House Republicans objected to the House Democrats’ insertion of the food-safety bill into the continuing resolution to fund the federal government through Sept. 30.

Rep. Frank Lucas (R-Okla.), the incoming Agriculture Committee chairman, said Democrats are resorting to legislative tricks to pass the FDA Food Safety Modernization Act.

“This is the sort of nonsense that Americans rejected just a few weeks ago,” Lucas said Wednesday afternoon on the House floor.

The food-safety bill passed the Senate last week, but a procedural error forced the House to reconsider the measure. Democrats feared that Republicans would try to stall the bill throughout the rest of the lame-duck session. Instead, on Wednesday morning, they tucked the food-safety bill into a continuing resolution to keep the government running past Dec. 18.

“[Democrats] have shut out Republicans over the past four years, and they continue to shut out common sense and the American people,” said Rep. Pete Sessions (R-Texas).

Some Republicans have objected to the bill because they said it gives too much authority to the Food and Drug Administration and creates too much of a burden on small farmers and ranchers.

The food-safety bill passed the Senate 73-25 last month before the technical glitch was discovered. A stronger version passed the House in 2009 by a vote of 283-142, but House Democrats are trying to pass the Senate version because they believe it is more politically feasible.

Rep. Jim McGovern (D-Mass.), who co-chairs the House Hunger Caucus, said he was “baffled” by the controversy over the bill, which would represent the most major changes to food-safety practices in more than 70 years.

“The fact is the food safety in this country needs to be strengthened and modernized,” McGovern said.

President Obama gave his blessing Wednesday afternoon to the one-year deal reached by Senate leaders to delay a scheduled 25 percent cut in payments to Medicare physicians. The $19.2 billion proposal draws on funding from the new healthcare reform law.

"I am pleased Democratic and Republican leaders in the Senate have agreed on legislation that will prevent a significant pay cut for doctors from taking effect and help ensure seniors on Medicare can continue to see the doctor they know and trust," Obama said in a policy statement.

"I encourage Congress to act quickly on this proposal," he continued. "This agreement is an important step forward to stabilize Medicare, but our work is far from finished. For too long, we have confronted this reoccurring problem with temporary fixes and stop-gap measures. It’s time for a permanent solution that seniors and their doctors can depend on and I look forward to working with Congress to address this matter once and for all in the coming year.”

The healthcare reform law creates state-run exchanges through which certain people may purchase insurance starting in 2014. The law includes subsidies for those under a specified income limit — about $88,000 for a family of four — and includes recapture penalties to those whose income exceeds the limit. The law provided a flat-cap penalty of $250 for individuals and $400 for families, but the doc-fix agreement reached Tuesday night is funded by a new penalty scale that hits higher-income earners with larger fines.

As Senate leaders consider a proposal for a yearlong fix to avert a scheduled 25 percent reduction in Medicare payments, the aging lobby is warning Congress that failure to stave off the cuts will upset their constituents.

Four in five seniors are worried that their doctors may stop treating Medicare patients if Congress cannot agree on a fix, according to an AARP Massachusetts survey released Wednesday. Meanwhile, 81 percent are concerned about having to find a new doctor if their current physician ceases accepting Medicare.

The poll indicated that more than 75 percent of seniors, regardless of party affiliation, would be more favorable to senators if they fought to protect Medicare payments to doctors. However, 83 said they would view their senators less favorably "if they did nothing to stop this cut."

“Our members are scared that their doctors may stop treating Medicare patients, and that they won’t be able to find a new one,” Deborah Banda, director of AARP Massachusetts, said in a statement. “Across party lines — Democrat, Republican, Independent — they want members of Congress to stop this cut, and say they will view their elected officials less favorably if they don’t.”

More than two-thirds of survey respondents say a more permanent solution to Medicare doctor payments is needed. The president’s debt commission last week agreed in its final proposal, which made overhauling the Medicare physician payment formula a main part of its plan for lowering healthcare costs.

The federal government must facilitate the widespread adoption of universal standards that will allow healthcare stakeholders to better share electronic health information and maintain patient privacy, according to a presidential advisory council report released Wednesday morning.

The National Coordinator for Health Information Technology and the Centers for Medicare and Medicaid Services should develop guidelines to facilitate the adoption of a universal language for assisting the exchange of electronic health information and the transition from paper to electronic health records (EHRs), the President’s Council of Advisors on Science and Technology (PCAST) report said.

Although leveraging health information technology in the healthcare setting provides numerous benefits, the impact of health IT over the past decade has been “modest,” with nearly 80 percent of physicians lacking basic digital records, PCAST said. Further, EHRs already in existence are limited in function and cannot be easily shared.

The report noted that last year’s stimulus package included as much as $27 billion to promote the adoption and use of EHR technologies. Providers and hospitals can already start registering for a CMS program that will provide incentives for using EHR technology in accordance with the agency's standards.

PCAST called on the federal government to develop within a year a set of metrics to measure progress toward an operational, universal, national health IT infrastructure, and it said federal agencies must coordinate government information systems with public health agencies and government benefit payment systems.

Senate Democrats had braced for GOP opposition and fear Sen. Tom Coburn will try to stop the measure.

Senate leaders announced late Tuesday night legislation to delay a 25 percent cut in Medicare payments that will take effect Jan. 1 without congressional intervention.

The bill, the Medicare and Medicaid Extenders Act of 2010, taps into subsidies for state-run insurance exchanges created by the new healthcare reform law to pay for the $19.2 billion, one-year "doc fix" to Medicare physician rates.

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) hammered out the agreement over the past few days and announced it Tuesday night. They are hoping to bring the agreement to a vote by unanimous consent as early as Wednesday, a Senate aide told The Hill.

The healthcare reform law creates state-run exchanges through which certain people may purchase insurance starting in 2014. The law includes subsidies for those under a specified income limit — about $88,000 for a family of four — and includes recapture penalties to those whose income exceeds the limit. The law provided a flat-cap penalty of $250 for individuals and $400 for families, but the doc-fix agreement reached Tuesday night would create a sliding scale for penalties.

The legislation announced last night also extends a number of Medicare provisions, including an extension of the therapy caps exception process through Dec. 31, 2011, for $900 million over 10 years.

It also would repeal a delay in the implementation of the new Medicare payment structure for nursing homes. The nursing home industry had been pushing hard for a repeal of the delay, which was included in the healthcare reform law. The new payment system would be effective Oct. 1, 2010, instead of Oct. 1, 2011, if the doc fix is approved.

A list of all the extenders and other provisions included in the bill can be found here. 

If approved by Congress, this would mark the fifth patch to Medicare payments this year. The most recent patch, agreed to last month, will only last through the end of the year.

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.