D.C. Circuit grants en banc rehearing in Halbig v. Burwell
The Washington Post
September 4, 2014
http://www.washingtonpost.com/news/volokh-conspiracy/wp/2014/09/04/d-c-circuit-grants-en-banc-rehearing-in-halbig-v-burwell/
This morning the U.S. Court of Appeals for the D.C. Circuit granted rehearing en banc in Halbig v. Burwell, one of four cases challenging the lawfulness of an IRS rule authorizing tax credits and cost-sharing subsidies for the purchase of health insurance in federal exchanges. According to the challengers, the IRS rule is illegal because, among other things, the PPACA only authorizes tax credits and subsidies for the purchase of insurance on exchanges “established by the State,” and the PPACA expressly defines “State” as one of the 50 states or the District of Columbia. The order is here. Oral argument is scheduled for December 17. In all likelihood, an opinion would not issue before mid-to-late Spring.
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CMS Finalizes Rule for Automatic Re-Enrollment in 2015 Health Plans
Bloomberg BNA
September 3, 2014
http://www.bna.com/cms-finalizes-rule-n17179894334/
Consumers in the Affordable Care Act health insurance marketplace operated by the federal government will be able to automatically re-enroll in coverage for 2015 under a final rule issued Sept. 2 by the Centers for Medicare & Medicaid Services. The rule (CMS-9941-F) finalizes a proposed rule issued June 26. It is scheduled to be published in the Federal Register Sept. 5 and is effective 30 days from that date. Consumers in the federally facilitated marketplace will receive notices shortly before open enrollment begins for 2015, according to a fact sheet issued by the CMS. The notices will explain the “auto-enrollment” process and how consumers can see if they qualify for additional financial assistance and shop for plans, it said. Consumers will also receive notices from their insurance company about 2015 premiums and how much they may save with premium tax credits, it said. Open enrollment begins Nov. 15.
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Federal court denies CGI protest over Medicare contract terms — and that matters a lot to other contractors
Washington Business Journal
September 2, 2014
http://www.bizjournals.com/washington/blog/fedbiz_daily/2014/09/federal-court-denies-cgi-protestovermedicare.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+vertical_35+%28Hospital+Industry+News%29
It might not be worth a couple hundred million dollars like the HealthCare.gov contract proved to be. But another lucrative health care contract might disappear from CGI Federal’s coffers — and the significance of the loss goes well beyond the Fairfax-based company. A federal court denied a protest filed by CGI over the terms of a request for quotes from the Centers for Medicare and Medicaid Services, making it extremely unlikely the company will continue supporting the agency's program to uncover wrongful Medicare payments.
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Maine health centers get $730K through health law
WCSH
September 1, 2014
http://www.wcsh6.com/story/news/local/2014/09/01/maine-health-center-grants/14928553/
Three health centers in Maine are getting more than $730,000 in funding through the Affordable Care Act. The US Department of Health and Human Services said that the money will fund patient-centered medical homes. The department says the team-based model aims to increase access to care and help a patient be treated for several needs at one time. Eastport Health Care, Island Community Medical Services in Vinalhaven and Katahdin Valley Health Center in Patten are the health centers in Maine that are receiving the funding. The grants are part of $35 million that's being given to 147 health centers throughout the country.
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Medicare Will Settle Short-Term Care Bills
The New York Times
August 29, 2014
http://www.nytimes.com/2014/08/30/business/medicare-will-settle-appeals-of-short-term-care-bills.html
Sharply criticized by Congress and others, Medicare quietly announced on Friday that it would settle hundreds of thousands of hospital appeals over bills for short-term care, by offering deals that could add up to several hundred million dollars. The decision is an effort by the government agency to end a protracted battle with thousands of hospitals over the amount they should receive for treating patients who stay just a day or two. So many hospitals have filed appeals with Medicare that a backlog now stretches for 18 months or more before the disputes are being resolved. The proposed settlement, which was quietly posted on the agency’s website late Friday afternoon before the holiday weekend, represents a considerable concession by Medicare. The financial payout that it is offering to individual hospitals would be a little more than two-thirds of the amounts they have insisted they are owed.
