Medicare

An insurance lobbyist who once worked for Sen. Chuck Grassley (R-Iowa) helped healthcare stocks take off earlier this month when he spread news of a major Medicare policy shift before it was announced by the Obama administration, according to a new report.

Mark Hayes, who lobbies for Humana and also works for political intelligence firm Height Securities, reportedly told an associate at Height that "very credible sources" had confirmed the administration would scrap its proposed cut to Medicare Advantage.

The email from Hayes, reported Wednesday by the Wall Street Journal, was sent to Height policy analyst Justin Simon on April 1 at 3:12 p.m. 

Hospitals profit heavily from their own mistakes, according to a study published Tuesday in the Journal of the American Medical Association.

Hospitals make roughly $30,000 more from patients who suffer at least one complication than they do from patients whose procedures go smoothly, the research found.

Both Medicare and private insurers foot the bill for longer hospital stays and additional procedures when patients suffer a surgical complication. Those extra payments are lucrative for hospitals, the JAMA study found.

“Policy makers talk about pay-for-performance, but instead Medicare and private payers are rewarding hospitals for complications,” said Barry Rosenberg, one of the study's co-authors. “The U.S. healthcare system is paying for harm.”

A 2009 law designed to promote electronic health records and make the healthcare system more efficient isn't living up to its goals, Republican senators said Tuesday.

Six GOP senators, led by Sen. John Thune (R-S.D.) released a lengthy report Tuesday criticizing the execution of a $35 billion initiative to promote the use of electronic health records.

Electronic record-keeping is widely hailed as a way to improve healthcare quality and reduce costs, by cutting down on errors and making it easier for doctors to coordinate their care. But the program appears to be raising healthcare costs and falling short of benchmarks for effective implementation, the senators said.

Congressional Democrats ratcheted up a years-long feud with the pharmaceutical industry Tuesday as they proposed significant cuts in Medicare's payments to drug companies.

Democrats in both the House and Senate will introduce bills this week to lower drug prices for the poorest seniors, saving the government roughly $140 billion in Medicare costs.

The pharmaceutical industry strongly opposes the proposal, and has kept past iterations from even coming up for a vote. But Democrats said the latest push will benefit from the intense political pressure to cut entitlement spending.

"What's different now is we can no longer afford this waste," Sen. Richard Blumenthal (D-Conn.) said. "This gives new meaning to the phrase 'low-hanging fruit.'"

This week brings a full schedule as top federal health officials head for Capitol Hill to defend their 2014 budget requests.

The Senate Finance Committee is also expected to approve Marilyn Tavenner, President Obama’s choice to lead the Centers for Medicare and Medicaid Services, which would send her nomination to the full Senate.

Monday starts with the National Food Policy Conference at the Capital Hilton hotel. The two-day event will feature officials from the Food and Drug Administration (FDA), the National Cancer Institute and a long list of private groups to discuss everything from sodium reduction to sugary drinks to produce safety. 

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Health and Human Services Secretary Kathleen Sebelius will head to Capitol Hill on Friday to defend her department's budget request — including $1.5 billion for exchanges that Congress is unlikely to provide.

Sebelius is slated to testify before the Ways and Means Committee. It's the first time Sebelius has gone before lawmakers since acknowledging that some people will see their premiums rise because of the healthcare law — an admission that could provide fodder for Republican critics. She has also recently said the initial roll-out of the new law has been more difficult than she expected.

There's plenty in the department's budget request for lawmakers to ask Sebelius about. It seeks an additional $1.5 billion for the federal insurance exchange, and HHS officials have so far not answered when asked about the consequences of not receiving that money. The budget also proposes a handful of Medicare benefit cuts, such as charging wealthy seniors a higher premium.

Republicans on a prominent House committee proposed a series of Medicare reforms Thursday, including the much-discussed possibility of unifying the program's deductibles for hospital and medical care.

Committee vice chairman Marsha Blackburn (R-Tenn.) and Rep. Renee Ellmers (R-N.C.) described the policies as short-term moves that would significantly strengthen the program without cutting benefits.

"The current Medicare program structure is unsustainable and will threaten current beneficiaries’ health security if not addressed," the lawmakers wrote in a memo. 

Rep. Greg Walden blasted Obama's proposed entitlement cuts the same day that GOP leaders called for more.

AARP said Wednesday it is "deeply dismayed" by President Obama's proposal to cut Social Security benefits, and sounded a skeptical note about some of his proposed Medicare cuts.

AARP hammered Obama for including in his budget proposal the policy known as "chained CPI" — a new way of calculating benefits that would ultimately shrink seniors' Social Security checks.

“AARP is deeply dismayed that President Obama would propose cutting the benefits of current and future Social Security recipients, including children, widows, veterans and people with disabilities, to reduce the deficit," AARP Executive Vice President Nancy A. LeaMond said in a statement.