Lame Duck for your Turkey Day Break
[caption id="attachment_650" align="alignleft" width="150" caption="Following White House tradition, President Barack Obama Officially Pardons Courage the Turkey - 2009"][/caption] Happy Turkey week everyone! With the elections over and the lame duck session the only thing left between Congressional staff and their Christmas break, here's a brief update of what's going on inside the beltway: Senate The Senate, on Friday, passed its temporary fix to the Sustainable Growth Rate formula that would otherwise lead to a 23 percent drop in Medicare physician reimbursement (known as the "Doc-Fix"). The fix would be very temporary, only lasting one month until the end of December, with hopes that Congress can devise a more long-term solution between now and then. The bill will cost the federal government $1 billion, but would reduce therapy service payments to providers who perform multiple services on the same day in order to offset that cost. House Before this one-month fix becomes law, though, it needs to pass the House, which plans on taking it up when it returns from Thanksgiving break on November 29th. In order to stop the cuts, the House must then pass the legislation before December 1st. Lame Duck and Rural Provisions During the end of the lame duck session in December, the NRHA will be working to attach other legislation to the longer-term SGR fix. Though this may be tough considering Congress' desire to move the bill quickly to the President's desk, there are still important issues looming. These include: extending certain expiring Medicare programs (our list of "rural extenders"), a fix to the 340b orphan drug exclusion for newly eligible entities under health reform, a fix to recent CMS regulations regarding hospitals' ability to include provider taxes on their cost reports, and other important issues. HHS Secretary Announcement Today - Insurance Company Medical Loss Ratios HHS Secretary Sebelius is set to make a huge announcement today regarding the health insurance industry medical loss ratio (MLR) requirements included in health reform. The MLR formula would require that 85 percent of insurance provider premiums go toward "clinical services and activities related to quality of care," with 15 percent going to administrative and advertising costs, and profits. (for smaller insurance providers, this ratio is adjusted to 80:20.) The regulations relating to this were released today through the White House Office of Management and Budget. America's Health Insurance Plans (AHIP) President and CEO Karen Ignagni released the following statement saying this plan would "reduce competition, disrupt coverage, and threaten patients' access to health plans' quality improvement services." National Health Service Corps Secretary Sebelius also announced today that HHS will release the $290 Million in new funding for the National Health Service Corps appropriated in health reform. The NHSC director says this will triple the current number of physicians able to participate in the program, which offers $60,000 in loan repayment to physicians agreeing to carry out their first two years of work in underserved or rural areas. Happy Thanksgiving!