Health Policy Friday

The Obama administration is expected to release final regulations regarding FY 2011 Medicare payments to hospitals.

The hospital industry will be tracking the regulations very closely to see if they amend the preliminary proposal that attracted considerable criticism when it was made public in April. The industry says the initial proposal would have cut payments by 0.1 percent on average per patient, on top of the 0.25 percent cut hospitals agreed to under healthcare reform.

"Should this rule take effect," American Hospital Association President and CEO Rich Umbdenstock said at the time, "billions of dollars would be taken out of the system just as hospitals are grappling with sweeping changes and payment reductions contained in the new health reform legislation."


The House Thursday evening rejected a bill guaranteeing health coverage to first responders to the site of the 9/11 attacks in New York City. The 255-159 failed because a two-thirds majority was needed under suspension of the rules.

Thursday evening, the three lead sponsors — New York Reps. Carolyn Malloney (D), Jerrold Nadler (D) and Pete King (R) — issued a joint statement.

"Today’s vote showed that we have the support we need to pass the Zadroga Act, and we look forward to passing the bill with a simple majority when Congress returns from its August recess," they said. "We thank our colleagues in the New York delegation for their dedication to those who were harmed by the terrorist attacks on our nation."


While the Department of Health and Human Services' regulation restricting abortion coverage in state high-risk pools got most of the ink, HHS moved forward on other health reform fronts as well.

On Thursday, HHS also released a request for comments regarding the state insurance exchanges that are to start operating in 2014. Comments are solicited regarding the minimum functions exchanges must perform, such as: certification procedures, rating of plans based on quality and price, the establishment of hotlines, standardized format to present benefit options and eligibility, and enrollment functions.

Comments are due by Oct. 4, in advance of future rulemaking and grant solicitations to assist states in establishing their exchange.

HHS also announced that grants of up to $1 million per state are available to help states begin to work to establish their exchange. Applications are due to the Office of Health Insurance Exchanges by Sept. 1.


As expected, HHS has chosen eHealth to act as the information technology pricing vendor for the consumer Web portal created by the healthcare reform law.

To make useful information on health-insurance prices available to the public, HHS is putting together a template for health plans to share benefit and pricing data for display in the portal. The template is expected to be ready by late August, and plans will have until Sept. 3 to submit their data.


The liberal Center for American Progress marks the 45th anniversary of Medicare with a new report praising healthcare reform's role in closing the prescription drug "doughnut hole."

The study found that brand-name and generic drug discounts will reduce the out-of-pocket expenses of seniors who stay in the gap by 23 percent in 2011 ($500 saved on an almost $2,200 bill).

For those seniors who reach catastrophic coverage in 2011, discounts are predicted to save them more than $1,500 — a reduction of their total out-of-pocket spending of nearly a third.