OVERNIGHT HEALTH: Anniversary day approaches

Agent/broker fight looms: The California nonprofit Consumer Watchdog on Tuesday released a new report outlining state regulators' ties to industry.

The report coincides with this weekend's spring meeting of the National Association of Insurance Commissioners, where regulators are expected to consider legislation that would shield agents and brokers from some of the effects of healthcare reform.

Agents have been lobbying hard to have their fees excluded from the calculation of the medical loss ratio, which requires healthcare plans to spend at least 80 percent of premiums on care or offer discounts. Read the Healthwatch story.

Iowa makes MLR appeal:
The latest waiver request for relief from a new requirement for insurers to spend at least 80 percent of premium dollars on care services comes from Iowa Insurance Commissioner Susan Voss. Her request asks for a gradual phase-in of the so-called "medical loss ratio," with 60 percent, 70 percent and 75 percent in 2011, 2012 and 2013, respectively.

"The Iowa market has one dominant carrier which already meets the 80 percent loss ratio, but Iowa has a number of smaller carriers which need time to adjust their business models to comply with the [MLR]," Voss wrote to HHS Secretary Kathleen Sebelius.

Iowa becomes the eighth state to apply for MLR relief. HHS approved Maine's request two weeks ago. 

Third one's a charm: Republicans on the House Small Business panel became the third House committee to investigate the 1,000-plus annual limit waivers the Department of Health and Human Services have granted for healthcare reform's annual limits provision. Read the Healthwatch story

Well, if you must... The Advanced Medical Technology Association (AdvaMed), which opposes healthcare reform's 2.3 percent excise tax on medical device manufacturers, is looking to protect its members if efforts to repeal the tax are unsuccessful. AdvaMed, in comments to the Internal Revenue Service on Tuesday, said it continues to oppose the tax but made a few recommendations on how to soften the blow.

“We seek regulatory guidance to ensure implementation of the device tax avoids multiple taxation of single product sales, and imputation of value to medical devices in excess of sales price," the group wrote. "Moreover, the rules should be flexible enough to accommodate the medical technology industry’s rapid innovation cycle, as well as the variety and complexity of products and transactions in this dynamic industry. We also believe that guidance should draw from and not conflict with other industry legal and regulatory authorities, where appropriate."

Virginia reaches out to SCOTUS: Virginia Attorney General Ken Cuccinelli (R) again asked the Supreme Court to fast-track the administration's appeal of his successful challenge to healthcare reform's individual mandate, writing that the nation will be "affected by uncertainty" until the high court finally weighs in. At the current pace of the challenges, legal observers expect the Supreme Court could rule as early as June 2012, about a year and a half before the individual mandate takes effect.

Abortion debate fires up South Dakota: Gov. Dennis Daugaard (R) on Tuesday signed into law some of the nation's toughest restrictions on abortion. The new law requires women to wait three days after meeting with a doctor before having an abortion, the longest waiting period in the country; the law also requires a visit to a crisis pregnancy center, at which counselors often seek to talk women out of abortions.

Planned Parenthood preps S.D. lawsuit: Planned Parenthood will sue to stop implementation of the law. The organization, which said it operates the state's only health center providing abortion care, said the 72-hour delay is unprecedented and that crisis pregnancy centers provide scientifically inaccurate medical information.

Next stop, Vermont?: More than 200 physicians say they're ready to pack their bags and set up and shop in Vermont if the state enacts a single-payer healthcare system. Physicians for a National Health Plan, which advocates for such a system, says docs from as far away as Hawaii would happily become Vermonters.

Wednesday's agenda:

Energy and Commerce makes a house call: The committee's health subpanel is holding a field hearing in Pennsylvania to explore everything wrong with healthcare reform. Those appearing include Pennsylvania Gov. Tom Corbett (R) and the state's acting insurance commissioner, Michael Consedine. 

Reading list:

Walgreens warns that it might face pressure from government payers as states grapple with Medicaid budgets, Reuters reports.

The Kansas City Star reports on efforts to digitize health records. 

The Washington Post Fact Checker blog said GOP claims that unions are major benefactors of annual limit waivers are "misleading."

The Kansas state Senate approved a measure that exempts citizens from healthcare reform's individual mandate, the Topeka Capital-Journal reports.

Investor's Business Daily lists "The 12 Worst Features of Obamacare."

The Association of Health Care Journalists urges journalists in Japan to heed the lessons of Haiti's earthquake and refrain from exploiting people's vulnerability "for gain or glory."

What you might have missed on Healthwatch:

Sen. Scott Brown (R-Mass.) rejects GOP efforts to defund Planned Parenthood.

Seniors in the Medicare doughnut hole have saved close to $40 million in three months. 

A group of 29 fiscally conservative organizations want to block federal funds for Planned Parenthood.

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Please let us know:

Julian Pecquet: jpecquet@thehill.com / 202-628-8527

Jason Millman: jmillman@thehill.com / 202-628-8351