Rep. Fred Upton (R-Mich.) is in position to become the next chairman of the powerful House Committee on Energy and Commerce after receiving the endorsement of the Republican steering committee Tuesday night.

The endorsement brings an end to the most contentious committee race since Republicans won back the House of Representatives in November. The chairmanship puts Upton in an enviable position for any House Republican, as he will lead efforts to investigate, repeal and replace the new healthcare reform law. 

His short-term agenda is clear: Upton called for the House to quickly repeal and replace the healthcare reform law in a Dec. 1 blog for The Hill. In the post co-authored with Rep. Joe Pitts (R-Pa.), who will lead the health subcomitte, Upton said the committee will provide comprehensive oversight to uncover problems with the new law and to find a new approach to reduce healthcare costs, reduce government’s role in healthcare and “protect the sanctity of life.”

“The Democrats have been derelict in their constitutional duty to oversee the implementation of this law and expose its problems; expect all of that to change in January,” Upton and Pitts wrote. “Real oversight is needed, and the Energy and Commerce Committee will work closely with other committees of jurisdiction to reveal, repeal and replace this law.”

Specifically, Upton said the committee plans to “pepper” the Congressional Budget Office and the Obama administration on taxes and mandates included in the reform law and how they affect care.

Despite his opposition to the healthcare reform law, Upton has been a strong supporter of the State Children’s Health Insurance Program. He voted for its reauthorization in 2009 and voted to override President George W. Bush’s vetoes of SCHIP in 2007 and 2008.

According to his website, Upton has coauthored bipartisan legislation to make investments in research and support services for those suffering from arthritis. He also supported establishing a nationwide alert system to locate missing senior citizens.

In the end, Upton’s campaign was not derailed by the opposition of anti-abortion groups, including the National Right to Life Committee, Americans United for Life Action (AULA) and the Susan B. Anthony List. According to AULA, Upton “voted against such common-sense policies as parents being notified if their minor child seeks an abortion at a federally funded facility, voted in favor of obstructing the partial-birth abortion ban and voted to allow the federal funding of embryo-destructive research.”

Upton’s primary mission to dismantle the healthcare reform law is clear, but with a Democratic Senate still in power, the effectiveness of his efforts are not.

Welcome to The Hill's evening roundup of the day's health policy news and advance look at tomorrow's schedule.

Tuesday’s health news:

GOP selects Upton for Energy chair: Rep. Fred Upton (R-Mich.) is in position to become the next chairman of the powerful House Committee on Energy and Commerce after receiving the endorsement of the Republican steering committee Tuesday night.

The endorsement brings an end to the most contentious committee race since Republicans won back the House of Representatives in November. The chairmanship puts Upton in an enviable position for any House Republican, as he will lead efforts to investigate, repeal and replace the new healthcare reform law. Rep. Joe Pitts (R-Pa.) will lead the health subcommittee. http://bit.ly/gP4DAU

House will take up food safety bill: The House will consider legislation to modernize the nation's food safety protections, House Majority Leader Steny Hoyer (D-Md.) told reporters Tuesday. Although the Senate passed the bill last week, it contained tax provisions that must originate in the House, according to the Constitution.

Hoyer said the bill will closely resemble the Senate-passed version, even though the House last year passed a stronger bill backed by members of the liberal caucus. The Senate approved the bill 73-25 before the procedural error was discovered.

However, the bill may face challenges in its second turn through Congress. Senate Republicans said they will oppose anything on the floor before addressing tax cuts and government funding matters, and Sen. Tom Coburn (R-Okla.) will have another chance to block the bill. http://bit.ly/gLt7WP

Senate to vote on 1-year doc fix: Senate leaders reached a one-year bipartisan agreement to tap healthcare reform funds to avoid a scheduled massive rate reduction for Medicare physician payments next year, a Senate aide told The Hill. Senate leaders are hoping to bring up the agreement for approval by unanimous consent Wednesday, the aide said.

The $19.2 billion “doc fix” avoids a scheduled 25 percent reduction in Medicare physician payments starting Jan. 1. The reform law provides subsidies to help certain people purchase insurance on state-run exchanges, as long as their income falls below certain levels. The doc fix would increase penalties to those whose income rises above the limit, the aide said. http://bit.ly/h4ql2u

Recession increased number of uninsured: The number of uninsured adults jumped 5.6 million between 2007 and 2009, according to a Health Affairs report released Tuesday. Job losses experienced during the recession were likely the main culprit, the report said.