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Federal grant to Miami health center will renovate and build clinics
Miami Herald
August 29, 2014
http://www.miamiherald.com/2014/08/29/4316301/federal-grant-to-miami-health.html
A community health center in Miami is one of two institutions in Florida to receive newly announced grants of $250,000 from the Affordable Care Act to help them build and renovate their medical facilities. The Jessie Trice Community Health Center, which treated its first patients from a trailer in 1967, now runs a dozen primary-care centers and 21 school-based clinics in and around Miami. Tampa Family Health Centers, which has 13 locations in Hillsborough County, is the other Florida recipient of the grants. The money for the two institutions is part of $35.7 million in ACA grants announced this week by the Department of Health and Human Services to support facility improvements at 147 health centers in 44 states, the District of Columbia and Puerto Rico. Dr. Fabian Thurston, the chief operating officer at the not-for-profit Trice center, said Thursday that the money will be used to refurbish and improve the Jefferson Reaves House, a 40-bed women’s residential center that since 1988 has been dedicated primarily to treating substance-abuse problems.
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Federal regulators approve Gov. Corbett's 'Healthy PA' Medicaid overhaul
Pittsburg Post-Gazette
August 29, 2014
http://www.post-gazette.com/news/state/2014/08/28/Healthy-PA-approval-expected-soon/stories/201408280284
Pennsylvania’s working poor could start receiving subsidized health insurance as early as Jan. 1 now that the federal government has approved the state’s proposed Medicaid overhaul. Federal regulators approved much of Gov. Tom Corbett’s “;Healthy PA” plan, the state and federal governments confirmed Thursday, ending months of negotiations between the two parties. Enrollment in what’s being called the “Healthy PA Private Coverage Option” will begin Dec. 1. Mr. Corbett’s plan, unveiled last year and formally submitted to the federal government for review in February, would not directly expand the state’s Medicaid program, but would instead offer federal subsidies to low-income Pennsylvanians to purchase private insurance. As many as 600,000 uninsured Pennsylvanians could be eligible, according to the state’s latest estimates.
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All the Companies Making Money From Healthcare.gov in One Chart
Bloomberg Businessweek
August 28, 2014
http://www.businessweek.com/articles/2014-08-28/all-the-companies-making-money-from-healthcare-dot-gov-in-one-chart
Healthcare.gov faltered last fall in large part because it was built by a crowd of uncoordinated contractors with no one in charge of making sure all the interlocking pieces fit together. As the White House tries to prevent a repeat catastrophe, government watchdogs are investigating why the Obamacare marketplace failed in the two months after it opened on Oct. 1, 2013. A new report (PDF) details the 60 separate government contracts, awarded to 33 companies, that contributed to building healthcare.gov. The chart above shows how much each contractor was awarded. The total price tag: almost $800 million, of which about $500 million had been paid as of February 2014, according to the Health and Human Services Office of Inspector General, which oversees the department responsible for healthcare.gov. CGI Federal (GIB) was the main contractor, awarded $251 million in five contracts to build, test, and maintain the exchange, beginning shortly after the Affordable Care Act became law in 2010.
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How you end up spending $800 million on HealthCare.gov
The Washington Post
August 27, 2014
http://www.washingtonpost.com/blogs/the-switch/wp/2014/08/27/how-you-end-up-spending-800-million-on-healthcare-gov/
Signed into law by President Obama on March 23, 2010, the Affordable Care Act has proven to be its own kind of jobs act, especially when it comes to the Washington-area IT community. When, in several places, the bill called for the creation of an "Internet website" to allow Americans to find and sign up for new health insurance coverage, it opened the tap on hundreds of millions of dollars that would eventually go to creating HealthCare.gov's front end and back end, as well as a small universe of accompanying digital sites. On Wednesday, the office of Daniel Levinson, the inspector general of the Department of Health and Human Services, put out a report detailing the dozens of contracts that went into building out the Federal Marketplace project. And a look at each in the disaggregate paints a picture of an effort far more sweeping than even that suggested by the half-billion dollars the federal government has already paid out to implement the digital side of the health insurance law.
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Medicare: Not Such a Budget-Buster Anymore
The New York Times
August 27, 2014
http://www.nytimes.com/2014/08/28/upshot/medicare-not-such-a-budget-buster-anymore.html?abt=0002&abg=1
You’re looking at the biggest story involving the federal budget and a crucial one for the future of the American economy. Every year for the last six years in a row, the Congressional Budget Office has reduced its estimate for how much the federal government will need to spend on Medicare in coming years. The latest reduction came in a report from the budget office on Wednesday morning. The changes are big. The difference between the current estimate for Medicare’s 2019 budget and the estimate for the 2019 budget four years ago is about $95 billion. That sum is greater than the government is expected to spend that year on unemployment insurance, welfare and Amtrak — combined. It’s equal to about one-fifth of the expected Pentagon budget in 2019. Widely discussed policy changes, like raising the estate tax, would generate just a tiny fraction of the budget savings relative to the recent changes in Medicare’s spending estimates.
