Congress tackles a full slate of hearings: There are only a few short weeks left for legislative accomplishments in the 111th Congress, but members are eager to hold forth on their favorite topics. Today they start by tackling a slew of issues, from stem cell research to Medicare reimbursements.

The Senate HELP Committee kicks things off in the morning with a hearing on  the Stem Cell Therapeutic Reauthorization Act of 2010, introduced by Sen. Orrin Hatch (R-Utah) early last month. The bill would reauthorize $53 million in funding for bone marrow and cord blood transplants and has bipartisan support. http://bit.ly/bwn9A8 

Medicare pricing under review: Lawmakers on the Energy and Commerce health panel delve into the touchy issue of adequate reimbursements for the durable medical equipment - wheelchairs, oxygen tanks, diabetic testing supplies - vital for seniors with disabilities and other conditions to continue living independently. Auditors have uncovered many problems with overpayments and fraud over the years, in part because reimbursement policy is based on 1987 prices; in 2006, for example, the Health and Human Services of the Inspector General found that Medicare would allow $7,215 in payments over three years for oxygen supplies that cost on average 12 times less - $587 - to purchase.

The hearing will examine the conception and implementation of the Medicare competitive bidding program and its potential effects on patients, providers and suppliers. The new healthcare reform law vastly expands competitive bidding, from nine metropolitan statistical areas currently to 100 in the second round of bidding to be conducted in 2011. By 2016, the new law requires that CMS apply rates observed in the competitively bid areas to other parts of the country. 

Sen. Mike Johanns' amendment to repeal the health reform law's 1099 business reporting requirement would have had a direct effect on several provisions of the law.

While most of the attention was focused on the 1099 provision itself, the Nebraska Republican also wanted to cut funding for prevention and public health by $11 billion and weaken the requirement that most Americans buy health insurance starting in 2014. The amendment failed a cloture vote by a 46-52 vote on Tuesday.

The American Public Health Association immediately praised the vote, saying the Johanns bill would have "effectively eliminated" the health reform law's Prevention and Public Health Fund.

"Today, the Senate signaled that it will not tolerate any efforts to undermine health reform and embraced public health and prevention as hallmarks of reform," executive director Georges Benjamin said in a statement. "The public health community applauds the Senate for  protecting the fund and appreciating the promise that disease prevention holds for all Americans."

The Johanns amendment would also have exempted many more people from the law's individual mandate requirement. The liberal Center for Budget and Policy Priorities estimated that the provision would result "increasing the number of uninsured people by 2 million (relative to what would occur under the health reform law), driving up premiums by as much as 4 percent for people with coverage through the new health insurance exchanges (because the pool of people in the exchanges would be less healthy, on average)."

Rep. Pete Stark (D-Calif.), the chairman of the House Ways and Means health subcommittee, said Tuesday that the federal government could end up paying too much for dialysis drugs under Medicare.

Stark was reacting to the findings of a study he requested from the Office of the Inspector General of the Department of Health and Human Services. The report found the cost of dialysis drugs dropped between 2003 and 2009 but the index the Medicare program uses to reimburse prescription drugs rose. 

"This report shows that we must find the right payment levels that preserve Medicare beneficiaries’ access to quality care," Stark said in a statement. "Dialysis drug costs have dropped while the index the government will use to increase prices over time has risen. If these trends continue, the government will be overpaying for dialysis drugs. We must continue to carefully track drug cost and utilization trends for dialysis treatment."

Energy and Commerce Democrats on Tuesday wrote to the owner of an Iowa egg farm linked to a recent salmonella outbreak that has sickened 1,519 people to demand answers about positive salmonella tests at the farm prior to the recent incident.

Wright County Egg owner Austin DeCoster has agreed to testify at an oversight subcommittee hearing next Tuesday. His farm received 426 positive results for salmonella between 2008 and 2010, according to documents obtained by the panel, including 73 samples that were potentially positive for the strain linked to the recent outbreak.

Wright County Egg did not share that information in its response for documents ahead of the hearing, prompting Tuesday's letter.

"When you testify before the Committee," the letter states, "we ask that you come prepared to explain why your facilities tested potentially positive for Salmonella Enteritidis contamination on so many occasions, what steps you took to address the contamination identified in these test results, and whether you shared these results with FDA or other federal or state food safety officials."

The letter is signed by Energy and Commerce Chairman Henry Waxman (D-Calif.) and Oversight and Investigations Subcommittee Chairman Bart Stupak (D-Mich.).

The Department of Health and Human Services on Tuesday awarded $31 million for prevention and wellness projects in nine states. The money was included in the healthcare reform law's Prevention and Public Health Fund.

The awards support public health efforts to reduce obesity and smoking, increase physical activity and improve nutrition.

Here's the list: 

• $3 million to the Alabama Department of Health: Mobile County, Alabama, for tobacco prevention;

• $2.3 million to the Arkansas Department of Health: City of North Little Rock, Arkansas, for obesity prevention; and Independence County, Arkansas, for obesity prevention;

• $5.8 million to Children's Memorial Hospital / City of Chicago, Illinois, for obesity prevention;

• $2.35 million to DeKalb County Board of Health, Georgia, for obesity prevention;

• $3.7 million to the North Carolina Division of Public Health: Appalachian District Health Department, North Carolina, for obesity prevention; and Pitt County, North Carolina, for obesity prevention;

• $4.85 million to the Pinellas County Health Department, Florida, for obesity prevention;

• $3.6 million to the Santa Clara County Public Health Department, California, for obesity prevention;

• $3.8 million to the Southern Nevada Health District, Nevada, for obesity prevention; and

• $1.6 million to the South Carolina Department of Health and Environmental Control for obesity prevention.