The number of adults under 65 insured by an employer fell from 164.2 million to 156.2 million over that time period, according to the report. There also was a decline in the percentage of children covered by employer health plans, but those numbers were offset by enrollment increases in Medicaid and the Children’s Health Insurance Program. http://bit.ly/gmNW56

Private insurers control costs better, report says: Private insurance plans might be better at controlling healthcare costs than Medicare, according to another Health Affairs study released Tuesday morning.

The study followed up on an influential 2009 New Yorker article that found Medicare spending on the elderly population is significantly higher in McAllen, Texas, than it is in El Paso, Texas. Using medical and expense data for patients in those towns who are privately insured by Blue Cross and Blue Shield, researchers found private insurers were cheaper and had a more consistent cost structure. http://bit.ly/gf6eTr

Writer weighs in: Atul Gawande, who penned the New Yorker piece last year, said the study’s results can be explained by two possible factors: McAllen doctors simply offer lower-cost care, or Blue Cross effectively restricts overspending.

“It’s hard to know which is the answer,” he wrote on the New Yorker’s website Tuesday. “Looking at the evidence available, we can’t be sure. But I am rooting for the idea that Blue Cross is making a difference. “ http://nyr.kr/fioj1X


Docs, hospitals have trust issues: The successful implementation of the new healthcare reform law will hinge on physicians and hospitals working out trust issues with one another, according to a new survey. The reform law requires increased collaboration and information sharing between physicians and hospitals, but one in five doctors don’t trust hospitals, the new PricewaterhouseCoopers survey said.

However, the thawing between the two sides has already begun. Almost 75 percent of physicians surveyed said they have financially aligned with hospitals through employment, joint ventures or directorships. http://bit.ly/eN3TMC

Sebelius says reform enhances quality: The healthcare reform law will improve the quality of health care and help avoid flaws in the system, HHS Secretary Kathleen Sebelius said in Tuesday afternoon remarks to the Institute for Healthcare Improvement.

“Today, we pay a lot of money for a system that rewards care delivered piece-by-piece, instead of in a seamless, coordinated manner,” Sebelius said. “Some Americans get extraordinary care. But quality varies widely, and far too many of our health care dollars go to pay for unnecessary treatments and overhead costs.” http://bit.ly/ifMWbV

Three firms to pay for false claims allegations: Abbott Laboratories, B. Braun Medical, Roxane Laboratories and affiliated entities agreed to pay a combined $421 million to settle charges they reported false and inflated prices for numerous pharmaceutical products, the Justice Department announced Tuesday. Because Medicare and Medicaid pay for the drugs were based on the false prices, the government paid millions of claims for much more than the manufacturers’ products were worth, the department said.

This marks the second straight day of bad press for Abbott. On Monday, a Senate investigation alleged that the company hired a Maryland doctor who was banned from St. Joseph Medical Center for allegedly performing unnecessary implants of Abbott’s heart stents.

House votes for red flags exemption: The House voted Tuesday night to exempt healthcare providers and certain other businesses from the red flags rule, which requires creditors to install identity theft detection and monitoring programs. The bill, which passed the Senate last week and passed by voice vote in the House, reverses an FTC assertion that healthcare providers should qualify as creditors because they sell a product or service for which a costumer can pay later. http://bit.ly/gNDRVL

Insurance giant grabs slice of IT market: Aetna announced it will pay about $500 million to acquire Medicity, a health information exchange (HIE) technology company based in Utah. Aetna said Medicity’s technology reaches more than 760 hospitals, 125,000 doctors and 250,000 total users.

“This acquisition will enable Aetna to offer a set of convenient, easy-to-access technology solutions for physicians, hospitals and other health care providers. That, in turn, can help improve the quality and efficiency of patient care,” said Mark T. Bertolini, Aetna CEO and president, in a statement.