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Deficit Forecast Trimmed as Rates Stay Low
The Wall Street Journal
August 27, 2014
http://online.wsj.com/articles/cbo-offers-mixed-forecast-of-u-s-budget-economy-over-next-decade-1409150020
The U.S. government's deficit over the next decade will be smaller than previously forecast, as a protracted period of low interest rates has slowed the increase of debt payments, the Congressional Budget Office said on Wednesday. The difference between revenue and spending is now forecast to be more than $400 billion smaller through 2024 than the agency estimated in April. Still, the cumulative deficit would be substantial, reaching $7.2 trillion over the same period. While interest payments on the debt will be less than originally forecast, they would reach $799 billion in 2024 alone, the CBO said. Federal finances are stabilizing after the fierce economic downturn and slow recovery, the CBO said. "The shadow [of the recession] lasted longer than we had thought it would," CBO Director Douglas Elmendorf said, adding that "at this point underlying financial conditions have improved." The deficit in fiscal year 2014, which ends Sept. 30, is projected to be $506 billion, or 2.9% of gross domestic product. That is less than one-third of the deficit in 2009—its recent peak—and slightly less than the average deficit over the past 40 years.
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Cummings presses feds on nursing home grades
Baltimore Sun
August 27, 2014
http://articles.baltimoresun.com/2014-08-27/news/bal-cummings-presses-feds-on-nursing-home-grades-20140826_1_cummings-nursing-homes-cms-administrator
Elijah E. Cummings on Tuesday called on federal health officials to reevaluate how they grade nursing homes in response to reports that some facilities are gaming the system. In a letter to the Centers for Medicare and Medicaid Services, the Baltimore lawmaker and top-ranking Democrat on the House Committee on Oversight and Government Reform requested a briefing on the issue next month. Cummings wrote he is particularly concerned the federal agency grades the homes in large part on self-reported metrics. "Some nursing homes have been able to obtain the highest overall rating of five stars even though government health inspectors have determined that the facility meets only average standards of care," Cummings wrote Marilyn Tavenner, the CMS administrator.
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Kevin Counihan, The New 'Obamacare CEO,' Faces Four Key Challenges
Forbes
August 26, 2014
http://www.forbes.com/sites/dandiamond/2014/08/26/meet-kevin-counihan-the-new-obamacare-ceo/
Kevin Counihan, who had served as the head of Connecticut’s health insurance exchange, on Tuesday was named the first CEO of Healthcare.gov. Counihan’s mission: To make sure that the federal insurance exchange, which suffered from crippling management failures last year, runs more effectively in the second year of Obamacare coverage expansion. As the first CEO of Healthcare.gov, Counihan will report to CMS administrator Marilyn Tavenner and have a “dotted line” reporting relationship to Sylvia Burwell, the HHS secretary. Counihan’s new role is “one of the toughest job in the federal government,” the Wall Street Journal‘s Louise Radnofsky notes, and he’ll face four key challenges in the early months.
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Connecticut Exchange CEO to Run HealthCare.gov
The Wall Street Journal
August 26, 2014
http://online.wsj.com/articles/connecticut-exchange-ceo-kevin-counihan-to-run-healthcare-gov-1409073144
Kevin Counihan, who led one of the few successfully launched insurance exchanges under the Affordable Care Act, was named chief executive officer of HealthCare.gov on Tuesday. Mr. Counihan, who ran Connecticut's exchange and is 59 years old, is about to take on one of the toughest jobs in the federal government. Health and Human Services Secretary Sylvia Mathews Burwell created the executive job in June as part of the administration's effort to overhaul the site in time for the second enrollment season. The health law called for the setting up of online exchanges where consumers can compare insurance plans and apply for tax credits toward the cost of coverage. HealthCare.gov is the platform the federal government uses to run exchanges on behalf of more than 30 states unable or unwilling to run their own.
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Issa demands CMS recoup billions from NY
The Hill
August 22, 2014
http://thehill.com/business-a-lobbying/215758-issa-demands-cms-recoup-billions-from-ny
House Oversight Committee Chairman Darrell Issa (R-Cali.) is demanding that the Centers for Medicare and Medicaid Services (CMS) recover billions in improper Medicaid payments from the state of New York. Issa and Rep. Jim Jordan (R-Ohio), chairman of the committee’s regulatory subcommittee, wrote to the CMS Thursday urging it to investigate overpayments to the Empire State over the past few decades and recoup as much as possible. “The Committee has documented that New York State, like many other states, has a long history of inappropriately, and at times unlawfully, shifting Medicaid costs to federal taxpayers,” Issa and Jordan said. The lawmakers are concerned former lobbyists with close ties to Gov. Andrew Cuomo (D-N.Y.) might be influencing the state to put to improper use $8 billion meant for restructuring its Medicaid program.
