OVERNIGHT HEALTH: Obama deficit plan spreads out pain over healthcare cuts

Rebate revision: Obama’s specific plan to expanding prescription drug rebates is slightly different from what we’re used to. The traditional proposal would expand Medicaid rebates to cover people who receive both Medicare and Medicaid; the version in Obama’s outline would expand the rebates to everyone who receives a low-income subsidy through Medicare. That’s a bigger group, so the potential savings are greater. Administration officials said it’s the most “straightforward” way to expand rebates.

More bad news for pharma: Expanded rebates aren’t the only longstanding prescription-drug policy included in the White House proposal — it also seeks to ban certain settlements in patent suits between brand-name and generic drug makers, which both industries oppose.

The proposal also would shorten the period during which brand-name biologic drugs are protected from generic competition. The healthcare reform law provided a 12-year period; Obama wants the supercommittee to cut that to seven years. As a senior administration official noted Monday, Obama endorsed the seven-year period during the reform debate and has proposed changing it in every budget proposal since.

Liberal critics: The healthcare savings were roundly panned by some members of the president's own party. The co-chairmen of the Congressional Progressive Caucus led the charge with a statement rejecting "any proposal that cuts benefits in Medicare or Medicaid." The Hill's Mike Lillis has more.

Arsenic juice: Sen. Charles Schumer (D-N.Y.) wants the Food and Drug Administration to set limits on inorganic arsenic levels in juice concentrate. The request comes after a segment of "The Dr. Oz Show" — lambasted by public health officials — raised concerns about the safety of apple juice concentrate, much of which is imported from China. Read the Healthwatch post.


Tuesday's agenda

Autism vote: The House is slated to take up an anti-autism bill with bipartisan support. Its sponsors are holding a press conference before floor debate that they hope will not only draw attention to the House vote but also help spur the Senate to act. The Senate's autism-research bill would cost $675 million if appropriators sign off, the Congressional Budget Office said.

Merger malaise: The House Judiciary Committee's Competition panel delves into the pending merger between two of the nation's largest pharmacy benefit managers (PBMs), Express Scripts and Medco Health Solutions. Lawmakers from both parties have raised concerns about the merger's effect on an already highly concentrated healthcare market.

The PBM lobby pre-empted the hearing with a new report touting the industry's savings for consumers and taxpayers. Healthwatch's Julian Pecquet has more.

Funding fight: Senate Health appropriators mark up the FY 2012 health spending bill. One battle to watch is funding for graduate medical education, which the president has proposed slashing to help balance the federal budget.

Rate review: The Department of Health and Human Services announces new health plan rate transparency efforts in the morning.

Innovate and castigate: House Republicans hold a first-of-its-kind "Jobs and Innovation" forum at which medical device makers will show off their latest products and blast federal regulations. The public will be able to join in the discussion on Facebook and Twitter.

The forum comes as negotiations with the government to reauthorize the user fees that fund regulatory oversight of the industry have stalled. A principal sticking point is the expedited review process for low-risk devices, which industry says is too burdensome.

Don't tax me…: The Senate Finance Committee will start the morning off with a hearing on tax reform options that could spark innovation.


State by state

Howdy partner: States will be able to get federal help in setting up their health insurance exchanges without having the government take over, under new rules proposed Monday. Healthwatch's Julian Pecquet has more.

Too flexible? Texas pharmacists say the state's proposal for a Medicaid managed care model would force pharmacies out of business because of a "precipitous decline in reimbursement rates." Federal regulators gave a tentative OK to the proposal last week, Kaiser Health News reported.

California's governor signed bills extending taxes on hospitals and managed-care plans to raise money for the state's Medicaid program.


Bill tracker

The Congressional Budget Office says a bill (S. 958) to continue funding medical training at children's hospitals would cost $1.568 billion over the next five years.

Rep. Louise Slaughter (D-N.Y.) has introduced legislation to help Americans dispose safely of their unused pharmaceuticals (H.R. 2939).

Rep. Randy Forbes (R-Va.) has a bill to "intensify stem cell research showing evidence of substantial clinical benefit to patients" (H.R. 2951).

Rep. Pete Olson (R-Texas) introduced a bill to foster better care coordination for people with pre-diabetes and diabetes (H.R. 2960). 

Rep. Mike Pompeo (R-Kansas) dropped legislation that would capture the healthcare reform law's Early Innovator grants returned by states and apply them to deficit reduction (H.R. 2961).


Fraud fight

The owner of a Miami-area mental health company was sentenced to 50 years in prison for orchestrating a $205 million Medicare fraud scheme.

A New Orleans physician was charged with conspiracy to commit healthcare fraud. He's accused of certifying that Medicare patients he never saw qualified for power wheelchairs and orthotic equipment.

A Kansas City man was sentenced for leading a conspiracy to illegally distribute more than $1 million worth of OxyContin and oxycodone that were obtained, in part, by defrauding Medicare.

A New Jersey man got 22 years for defrauding Medicaid and distributing black market prescription pain pills. A doctor was also sentenced to three years in prison today for his role in the fraud.


Lobbying registrations

KNA Services / Lake Nona Medical Center and VA Hospital (help with grants)

The Nickles Group / Food Marketing Institute (menu labeling requirements)

The Nickles Group / National Association of Convenience Stores (menu labeling requirements)

Van Heuvelen Strategies / Health Care Navigator (nursing home reimbursements)

Community Catalyst Action Fund (self-registration) / Promotes healthcare polices and delivery systems for individuals & communities

The Da Vinci Group / Alkermes (healthcare and drug & alcohol issues)

Three Bridges Advisors / Wheeling Hospital (Medicare reimbursements)

Ernst & Young / Food Marketing Institute


Reading list

The Washington Post's Sarah Kliff dives into the policy details of President Obama's proposed healthcare cuts.

ThinkProgress has video of GOP presidential contender Rick Santorum comparing universal healthcare to "food insurance."

Reuters takes a look at the provisions of healthcare reform's medical loss ratio.


What you might have missed on Healthwatch

Anita Perry: The nurse Gov. Perry wants to take with him to the White House

Survey: Seniors confused by Medicare, federal health law

Centrist Dem group wants supercommittee to go small, not big

Michele Bachmann keeps up her attacks against Rick Perry's HPV vaccine mandate on "The Tonight Show."

Week ahead: State officials are in town with plenty of questions about the healthcare reform law's insurance exchanges


Comments / complaints / suggestions?

Please let us know:

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

Sam Baker: sbaker@thehill.com / 202-628-8351


Follow us on Twitter @hillhealthwatch