Last Tuesday, Senior Republican leadership in the Senate held a closed-door briefing for Republican Senate members regarding Senate health care reform legislation. Senior Republican leadership reportedly indicated that they favor the retention of guaranteed protections for individuals with preexisting conditions, a more gradual roll back of the expansion of Medicaid, and may opt to keep many of the taxes included in the Affordable Care Act (ACA). In the meantime, the Trump White House continued to send mixed signals regarding its willingness to continue to fund cost-sharing subsidies to insurers. Anthem announced that in 2018 it will not participate in the State of Ohio’s ACA marketplace, which will result in 10,500 people in 18 counties with no ACA insurance coverage choices according to the State’s Department of Insurance. Anthem cited as the reason for its action “continual changes in federal operations, rules and guidance” and a “shrinking individual market.”
This Tuesday the U.S. Senate Committee on Health, Education, Labor & Pensions will hold a full committee hearing on “The Cost of Prescription Drugs: How the Drug Delivery System Affects What Patients Pay.” The witnesses will be: (i) Dan Mendelson, President, Avalere Health; (ii) Allan Coukell, Senior Director of Health Programs, Pew Charitable Trusts; (iii) Paul Howard, Ph.D., Senior Fellow and Director of Health Policy, Manhattan Institute; and (iv) Gerald Anderson, Ph.D., Professor of Medicine, Johns Hopkins University School of Medicine. Live video of the hearing and witness testimony will be available at https://www.help.senate.gov/hearings/the-cost-of-prescription-drugs-how-the-drug-delivery-system-affects-what-patients-pay.
Also on Tuesday, the U.S. House of Representatives Energy and Commerce Health Subcommittee will hold a hearing entitled “Examining the Extension of Safety Net Health Programs.” Further information, including the Hearing Notice and the webcast, are available at
The Department of Health and Human Services’ Office of Inspector General (OIG) released a report entitled “Medicare Paid Hundreds of Millions in Electronic Health Record Incentive Payments That Did Not Comply With Federal Requirements.” The OIG found that the Centers for Medicare & Medicaid Services (CMS) did not always make Electronic Health Record (EHR) incentive payments under the Health Information Technology for Economic and Clinical Health Act to eligible professionals (EPs) in accordance with federal requirements. The federal government makes payments to EPs who attest to the “meaningful use” of EHRs. To receive an incentive payment, EPs attest that they meet program requirements by self-reporting data through the CMS online system. The OIG estimates that CMS improperly paid $729.4 million (12 percent of the total) in incentive payments to EPs who did not meet meaningful use requirements. The OIG determined that these errors occurred because sampled EPs did not maintain support for their attestations and CMS conducted minimal documentation reviews. A copy of the OIG report is available at https://oig.hhs.gov/oas/reports/region5/51400047.pdf.