GOP Sens. Olympia Snowe and Susan Collins of Maine join Democrats in approving the legislation.

The industry group representing Medicaid managed care plans is applauding a new report by federal investigators that found that the Centers for Medicare and Medicaid Services has been approving contracts that don't meet federal requirements. 

While some federal officials highlighted the importance of making sure Medicaid gets value for its money, the private plans say they're the ones who have been getting shortchanged. The new report by the Government Accountability Office, Medicaid Health Plans of America says, confirms those suspicions.

"Federal law mandates that states provide Medicaid health plans with ... payments that are actuarially sound, a requirement which helps these health plans obtain adequate reimbursement and provide needed care," MHPA President and CEO Thomas Johnson said in a statement. "States, however, use a variety of rate-setting methods that are often influenced by state budgetary factors and not by the cost of health care expenditures. While CMS is required to certify that states' rates are actuarially sound, Medicaid health plans have long felt that enforcement of this requirement through the CMS regional offices has been inconsistent. The findings of this study confirm the experiences of our member health plans."

Children's hospitals say the new healthcare reform law inadvertently denies them drug discounts worth millions of dollars a year — and they want lawmakers to fix the problem they created.

Sen. Sherrod Brown (D-Ohio) is gathering signatures in a letter urging Majority Leader Harry Reid (D-Nev.) to make a technical correction to the new law "at the earliest opportunity." The House has already twice passed legislation that would amend the law.

At issue is the drug discount program for hospitals that serve low-income populations, known as 340B. The healthcare reform law enacted in March extends the program to cover more facilities, including free-standing cancer centers, critical access hospitals, rural referral centers and sole community hospitals.

Children's hospitals are also included in that list, but the National Association of Children's Hospitals says that's a mistake: Children's hospitals became eligible to participate in 340B starting in September 2009, months before healthcare reform was signed into law. That's an important distinction because certain drugs are excluded from the discount program for entities that were newly made eligible by the healthcare reform law.

The Reconciliation Act, signed in parallel with healthcare reform, exempts a class of pharmaceuticals known as orphan drugs from the discount program. These are drugs developed to treat rare medical conditions.

Children's hospitals say the orphan drug exemption should not apply to them, because they weren't added by the healthcare reform law.

"Children's hospitals use on a daily basis most of the 347 drugs that have received orphan drug status," Brown writes in the letter, obtained by The Hill. "The hospitals participating in the 340B drug discount program have achieved significant savings. They estimate that those savings would be reduced dramatically with the orphan drug exemption."

NACH says the loss of the orphan drug discount would cut children's hospitals' 340B savings by 50 percent to 90 percent. Without a fix, their only options would be to pay full price for the drugs or leave the 340B program in order to buy the drugs through a group purchasing organization.

MEDICAID, CONTINUED

Supported by Maine GOP Sens. Susan Collins and Olympia Snowe, Senate Democrats on Wednesday advanced their proposal providing $16.1 billion in emergency Medicaid funding to states next year. The 61 to 38 cloture vote sets the stage for final passage Thursday. But the wildcard yesterday was the announcement that House lawmakers will interrupt their August vacation to return to Washington next week to pass the bill.

The urgency was created not on account of the Medicaid funding, which states can't tap until January, but by a $10 billion provision for education programs also contained in the package.

"As millions of children prepare to go back to school — many in just a few days — the House will act quickly to approve this legislation once the Senate votes," Speaker Nancy Pelosi (D-Calif.) said in a statement. 

Earlier, she said the choice was made "to save teachers’ jobs."

Republicans aren't so sure. House Minority Leader John Boehner (R-Ohio) issued a statement arguing that Americans "don’t want more Washington ‘stimulus’ spending — especially in the form of a pay-off to union bosses and liberal special interests."

The House vote is scheduled for next Tuesday.

• The Medicare trustees will issue their annual report Thursday detailing the financial health of the program. Always a well-watched event, this year's report has an added importance: it's the group's first analysis of Medicare's solvency since the new healthcare reform bill became law.

Last year's report gave Medicare's hospital fund (Part A) until 2017 before coffers ran dry. An April analysis by Richard Foster, Medicare's chief actuary, said the new law will extend the life of that fund by 12 years. And what will the trustees say? 