Anti-abortion group will host RNC debate: The Susan B. Anthony (SBA) List will co-sponsor the upcoming debate between candidates running for the chairmanship of the Republican National Committee. "It is critical that the next RNC chairman sincerely recognize the electoral power of the pro-life movement, can articulate its message and is prepared to advance its priorities," Marjorie Dannenfelser, president of SBA List, said in a statement. http://bit.ly/hyfekS

On the agenda for Wednesday:

Cloture vote for 9/11 benefits: The Senate is expected to vote Wednesday morning on a motion to end debate on a bill that would provide health benefits and compensation to Ground Zero first responders.

Senate Majority Leader Harry Reid (D-Nev.) filed the cloture motion Monday night, and Democrats need one Republican to set up a final vote on the $7.4 billion bill.

Health IT focus: The President’s Council of Advisors on Science and Technology (PCAST) will release recommendations on creating a health information technology "ecosystem" that allows for real-time exchange of patient information to improve public health, enhance privacy and security of personal data and create new health IT markets while addressing the need to cut costs. 

Around the Web:

Unhealthy Pentagon budget: Health care costs will account for 10 percent of the Pentagon budget by 2015, according to CNNMoney.com. Military health costs have risen from $19 billion in 2001 to $49 billion this year, the report said. http://bit.ly/furGoK

FDA considers regulating breast milk banks: Breast milk banks should be unregulated for now, but more study is needed on the issue, the FDA said, according to a Bloomberg report. http://on.msnbc.com/glAyS8

For your mental health: More primary-care physicians are screening for depression and other mental-health conditions during routine visits, the Wall Street Journal reports. http://on.wsj.com/h3effs

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Healthcare providers are one step closer to being exempt from installing medical identity theft programs after the House voted Tuesday night to grant them relief from a Federal Trade Commission rule.

The House voted to exempt healthcare providers and certain other businesses from the red flags rule, which requires creditors to install identity theft detection and monitoring programs. The bill, which passed the Senate last week and passed by voice vote in the House, reverses an FTC assertion that healthcare providers should qualify as creditors because they sell a product or service for which a costumer can pay later.

Wrangling over the red flags rule resulted in years of implementation delays and legal challenges. The rule was scheduled to go into effect by the end of the year.

The bill now awaits the president’s signature.

The American Medical Association praised Congress for supporting “AMA’s long-standing argument to the FTC that physicians are not creditors,” AMA president Cecil Wilson said in a statement.

”This bill will help eliminate the current confusion about the rule’s application to physicians,” Wilson said.

Health and Human Services secretary says the law provides a "serious platform" for improving the quality of care.

The House this week will consider legislation to modernize the nation's food-safety protections, a top Democrat indicated Tuesday.

Although the Senate passed a food-safety bill last week, it contained tax provisions that, according to the Constitution, must originate in the House.  

House Majority Leader Steny Hoyer (D-Md.) told reporters Tuesday that the lower chamber this week will take up a new House bill, in hopes of sending it back to the Senate before the weekend.

Though the House last year had passed a much stronger food-safety bill pushed by liberal members of the caucus, the proposal emerging this week will more closely resemble the Senate-passed version, Hoyer indicated.

"We think that's a better bill," Hoyer said of the initial House measure, "but we're inclined to take the Senate bill, and the new bill will reflect the Senate bill."

Returning the bill to the Senate complicates the process. Not only have Senate Republicans vowed to oppose anything that hits the floor before tax cuts and government funding matters are finalized, but the second upper chamber vote allows Sen. Tom Coburn (R-Okla.) another chance to block the bill.

Last month, Coburn had forced a lengthy debate on the measure, which eventually passed easily, 73 to 25. Coburn's stalling tactics have left bill supporters wary that there's little room on the Senate calendar to accommodate the food safety vote if he repeats them.

Anti-abortion rights group Susan B. Anthony List has signed on as a co-sponsor of the upcoming debate between candidates running for the chairmanship of the Republican National Committee.  

Americans for Tax Reform, the group headed by Grover Norquist, is also sponsoring the forum, which will be held Jan. 3 at the National Press Club.

"It is critical that the next RNC chairman sincerely recognize the electoral power of the pro-life movement, can articulate its message, and is prepared to advance its priorities," Marjorie Dannenfelser, president of SBA List, said in a statement. "We look forward to vetting the candidates on Life through thoughtful questioning and open discussion."