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Feds unveil new birth control mandate
The Hill
August 22, 2014
http://thehill.com/regulation/healthcare/215775-feds-to-unveil-birth-control-mandate-fix
The Obama administration is moving forward with regulations meant to enable certain businesses and charities to steer clear of the Affordable Care Act’s so-called birth control mandate, while ensuring free contraception coverage for women under the law. The action amounts to an administrative workaround in response to a slew of legal challenges from groups citing religious objections to portions of the mandate. In June, the Supreme Court ruled that closely held religious companies cannot be compelled to offer their employees certain forms of birth control. Under the proposal, the government would step in and cover the law’s contraception requirements in instances where employers announce their religious objections in writing. The organizations would not have to play any direct role in providing for contraceptive coverage to which they object, according to a final interim rule from the Centers for Medicare and Medicaid.
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Government issues new revision on birth control insurance mandate
Los Angeles Times
August 22, 2014
http://www.latimes.com/nation/la-na-obama-contraception-20140823-story.html
The Obama administration issued a new rule Friday aimed at winding down its years-long fight with religious groups over the requirement in its landmark healthcare law that companies provide insurance that covers contraceptives. The new rule will allow employers to register objections to paying for such care with the government, which would then arrange for insurers to provide coverage to women seeking it, according to the rule published in the federal register Friday. Previously, the rule called for groups to file their objections directly with insurers. Women across the country deserve access to recommended preventive services that are important to their health, no matter where they work. - Health and Human Services Secretary Sylvia Burwell. "Women across the country deserve access to recommended preventive services that are important to their health, no matter where they work," said Health and Human Services Secretary Sylvia Burwell in a statement. "Today's announcement reinforces our commitment to providing women with access to coverage for contraception, while respecting religious considerations raised by nonprofit organizations and closely held for-profit companies."
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New contraceptive coverage plan to be offered for religious nonprofits
Politico
August 22, 2014
http://www.politico.com/story/2014/08/obamacare-contraception-coverage-new-plan-110261.html
The Obama administration is offering yet another way for religious nonprofits to avoid providing contraceptive coverage under Obamacare, but the accommodation released Friday is unlikely to put an end to the ongoing court battles over the issue. The new plan, which addresses a high-profile component of the health care law, essentially adds HHS to the notification process for any group that objects to the coverage requirement. The legal challenges brought by scores of organizations across the country have put contraceptive coverage at risk for some women but not threatened the health care law itself. Under the accommodation, federal health officials will allow religious nonprofits such as Wheaton College and Little Sisters of the Poor to tell HHS that they object to providing the contraceptive benefit. The government will then instruct their insurance provider to offer the coverage at no cost to either the religious entity or its employees.
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Oregon Sues Oracle, Executives Over Health Exchange
The Wall Street Journal
August 22, 2014
http://online.wsj.com/articles/oregon-sues-oracle-executives-over-health-exchange-1408740298
The state of Oregon filed a lawsuit Friday against Oracle Corp. and several of its executives over the technology company's role in creating the troubled website for the state's online health-insurance exchange. The lawsuit, filed in Marion County Circuit Court in Salem, seeks more than $200 million in damages and alleges that Oracle officials made false statements, breached contracts and engaged in "a pattern of racketeering activity." Oracle was the largest technology contractor working on Oregon's health insurance enrollment website, known as Cover Oregon. The public website was never launched, forcing the state to hire hundreds of workers to process paper applications by hand. The website's failure became a political problem to Democratic Gov. John Kitzhaber, who is running for re-election.
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Backlash after Cuomo names lobbyist to oversee Medicaid spending
New York Post
August 21, 2014
http://nypost.com/2014/08/21/congressman-questions-cuomos-naming-of-lobbyist-to-oversee-medicaid-spending/
A leading Republican congressman is demanding an investigation into how a lobbyist was named by the Cuomo administration to help oversee $8 billion in Medicaid funds, The Post has learned. The probe would focus on Jim Introne, a top Cuomo health adviser who previously served as a hospital lobbyist and health-care consultant. “Of particular concern is that Gov. Cuomo has appointed former health-care lobbyist Jim Introne to oversee the disbursal of the Medicaid waiver money,” House Oversight Committee chair Darrell Issa (R-Calif.) said in a letter Thursday to the federal Center for Medicare and Medicaid Services. Introne was a lobbyist for Catholic hospitals before joining the Cuomo administration in 2011 as the governor’s deputy for health. He oversaw a program to squeeze savings from New York’s mammoth $45 billion Medicaid program.
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