We'll know at 11 this morning. 

Sen. John Ensign (R-Nev.) has asked federal regulators to make sure new rules banning cost-sharing for preventive care don't inadvertently preclude employers from rewarding cost-effective care.

In a letter to the heads of the Health, Treasury and Labor departments, Ensign gives the example of a self-insured employer that currently pays $1,500 for employees to get a routine colonoscopy, which can cost anywhere from $900 to $7,200; under the new rules, Ensign asks, would the employer be prohibited from making the employee pay a portion of the procedure if the employee chooses a more expensive option?

"I am concerned that the interim final regulations could thwart the ability of companies to offer preventive care while continuing to incentivize employees," Ensign writes. "If so, this could result in increased healthcare costs and negatively impact quality of care."

House Speaker Nancy Pelosi (D-Calif.) will call House lawmakers — currently in the midst of their August recess — back to Washington next week in order to pass legislation extending billions of dollars in Medicaid and education funding, Pelosi announced Wednesday.

The urgency, the Speaker said, is largely due to the looming school year.

"As millions of children prepare to go back to school – many in just a few days — the House will act quickly to approve this legislation once the Senate votes," Pelosi said in a statement. 

"In consultation with our leadership, I am calling members of the House back to Washington at the beginning of the week to pass this bill and send it to President Obama without further delay."

The Senate on Wednesday voted to end debate on the proposal, which includes $16.1 billion in emergency Medicaid funding and another $10 billion to prevent states from laying off teachers, firefighters and police officers.

The Senate is expected to pass the bill tomorrow, which the House will take up either Monday or Tuesday.

The Obama administration will soon launch a program aiming to enroll kids in subsidized health insurance plans by tapping a system in which 44 million children are already participating: youth sports.

The seven-state pilot is designed to cover the millions of uninsured kids who are eligible for Medicaid and the Children's Health Insurance Program (CHIP) but have not signed up.

Under the experimental program, the Centers for Medicare and Medicaid Services (CMS) will provide youth sports coaches with training and information on Medicaid and CHIP, in hopes that they'll pass the news on to eligible families. CMS will also promote the insurance programs at certain youth sports events in the participating states.

"Even as we move forward with health insurance reform for all Americans, we must not lose our momentum to insure kids now,” HHS Secretary Kathleen Sebelius said in a statement. “Kids should not have to miss out on their favorite sports and other activities that get them moving because they lack health insurance coverage."

A recent report from the Kaiser Family Foundation (KFF) indicates that outreach could use a boost. Of the 8.1 million kids estimated to lack health insurance coverage in 2008, KFF found, more than half were eligible for Medicaid or CHIP but not enrolled.

The states affected by CMS' pilot program are Colorado, Florida, Maryland, New York, Oregon, Ohio and Wisconsin.

White House press secretary Robert Gibbs flatly dismissed Missouri's vote Tuesday rejecting a key part of the healthcare law.

Sen. Robert Casey this week introduced legislation to expand the nation's minimum wage and overtime laws to hundreds of thousands of home care workers, who are currently excluded from those protections.

The reforms will be needed, the Pennsylvania Democrat argued, both to end the decades-old discrimination against those workers and to expand the home care workforce to meet the ever-growing need for the services they offer.

"Our Commonwealth, as well as the rest of the nation, is facing a serious problem: providing access to a quality workforce for an aging population,” Casey said in a statement announcing the bill. “The baby boom generation will start turning 65 next year and will begin to qualify for Medicare. By 2030, all 78 million will have reached that age. As this population ages, they will place new demands on our health care system." 

"We have a responsibility to do this and to get it right."

In 1974, Congress extended the Fair Labor Standards Act (FLSA) to provide wage protections to many direct care workers, including certified nursing assistants and home health aides. But the law specifically excluded workers offering so-called “companionship services,” the category where the Labor Department has put home care workers.

As a result, home care workers tend to receive lower wages and fewer benefits than most other professionals, leading to a high turnover that threatens seniors' access to in-home healthcare services.

Rep. Linda Sanchez (D-Calif.) introduced an identical bill in the House last week.

“Finally, the voices of these hardworking men and women have been heard," Leonila Vega, executive director of the Direct Care Alliance, said of the legislation. "Clearly, the time has come to end unfair labor practices."