OVERNIGHT HEALTH: Medicaid cuts still in flux

Imaging tests under the scanner: Physicians who order lots of diagnostic imaging tests should be required to get prior approval if they want to get paid under Medicare, the panel of experts who recommend payment policies urged Congress.

The near unanimous recommendation from the 17-member Medicare Payment Advisory Commission immediately provoked rationing accusations from industry. The recommendation is part of a semi-annual report to Congress, released Wednesday. Read the Healthwatch story.

Senate Republicans demand Medicare plan from Obama: Senate Republicans are ramping up pressure on President Obama to propose solutions to Medicare's pending insolvency. 

Sen. John Cornyn (R-Texas), the chairman of the National Republican Senatorial Committee and a member of the budget panel, spearheaded a letter to the president that urges him to submit a legislative proposal to Congress. Healthwatch has the story.

Censored mail: House Democrats on Wednesday charged House Republicans with trying to censor outgoing Democratic mailings that criticize the Republican plan to change the Medicare program.

Rep. Gerry Connolly (D-Va.) was one of three members who complained about this on Wednesday, calling it "blatant and transparent censorship." The Hill has the story.

Discounted drugs: Many states lack either the policies or the information that they need to oversee reimbursements for drugs purchased under the 340B Drug Discount Program to safety-net organizations, says a new report from the Health and Human Services Office of Inspector General.

MLR madness continues: Republicans on the House Energy and Commerce health subcommittee still do not like provisions of healthcare reform that govern how insurers spend their money. The policy, known as the medical loss ratio, requires plans to spend 80 or 85 percent of premiums on medical costs.

GOP lawmakers pressed HHS's Steve Larsen to defend the policy Wednesday, saying it's costing jobs and threatening the availability of policies that have offer low premiums in exchange for high deductibles. Larsen's prepared remarks are available here.

More on Medicaid: Separately from the MedPAC report, the equivalent panel for Medicaid — known as MACPAC — released its own June report on Wednesday. The document takes a long and mostly historical look at Medicaid managed care plans. The insurance industry is urging states to look toward Medicaid managed care as they try to find savings in the program.

In an issue brief published Wednesday, the Commonwealth Fund says for-profit Medicaid managed-care plans raise costs while providing lower-quality services.

CER: The Government Accountability Office released its survey of organizations that have gotten grants from HHS agencies for comparative effectiveness research. The report, based on HHS's records, is online here.

Diabetes research: Reps. Eliot Engel (D-N.Y.) and Michael Burgess (R-Texas) reintroduced legislation to fight gestational diabetes. The bill cleared the House last Congress but stalled in the Senate.

The bill would:
• Develop a research project within the Centers for Disease Control and Prevention diabetes program to enhance surveillance and public health research on gestational diabetes;
• Provide demonstration grants to focus on reducing the incidence of gestational diabetes; and
• Expand basic, clinical and public health research investigating gestational diabetes and current treatments and therapies available.

Thursday's agenda:

Sen. Tom Harkin (D-Iowa) will join several Obama administration officials, including HHS Secretary Kathleen Sebelius, to release the administration's National Prevention Strategy.

OSHA undermining states? The Education and Workforce subcommittee on workforce protections examines whether the federal Occupational Safety and Health Administration is undermining state efforts to promote workplace safety. Some 27 states and territories have their own workplace safety programs, according to the panel, but OSHA scrutiny and funding shortfalls may be undermining them.

Witnesses include officials from the U.S. Department of Labor and from North Carolina's Department of Labor, Occupational Safety & Health Division.

Home care struggles: Home care workers and people with disabilities hold a congressional breakfast briefing to push for legislation that would repeal the sector's exemption from minimum wage and overtime laws. 

The Direct Care Job Quality Improvement Act is being championed by Rep. Linda Sanchez (D-Calif.) and Sen. Bob Casey Jr. (D-Pa.). Meanwhile, the U.S. Department of Labor is expected to issue regulations later this year that could overturn the exemptions.

Reading list

L.A. public schools are banning flavored milk and junk food, reports the Los Angeles Times.

Sick children covered by Medicaid or CHIP must wait twice as long as those on private insurance to see a specialist, Reuters reports based on a study to be published Thursday in the New England Journal of Medicine.

What you might have missed on Healthwatch

The U.S. is falling behind Europe and other industrialized countries in life expectancy despite spending at least 50 percent more per person on healthcare, according to a new study.

Sen. Joe Lieberman (I-Conn.) is taking on Democratic leaders over cuts to Medicare benefits; he has suggested modest cuts to Medicare benefits in an effort to soften the hard divisions in the debt-limit talks.


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Julian Pecquet: jpecquet@thehill.com / 202-628-8527

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