Several candidates have announced their runs for the RNC chairmanship. Current leader Michael Steele hasn't said whether he will seek a second term.

Senate leaders reached a one-year bipartisan agreement to freeze Medicare physician payments using a healthcare reform provision to avoid a massive rate reduction scheduled for next year, a Senate aide told The Hill.

The $19.2 billion “doc fix,” which avoids a scheduled 25 percent reduction in Medicare physician payments starting Jan. 1, is paid for by recovering a larger share of subsidies designated for people to buy health insurance through state-run exchanges starting in 2014, the aide said.

The measure is expected to be brought up for approval by unanimous consent sometime tomorrow, according to the aide.

The reform law created insurance exchanges, beginning in 2014, for people who are unemployed, self-employed or work for business that doesn’t offer insurance. Almost 20 million may be eligible for subsidies, with the cutoff level set at four times the federal poverty level — or about $88,000 for a family of four. The deal reached Monday night would increase financial penalties to those who misrepresent their income to the insurance exchanges.  

The agreement was reached Monday night by staff for Majority Leader Harry Reid (D-Nev.), Minority Leader Mitch McConnell (R-Ky.), Finance Committee Chairman Max Baucus (D-Mont.) and ranking member Chuck Grassley (R-Iowa), the aide said.

Congress has already approved four separate doc fixes this year, with the most recent agreement lasting only a month. The $1 billion fix was paid for by cutting therapy service payments by 20 percent.

The presidential deficit commission report that was voted down last week recommended a more permanent solution to the sustainable growth rate, which is the formula used to determine Medicare physician payments.

The successful implementation of the new healthcare reform law will hinge on physicians and hospitals working out trust issues with one another, according to a new survey.

The reform law requires increased collaboration and information sharing between physicians and hospitals, including through new accountable care organization (ACO) arrangements, to reduce costs and increase quality.

However, one in five physicians don’t trust hospitals, and 60 percent of hospitals believe it will be difficult to obtain information from community physicians to improve patient care, according to a new PricewaterhouseCoopers (PwC) survey. Physicians said they were less inclined to trust hospitals because of competing goals, not enough physician leadership on hospital boards and lack of transparency, communication and similar incentives.

The relationship between physicians and hospitals soured during the 1990s, as hospitals bought and sold physician practices and physicians opened outpatient surgery centers and special hospitals to compete, the report said. However, the trend is reverting back toward consolidation, the PwC survey said. Almost three-fourths of physicians surveyed said they have financially aligned with hospitals through employment, joint ventures or directorships, and 58 percent said they want a closer financial relationship.

More than half (54 percent) believe hospitals and physicians will become more aligned over the next five years through ACOs, which were incentivized in the reform law. The Department of Health and Human Services is expected to release regulations on ACOs by early next year.

Private insurance plans might be better at controlling healthcare costs than Medicare, according to a Health Affairs study released Tuesday morning.

The study followed up on an influential 2009 New Yorker article that found Medicare spending on the elderly population is significantly higher in McAllen, Texas, than it is in El Paso, Texas. Using medical and expense data for patients in those towns who are privately insured by Blue Cross and Blue Shield, researchers found private insurers were cheaper and had a more consistent cost structure.

Researchers said their findings were consistent with the New Yorker article that found doctors were increasing the use of profitable Medicare services when they were not being closely monitored. However, private insurance plans, because of their more stringent reviews for the use of medical services, might be better at containing costs, researchers said.

According to the study, Medicare spent almost double in McAllen ($14,817 per patient) than what it spent on an average El Paso beneficiary ($7,947 per patient). Both figures, however, far surpassed private insurance costs: Blue Cross spent $2,266 on the average McAllen enrollee, while spending $2,428 on the average El Paso enrollee.

Researchers said home healthcare accounted for the greatest variability in Medicare spending between the two regions, with McAllen using the service 4.6 times more than in El Paso. Researchers found even more variations in services, including double the rate of cardiac surgery in McAllen. However, those sharp variations in the use of Medicare services were not found in the private insurance population under the age of 65.

Ultimately, the variation in services might be explained by private insurance companies and Medicare exhibiting “very different interactions” with local providers, researchers said.