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August 20, 2014
Funding for the 2010 Affordable Care Act hinges, in part, on a 2.3 percent excise tax on medical device sales. The tax applies to cardiac defibrillators, imaging equipment and a variety of other equipment sold to hospitals, doctors and other providers. Congressional efforts to eliminate the tax enjoy significant bipartisan support in Congress from Republicans and Democrats, particularly from states that are home to a concentration of medical device manufacturers.
Internal Revenue Service collection of the tax began in 2013. A Treasury Department’s Inspector General report released on Tuesday indicates that taxpayer reporting on the IRS excise tax form does not account for all applicable medical device sales. Also, the tax agency is struggling to reconcile data provided by taxpayers and cannot accurately identify all of the medical device makers that are required to file the form and pay the tax. Through the first half of 2013, Treasury auditors estimate that the tax levy should have collected $1.2 billion in excise taxes, but the IRS has received $913 million.
August 14, 2014
The White House Office of Management and Budget is the last stop prior to final approval of most agency rule proposals. This week, the Centers for Medicare and Medicaid Services sent to OMB a final rule revising several Medicare provider enrollment conditions, designed to block fraudulent suppliers. The proposal also adjusts an incentive reward for reporting potential fraudulent providers. Initial proposed rules, unveiled in 2013, suggested an increase of the reward from 10 percent of over-payments recovered to 15 percent.
Also, the original draft included a provision limiting the ability of an ambulance service to “back bill” for transportation services provided prior to a new Medicare provider enrollment application. However, ambulance providers commented that back billing is sometimes necessary to provide emergency coverage in a service region following the abrupt withdrawal of another ambulance service, when there isn’t enough time to process a new application.
The timetable for White House handling of rules and the final components of the new regulations can vary. Approval can be processed within days of receipt or a proposal can linger at OMB for months due to internal discussion and debate.
August 12, 2014
Medicare identification cards would no longer display beneficiaries’ Social Security numbers under a new bill outlined recently by the chairman of the House Ways and Means Subcommittee on Health. Rep. Kevin Brady, R-Texas, released the draft text of a measure that compiles a wide range of suggestions to thwart Medicare and Medicaid payment fraud and abuse. The proposals– collected from a bipartisan suggestions offered by committee members — range from halting payments for health services provided to deceased beneficiaries to enhanced fraud abuse monitoring of various specific provider payments, such as those for medical equipment, vacuum erection systems and ambulance services.
The aim of ending the printing of Social Security numbers on Medicare cards is to protect against possible fraud against Medicare beneficiaries, rather than to save the program’s money. The Medicare card is one of the few remaining federal documents that still display the full Social Security number, opening up the possibility for identity theft if the card is lost or stolen.
Eliminating Social Security numbers on the card is a long-running bipartisan congressional objective that has not been taken up by the Centers for Medicare and Medicaid Services. HealthBeat’s John Reichard reported in April on questions about the ID card posed to CMS official at a panel hearing on Medicare fraud. The Medicare agency insists that it lacks the resources to make the change.
The Government Accountability Office in 2012 reviewed several options offered to CMS to change the Medicare card. The suggestions included replacing the number, only partially displaying it, or denoting it in a machine readable bar code.
A bracelet monitoring device, FitBit, used to track individual fitness health information is the current privacy target of Senator Charles E. Schumer. The device provides feedback on location and basic individual health statistics to assist a fitness regimen.
The New York Democrat insists the information is private health data and is seeking Federal Trade Commission action to force the manufacturer to offer an “opt-out” option on the sale of the health and fitness data to third parties. Schumer issued his call for regulatory action in a recent statement and New York television appearance.
Last year, an FTC staff report recommended privacy guidelines for mobile health application providers, which would allow for user selection of the types of information that can be shared.
August 8, 2014
A House Foreign Affairs subcommittee hearing Thursday on the Ebola outbreak in West Africa prompted a discussion on Department of Health and Human Services (HHS) funding levels. The lead agency responding to the Ebola crisis is the Centers for Disease Control and Prevention (CDC), which is funded through the HHS budget. The chairman of the House panel questioned whether enough money was available for CDC programs designed to prepare for a pandemic health crisis. CQ HealthBeat’s Kerry Young reported that a senior GOP appropriator, also attending the hearing, inquired about the need to shift current HHS funding toward toward addressing the CDC response to the Ebola crisis.
However, the HHS budget is already subject to separate transfers to cover new expenses from an influx of migrant children at the border with Mexico. A HHS agency, the Administration for Children and Families, is responsible for housing and care for the migrant children. The administration requested emergency program funding for HHS border relief efforts, but Congress was unable to reach an agreement on supplemental spending prior to the August congressional recess.
Neither the House nor Senate has passed a fiscal 2015 spending bill for HHS, whose appropriations are frequently stymied by disputes over additional spending for the implementation of the 2010 health care law. When Congress returns in September, appropriators could offer additional HHS pandemic response funding in separate planned action on a stopgap continuing spending resolution which would extend funding for all federal agencies past the Oct. 1 start of the new federal fiscal year.
August 7, 2014
A House Foreign Affairs subcommittee today holds a hearing on the U.S. response to the Ebola crisis. Roll Call will live stream the hearing session starting at 2:00 p.m.
Witnesses at the hearing include Thomas R. Frieden, Director of the Centers for Disease Control and Prevention, and officials from the State Department and U.S. Agency for International Development.
August 5, 2014
Concern about the Ebola outbreak in West Africa has prompted a heightened response from the Centers for Disease Control and Prevention. The federal health agency imposed tight security and safety precautions as the first Americans infected with the virus arrived in the United States from Liberia, where they had been working. Dr. Kent Brantly arrived on Saturday in Atlanta for treatment at Emory University Hospital, and Nancy Writebol is due to arrive on Tuesday. CNN reports that both received doses of an experimental drug. The report could lead to calls for wider use of the product, which has not been approved for use, based on anecdotal reports about promising results in the two patients.
August 1, 2014
Just in time for the closing of a comment period on proposed new rules on nutrition labels on most packaged food products, Connecticut Democratic Rep. Rosa DeLauro weighed in with a letter to the FDA encouraging the plan to keep added sugar as a stand-alone line on the proposed food nutrition labels. It wasn’t her only proposal this week on keeping the sweet ingredient in check.
The Department of Health and Human Services has announced a slight increase in the Medicare Part D program’s premiums for next year. The prescription drug benefit, first implemented in 2006, now offers drug coverage to 39 million people.
In July, two pivotal scorekeepers on federal spending issued annual reports on the long-term outlook for federal health care spending. Full story
The Centers of Disease Control and Prevention has intensified the U.S. response to the Ebola outbreak in West Africa, which reportedly is worsening. CDC Director Thomas Frieden said in a press briefing on Thursday that the agency is sending dozens more workers to the region, as well as issuing an advisory against non-essential travel to Guinea, Liberia and Sierra Leone.
July 31, 2014
A Government Accountability Office report released on Tuesday examines states’ increasing reliance on taxes on health care providers to help cover Medicaid spending.
The venerable Congressional Research Service, which advises Congress on a wide-range of major policy issues, recently issued a report for lawmakers on last month’s Supreme Court ruling in Burwell v. Hobby Lobby Stores, which struck down the health care overhaul law’s contraceptive services coverage requirements on “closely-held” companies.
The House earlier this week quietly passed by voice vote a bill that would streamline the Food and Drug Administration application process for sunscreen ingredients. The measure sets a specific timetable to review applications.