REGULATORY REACTION: Industry groups had until midnight Friday to weigh in as regulators finalize a major rule tackling vital aspects of healthcare reform. The omnibus interim final rule tackles coverage of preexisting conditions for minors, annual and lifetime limits on essential benefits, restrictions on rescissions, and patient protections relating to emergency services and choice of healthcare professionals.
America's Health Insurance Plans (AHIP) is asking regulators to:
• clarify the application of the annual dollar limit requirements to value-based programs and care management initiatives;
• clarify the distinction between a cancellation and a rescission;
• revise the methodology and manner of determining reimbursement for emergency services to protect consumers, mitigate costs, and recognize the role of state-specific factors;
• clarify that the regulation neither disrupts existing state consumer protection laws addressing balance billing prohibitions nor precludes states from enacting new laws in this area.
The Federation of American Hospitals for its part has asked that regulators define a core set of essential health benefits that healthcare plans must cover starting in 2014. These should include inpatient and outpatient hospital coverage: http://bit.ly/aLkwII
AHIP talking points: According to AHIP, the law's internal appeals and external review provisions should mirror existing consumer protections, the appeals process should be simple and cost-effective, and regulators should recognize good-faith efforts to meet the immediate deadline.
AHIP White Paper: Requested from the Davis and Harman law firm, it outlines the non-discrimination requirements that the law applies to fully insured, “non-grandfathered” group healthcare plans.
ELECTORAL POLITICS: Healthcare issues are still being hotly debated in the run-up to the November elections.
Florida flip-flop: Senate candidate Charlie Crist (I) over the past few days has twice sought to walk back his statement to a Florida television station Friday that he would have voted for the healthcare reform law had he been a sitting senator.
Crist quickly took back those on Friday, saying he "misspoke." Over the weekend, he told CNN that he would have voted against the bill, but does not favor a full repeal: http://bit.ly/9YjOZo
Predictably, his opponents Marco Rubio (R) and Kendrick Meek (D) are accusing the governor of flip-flopping. Rubio leads the field 40 percent versus 30 percent for Crist and 21 percent for Meek, according to the latest Rasmussen poll: http://bit.ly/bGHVz5
Next door in Georgia: Candidates for governor clashed over healthcare reform, stem cell research and tort reform: http://bit.ly/9peqwC
Repeal or revise? In New York, 14th District candidate Randy Hultgren (R) has made repealing the bill a campaign promise, reports the Daily Herald. Incumbent Bill Foster (D) voted for the measure but wants to eliminate the unpopular 1099 tax-reporting requirement: http://bit.ly/cAs34y
TOBACCO: The Tobacco Products Scientific Advisory Committee holds a meeting on harmful substances in tobacco products. Check out the schedule: http://bit.ly/cpsqC5