Health Roundup: Congress prepares to vote on SGR, food safety, 1099s

The House and Senate both have hefty health agendas Monday as they attempt to pass several remaining items before the new Congress takes over.

Delaying the SGR showdown … again: The House is expected to take up a one-month "fix" to the Medicare Physician Payment System under suspension of the rules this evening. If the House doesn't act, doctors face a 23 percent cut in Medicare payments starting Wednesday.

The Senate passed a bipartisan, $1 billion fix on Nov. 18. It's paid by cutting therapy service payments by 20 percent and using those savings to pay for the "doc fix" instead of redistributing them into the Medicare Physician Fee Schedule.

Food-safety bill includes 1099 provisions: The Senate may for the first time repeal a provision of Democrats' healthcare reform bill when it takes up food-safety legislation today.

According to Senate staff, the timeline should start with a cloture vote on the final bill, as amended by the small-farms exemption from Democratic Sens. Jon Tester (Mont.) and Kay Hagan (N.C.). The procedural motion will need 60 votes to pass.

This will be followed by a vote on four amendments, all requiring a 67-vote threshold: 

• Sen. Mike Johanns's (R-Neb.) amendment to repeal the 1099 provision (this is offset by unspent and unobligated federal dollars, to be identified by the Office of Management and Budget);

• Sen. Max Baucus's (D-Mont.) alternative amendment to repeal 1099 without paying for it (this would add to the deficit but at the same time lower the cost of repealing healthcare reform, a Republican priority);

• Sen. Tom Coburn's (R-Okla.) moratorium on congressionally directed appropriations; and 

• Coburn's food-safety substitute amendment, which is an alternate, stripped-down food-safety proposal.

The vote on amendments will be followed by a final vote on the food-safety bill, which will require a 51-vote threshold.

The House passed its version of the legislation in July 2009. It's not clear how the Senate and House versions would be reconciled.

Healthcare law repeal gains momentum in courts: A decision this week by a federal judge in Ohio marks at least the third time a legal challenge to Democrats' healthcare law has been allowed to go forward, underscoring the extent to which the legal push for repeal is gaining momentum.

While top-ranking Republicans have acknowledged that they won't be able to fulfill their campaign promise to “repeal and replace” the law so long as a Democrat sits in the White House, many see promise in the court fight against it. A number of Republicans have signed onto a 21-state challenge to the law that seems almost certain to end up at the Supreme Court. 

Newly elected governors in at least five states are also preparing to join the fray, even as advocates of the law push back.

Administration says healthcare law can survive without mandate: Obama administration officials this week told a federal judge that even if the healthcare reform law's individual mandate is ruled unconstitutional, other parts of the law should be allowed to stand.

Medicaid could be paying for unapproved drugs: A new report from the Health and Human Services Department's Office of Inspector General found that 38 percent of drugs paid for by Medicaid in 2008 did not have an approved application number in the National Drug Code (NDC) Directory or were not in the NDC directory at all.

"As a result, Medicaid could potentially pay for drugs that are not approved by FDA," the report found. "Without accurate approval and listing information, it is impossible to determine whether these drugs were paid for appropriately."

Task force created to protect agents and brokers: The National Association of Insurance Commissioners announced Wednesday the creation of a new task force to try to protect insurance agents and brokers from the side effects of Democrats' healthcare reform law. Some liberals say agents and brokers should go the way of the travel agent when state insurance exchanges with standardized offerings are up and running in 2014, but the NAIC says they will still serve an important function.

Kuwait disses U.S. model in pursuit of healthcare reform: According to Nadeem Al-Duaij, chairman of the nonprofit Kuwait Health Initiative that's helping reform the health sector in that country: "There currently exists no evidence to support the use of for-profit insurances to finance a nation's health care in a fair and cost-effective manner. Quite the contrary, such mechanisms have time and again resulted in poor health outcomes, in inequalities in health care access and delivery, and in an inability to contain rising health care costs. We believe in the need for health insurance to protect the individual from catastrophic health expenditures but this must be done through the adoption of a non-profit social health insurance or similar scheme that is supported by current health policy evidence."