OVERNIGHT HEALTH: SGR alternative takes shape

CLASS dismissed: The positive Medicare Advantage numbers gave the administration a counterweight to a GOP report that said even many Democrats were concerned about the Community Living Assistance Services and Supports (CLASS) Act — healthcare reform’s new insurance program for long-term care. Republicans have always argued that the CLASS Act isn’t financially sound, and administration officials admit that it needs some work in order to be solvent. The new report, published by the Republican Study Committee, quotes from e-mails in which Health and Human Services (HHS) employees called the program “a recipe for disaster.”

Read the report here.

Pull the plug on grandfathering? Another day, another oversight hearing about the healthcare reform law. This time the focus, at least ostensibly, was on rules for grandfathered plans. Republicans on the Energy and Commerce Health subcommittee also took aim at the medical loss ratio, the CLASS Act, the way the administration investigates fraud, and negotiations with healthcare industries during the legislative debate.

Democrats accused the GOP of trying to eliminate valuable consumer protections. Healthwatch has more from the hearing.

Home health: More than half of all home healthcare companies would lose money by seeing Medicare patients if proposed payment cuts are allowed to take effect, the industry says. Read the Healthwatch post.

Data debate: Three journalism organizations accused a federal health agency Thursday of “blatant intimidation” and pressed it to re-release once-public records about healthcare oversight. The Health Resources and Services Administration (HRSA) recently pulled down a public version of the database it uses to track records such as disciplinary actions. The journalism organizations say HRSA removed an important tool — and intimidated a reporter who was using the records for a story. Their letter to HRSA is here.

A HRSA spokesman said his agency wasn’t trying to intimidate the reporter — it thought he had gotten access to confidential information, and dropped the issue after realizing that wasn’t the case. HRSA pulled the public database while reviewing whether it adequately protects individual doctors’ information, as required by law, the spokesman said.

Friday’s agenda
Tim Hill, HHS’s new point person on insurance exchanges, is speaking at 9 a.m. at AHIP’s exchanges conference.

And the Medicare Payment Advisory Commission wraps up its two-day meeting with discussions about Medicare Advantage, Part D and home infusion.

State by state
Michigan Gov. Rick Snyder unveiled a “sweeping health reform plan Wednesday that includes a low-cost marketplace for health insurance, reforms for Blue Cross Blue Shield, coverage for autism treatment and a full-throttle charge to get Michiganians in shape,” the Detroit News reports.

California risks bogging down the national effort to reform the healthcare system, reports the Los Angeles Times.

The steering committee looking at an insurance exchange in Wyoming is open to a partnership with the federal government.

Regulatory review
Regulations under review at the Centers for Medicare and Medicaid Services regarding the release of Medicare billing data would make independent accountability impossible, consumer groups say. ProPublica has more.

Dentists want regulators to fix a glitch in the healthcare law that they say could cause millions of Americans to lose their employer-sponsored pediatric dental coverage because they’d have to get it through the new health insurance exchanges. They unveiled a white paper Thursday that outlines a fix.

Bill tracker
Sen. Herb Kohl (D-Wis.) reintroduced his legislation to allow nurses at long-term-care facilities to administer painkillers (S. 1560).

Rep. Mary Bono Mack (R-Calif.) said the Food and Drug Administration now supports a key provision of her legislation to establish a minimum standard of education for prescribers of powerful pain medications (H.R. 2119).

Rep. Ron Paul (R-Texas) has introduced legislation to protect health claims by users of dietary supplements (H.R. 2908)

Sen. Amy Klobuchar (D-Minn.) has a bill to facilitate emergency medical services personnel training and certification curricula for military veterans (S. 1553).

Rep. Barbara Lee (D-Calif.) was expected to drop legislation on behalf of the Asian Pacific American, Black and Hispanic caucuses to tackle health disparities. The bill outlines initiatives to better identify racial and ethnic health disparities and provides investments and reforms for closing the gap in care. It also calls for increased data collection and reporting, workforce diversity and cultural and linguistically appropriate healthcare services.

Fraud fight
A fake doctor in Atlanta who treated more than 1,000 patients pleaded guilty to healthcare fraud and disclosing patients’ medical records.

A Philadelphia man got 66 years in prison for a Medicare durable medical equipment kickback scheme.

A former supervisor at a Florida Department of Children and Families call center was found guilty of selling the Medicare numbers of elderly and disabled Floridians for use in a Medicare fraud scam.

Home health services provider Maxim settled Medicaid fraud allegations by agreeing to pay Massachusetts more than $1.25 million.

Lobbying registrations
Brown Rudnick / Health Care Navigators
Capitol Decisions / Med Pro Billing
Broydrick & Associates / Blank Children’s Hospital

Reading list

President Obama might not include an increase in the Medicare eligibility age when he releases recommendations for the supercommittee on Monday.

Virginia’s Board of Health adopted tight new restrictions on abortion providers Thursday.

A University of Pennsylvania bioethicist is offering $10,000 to anyone who can back up Rep. Michele Bachmann’s (R-Minn.) claims linking Gardasil and mental disabilities.

Nutrition experts at the Harvard School of Public Health have created their own food-pyramid alternative.

What you might have missed on Healthwatch:
‘Bachelorette’ takes on Sen. Collins over nutrition guidelines for school lunches

News bites: Obama retreats on Medicare, antibiotics raise concerns and abortion limits are revealed

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