: Are You There God? It’s Me, Tummy.
- “Rick Warren and Church Tackle Obesity,” CNN: 50% diet, 50% faith. What exercise? Read the rest of this entry »