Almost 29 million middle-income Americans will be eligible for a "historical tax cut" worth $110 billion in 2014 alone thanks to the healthcare reform law, according to a new report released Tuesday.

The national healthcare consumer organization Families USA commissioned the Lewin Group to use its economic models to estimate how many people would be eligible for the new premium tax credits created by the law. Families USA Executive Director Ron Pollack said the report's release was a timely reminder of the health law's benefits to working, middle-class families at a time when much of the conversation in the nation's capital is focused on both rising healthcare costs and the need for tax cuts.

"This is one of the largest middle-income tax cuts in history," Pollack told reporters during a conference call. "And it will enable many hard-working Americans to afford private health insurance premiums that continue to stretch family budgets."

In addition to the expansion of the Medicaid program for the poor, the new law will offer tax credits to about 24.8 million people in families with a full-time employed worker and another 2.5 million people in families with a part-time worker.

The report also points out that the law will be especially helpful to workers in small businesses: 

• More than half (52.9 percent) of those people eligible for the premium tax credit — 15.2 million people — work in businesses with fewer than 100 workers; 
• About 40 percent of the people eligible for the tax credit (11.4 million people) are employed in businesses with fewer than 25 workers.

Families USA said it plans to release state-by-state information on the number of people eligible for the tax credits in coming weeks.

California-based Consumer Watchdog wrote to President Obama on Tuesday urging him to use the powers of his office to get tough on healthcare plans.

The group suggested that Obama "use the full power of your office" to advocate for tough "prior approval" insurance regulations in Congress. If that fails, the White House should "take your case to the states" and try to get prior-approval premium regulations through the state ballot measure process in the 24 states — and the District of Columbia — where that's an option.

Consumer Watchdog added that California's property and casualty insurance regulation, known as Proposition 103, could be "the model for a state-by-state campaign to enact prior approval regulation of health insurance rates." Proposition 103 was authored by Consumer Watchdog founder Harvey Rosenfield and requires that auto insurance rates be approved by the elected insurance commissioner; it also gives consumers the right to object to "unreasonable increases" and demand hearings on those objections. The law was approved by voters and enacted in 1988.

The group also requests that the administration make the federal regulations granted by the new healthcare law as tough as possible. The law grants the Department of Health and Human Services the ability to review "unreasonable" premium increases and requires insurance companies to publicly justify such increases.

Consumer Watchdog suggests that: 

• HHS regulations must define 'unreasonable' in a way that allows for the broadest possible review of rates, and ensure full public disclosure of the justifications insurers file for unreasonable increases;

• Insurer disclosures must include robust data for rate reviews to shine new light on questionable rate hikes; otherwise the industry will just gain another way to obscure data and mislead the public;

• HHS should address the need for strengthening state regulation in the second round of rate review grants. Additional funds should be limited to states that demonstrate concrete movement toward prior approval premium regulation, where regulators must approve rate increases before they take effect; and 

• A state’s promise of increased “review” and transparency is not enough if the insurance commissioner does not have authority to reject excessive, even unjustified, rates.

Sen. Tom Carper (D-Del.) on Tuesday blasted the Medicare agency for what he considers an inadequate response to his concerns about the prescription-drug program's integrity.

"The Centers for Medicare and Medicaid response to my concerns about the $1.2 billion in Medicare prescription drug claims that contained invalid prescriber identifiers left a lot to be desired," Carper said in a statement.

Carper wrote to the Centers for Medicare and Medicaid Services on July 29 and requested the agency establish a process to ensure valid identification numbers on reimbursed prescriptions under the Part D program. The law requires the identification numbers to ensure drugs are being prescribed by legitimate health professionals, but an audit by the Health and Human Services Office of Inspector General found that $1.2 billion in reimbursements in 2007 — representing more than 18 million claims — contained invalid prescriber identification.

In its response to Carper, CMS points out that invalid identifiers don't automatically indicate an invalid prescription or a fraudulent claim. Some 98 percent of the errors the OIG found were related to a problem with invalid Drug Enforcement Agency numbers that has since been fixed, the agency added.

CMS said it would begin a prescriber identification project this month, while also allowing some prescriptions with wrong identifiers to go forward to avoid penalizing patients.

"Preserving beneficiary access to necessary prescription medications is at the heart of CMS’ mission for the Part D program," the agency wrote, "and the problem identified by the OIG, while serious, should be addressed by CMS in a manner that does not jeopardize the Agency’s mission to provide needed medical services and supports for our beneficiaries."

Carper was unimpressed.

"Instead of immediately addressing this problem," he said, "CMS is instead only reminding the Medicare prescription drug plans to follow the existing law and hiring yet another contractor to study the problem for a year. That just won't cut it."

Carper is a member of the Senate Finance Committee, which has jurisdiction over Medicare.

Sen. Mike Johanns's (R-Neb.) amendment to eliminate the healthcare reform law's 1099 reporting provision for businesses would have "seriously" weakened the requirement that people buy insurance starting in 2014, the left-wing Center on Budget and Policy Priorities said.

The amendment failed to clear the cloture-vote hurdle Tuesday morning, 46 to 52.

"While the Affordable Health Act would allow some people to remain uninsured without incurring a penalty, the Johanns amendment would allow many more to do so, meaning that fewer people would receive federal subsidies to help them buy coverage," the center writes.

"This would reduce federal costs for these subsidies, but at the price of increasing the number of uninsured people by 2 million (relative to what would occur under the health reform law), driving up premiums by as much as 4 percent for people with coverage through the new health insurance exchanges (because the pool of people in the exchanges would be less healthy, on average), and raising the cost to health care providers and state and local governments of providing health care to the uninsured."