Six months after health reform's enactment, Health and Human Services Secretary Kathleen Sebelius has missed seven deadlines mandated by the new law, according to the Congressional Research Service.
The CRS memorandum was requested by Republican senators Tom Coburn (Okla.), Orrin Hatch (Utah) and John Cornyn (Texas). It was sent to them on Friday.
"Future months are unlikely to see HHS improve its record of compliance," Coburn writes on his Web site. "The Department failed to meet one-third of 22 deadlines in six months, yet now the Department has less than three months to meet another 29 requirements required by law."
Many of the missed deadlines concern just a few days or relatively obscure provisions, although several states failed to have their high-risk pools in place for two months.
HHS raised some issues with the report.
An administration official pointed out that the reconciliation act, enacted March 31, pushed back the deadline for Medicare drug discounts. And the federal government's federal high-risk pool was established on July 1.
"The Administration has met and beaten deadlines required by the Affordable Care Act," HHS spokesperson Jessica Santillo said. "As a result, young adults have been able stay on their parents’ health insurance, over 1 million seniors who have fallen into the Medicare Part D donut hole have gotten checks to help with their prescriptions, uninsured Americans with pre-existing conditions are starting to get life-saving coverage, we have the nation’s strongest Patient’s Bill of Rights in place, and some of the worst insurance industry practices are coming to an end."
Outside experts have praised the department's handling of high-profile mandates such as promulgating regulations for young adults to stay on their parents' insurance until the age of 26, setting up an early retiree reinsurance program and creating an insurance Web portal.
Medically underserved populations and health shortage areas: A new committee was supposed to issue a report on the methodology and criteria used for identifying the above by June 1. The committee wasn't appointed until July 9; its first meeting was Sept. 22.
Medicare drug discounts: Contract agreement language for drug manufacturers to provide access to discounted drugs in the Medicare "doughnut hole" was due May 1. The agreement was released Aug. 2. HHS points out that the reconciliation act changed the date for the coverage gap discount program to Jan. 1, 2011.
Underserved rural communities: A regulatory definition was due May 22. It was published May 26 and became effective June 25.
Temporary high-risk pools: They were supposed to be established by June 21. Some states' pools weren't operational until August. HHS points out that the federal pool was established July 1, the same day federal help was made available for states to establish and operate their own programs.
Nutrition information: Information for retailers who want to voluntarily provide such information to consumers was expected July 21. The notice was published Aug. 25.
Screening procedures for government health programs: Phased-in screening for Medicare, Medicaid and CHIP to be established Sept. 19. Proposed rule and implementation guidance published Sept. 23.
340B drug discount program: HHS was supposed to issue regulations by Sept. 19 on three aspects of the discount program for safety net hospitals - civil monetary penalties, dispute resolution and ceiling price calculations. Public comment was sought on Sept. 20.
The CRS did not have enough information to determine whether four other programs met their deadline: creating a committee to assist in creating a young women's breast health campaign; developing a plan to increase the Indian Health Care Service's staff; establishing a waiver program for states; and reporting on nurse retention grants and contracts.
This post was updated with new information from HHS at 4:35 p.m.