Medicaid

Children's hospitals and other medical centers on Monday became eligible to enroll in a Medicaid program that offers discounted drugs, as called for in the healthcare reform law.

As many as 1,500 additional hospitals — including children’s hospitals, free-standing cancer centers, critical access hospitals, rural referral centers and sole community hospitals — are now eligible for the 340B program, which provides discounts on brand-name drugs to facilities that serve poor people. Factoring in clinics and health centers, the number of sites participating in the 340B program will rise from more than 14,000 to nearly 20,000, according to the Department of Health and Human Services.

HHS estimates the facilities will be able to save an average of 20 percent to 50 percent of the cost for covered drugs thanks to the program.

The drug industry agreed to the expansion during the healthcare reform debate but beat back proposals to expand the discount to inpatient drugs, which are delivered at the hospital. The discount only applies to outpatient drugs.

Entities that have completed the registration process will be added as their eligibility is confirmed, according to HHS. The registration process will require at least three days of processing time. 

All required documents need to be submitted by September 27. The rolling, online admission process ends Sept. 30.

Cash-strapped states won't be able to sigh in relief just yet.

Senate Majority Leader Harry Reid (D-Nev.) is expected shortly to ask the Senate to table a bill that would have extended enhanced federal Medicaid payments to states for six months. The $16.1 billion Medicaid provision is paid for but is part of a larger education and public safety jobs bill.

Reid filed for cloture on the bill Thursday but the Congressional Budget Office helped doom it on Monday when it said it would increase the deficit by almost $5 billion.

"Earlier today CBO informed us that the score did not turn out as we intended," reads a message from the Senate leadership. "Certain spending cuts did not produce the savings needed.

"Therefore, we expect Senator Reid to soon ask consent to modify the pending amendment so that it is indeed budget neutral. 

"We expect Republicans to object to that request. If they do, Sen. Reid will move to table the pending motion to concur and offer a new amendment. 

"That amendment will fund hundreds of thousands of jobs and will be fully paid for according to CBO."

If, as expected, Reid refiles for cloture, a vote on the Medicaid FMAP (federal medical assistance percentages) extension will be delayed until Wednesday at the earliest.

The Senate bill that would extend enhanced federal Medicaid payments to states would raise the deficit by almost $5 billion, according to a Congressional Budget Office estimate obtained by The Hill. 

The $16.1 billion cost of the Medicaid FMAP (Federal Medical Assistance Percentages) increase is fully offset, but other provisions of the bill would add $4.891 billion to the deficit over 10 years. Lobbyists and health policy analysts say the score might doom a proposal that was already failing to attract support from moderate Republicans. 

A cloture vote is expected around 5:30 p.m.

The Senate plans to hold a cloture vote Monday; the provision mirrors one in the most recent tax extenders package.

Rep. Linda Sanchez (D-Calif.) on Wednesday introduced legislation to expand overtime and minimum wage protections to home care workers, who don’t currently have those rights.

Sanchez, a member of the Ways and Means Committee, says the exclusion represents a case of discrimination against hundreds of thousands of workers who tend the sick and elderly, allowing them the freedom to stay at home in lieu of entering nursing homes and other institutional facilities.

“All work in this country has dignity,” Sanchez said during the bill’s unveiling on Capitol Hill. “There isn’t a reason why these workers should be excluded.”

Although Congress 35 years ago extended the Fair Labor Standards Act (FLSA) to provide minimum wage and overtime protections to many in-home direct care workers — including certified nursing assistants and home health aides — the law cut out an exemption for those performing so-called “companionship services,” a category into which the Labor Department has placed home care workers.

The result, critics say, is a home care workforce that gets paid less, works longer hours and suffers more turnover than most other professions. Indeed, home care workers perennially make it onto Forbes’ list of the lowest-paying jobs in the country, earning less than parking lot attendants, housecleaners and bartenders, in one recent survey.

For 35 years, home care workers have been excluded from the minimum wage and overtime protections granted to the rest of the nation's workforce. This week, a House Democrat will take a step toward eliminating that discrepancy, which many in the party consider discriminatory.

Rep. Linda Sanchez will introduce legislation Wednesday to expand the wage protections of the Fair Labor Standards Act (FLSA) to home care workers, who provide health and other domestic services to the sick and elderly. The California Democrat says the change is needed to entice more home care workers into the field in the face of an ever-increasing demand for their services.

"It's one of the worst-paid jobs in the country," Sanchez told The Hill on Tuesday. "In this day and age," she added, the current FLSA exemption "is shocking."

Senior advocates agree. AARP spokesman Jordan McNerney said Tuesday the group has yet to see the Sanchez bill, but supports the concept. 

“As older Americans continue to choose home and community-based care over more costly nursing homes," he said in an e-mail, "the home health workers who care for them should be fairly compensated."

Calling for new stimulus legislation, a group of local government groups and liberal lawmakers will gather Tuesday afternoon on Capitol Hill to warn that local economies have hit a "crisis point" that threatens the nation's rebound from the recession.

Officials from the National League of Cities, the U.S. Conference of Mayors and the National Association of Counties will unveil a new report outlining the layoffs and cuts to safety-net programs if Congress doesn't pass a new jobs bill.

Joining the groups will be a number of liberal Democrats, including Reps. Barbara Lee (Calif.), Phil Hare (Ill.), Lynn Woolsey (Calif.) and Keith Ellison (Minn.).

Sen. Sherrod Brown (D-Ohio) and House Labor Committee Chairman George Miller (D-Calif.) have also been invited.

The Senate this week is expected to consider legislation providing $30 billion to encourage community banks to increase their lending to small businesses. The upper chamber already ended debate on the measure last week, clearing the way for final passage.

The House passed a similar bill on June 17.

The Obama administration on Monday announced $2.25 billion in federal grants designed to help severely disabled Americans move from hospitals and nursing facilities to their own homes.

The funding — included in the Democrats’ new healthcare reform law — will enhance Medicaid’s five-year-old “money-follows-the-person” (MFP) demonstration, which helps states shift patients with chronic illnesses from institutional facilities to community-based settings. The program is intended to save Medicaid money while also lending greater independence to the disabled.

Currently, 29 states and the District of Columbia have adopted MFP programs, according to the Centers for Medicare and Medicaid Services (CMS). The new reform law encourages states not already enrolled to apply for grants, while allowing current participants to expand their programs.   

The law provides $450 million for each of the five years, beginning with 2012, for a total of $2.25 billion.

On Aug. 11, CMS will host a call for interested applicants.

The announcement arrives on the 20th anniversary of the Americans with Disabilities Act, which extended certain anti-discrimination protections contained in civil rights laws to folks with disabilities. 

A bill that would have the federal government cover medical malpractice costs for physicians who volunteer at community health centers cleared the Energy and Commerce panel's health subcommittee on Thursday.

The sponsors of the bipartisan Family Health Care Accessibility Act, Reps. Tim Murphy (R-Pa.) and Gene Green (D-Texas), say the bill would enable underserved communities to have access to care at minimal cost to the government. The bill extends to volunteers the medical liability protections currently offered by the Federal Tort Claims Act to physicians employed at community health centers.

"Extending medical liability protections to volunteer physicians would result in more doctors and more patients being served at a lower cost to these centers," Murphy said. "And the cost to do this is pennies on the dollar. It is estimated that extension of FTCA protection would cost the federal government just $1.5 million a year, but it would serve millions more new patients."

Murphy and Green say physicians who currently want to volunteer have to pay as much as $100,000 a year in medical malpractice insurance, making it too costly for them to do so. At the same time, the new healthcare reform law increased funding for community health centers by $11 billion and requires them to cover as many as 40 million patients — twice the current number — by 2015 because of the law's Medicaid expansion.

"This is the third time we’ve moved the bill out of committee, and I’m hoping that the Senate will be able to get behind the bill," Green said. "It is extremely important to the community health centers in my area and across the country to be able to bring on licensed medical practitioners willing to volunteer their time with the support of federal liability coverage."

The health panel unanimously passed the bill with a recommendation for passage by the full committee.