OVERNIGHT HEALTH: Supercommittee still at odds over Medicare

The deficit-cutting supercommittee on Tuesday weighed a new proposal for overhauling Medicare, but members clearly still have some reservations. The proposal would partially convert Medicare into a type of voucher system for private insurance. But it also would give seniors the option of remaining in the existing program. Supercommittee members from both parties raised questions about the proposal during a public hearing. 

Democrats worried that traditional Medicare would get stuck with the sickest patients, which would drive up costs, which would scare away even more people, which would further increase costs, and so on until the program collapses. Sen. Pat Toomey (R-Pa.), meanwhile, said he's concerned that a real transformation in healthcare is impossible with Medicare's fee-for-service system still hanging around.

Healthwatch's Sam Baker has more.

Medicare is the easy part: Former White House budget director Alice Rivlin said at Tuesday's supercommittee hearing that Medicare is easy compared to the challenge of overhauling Medicaid.

"We had a good plan for Medicare; we offered a menu on Medicaid,” she said, explaining that it's harder to settle on a single proposal or set of proposals for the joint state-federal program.

Rep. Fred Upton (R-Mich.) focused his healthcare questioning on Medicaid. He asked about rolling back the Medicaid expansion in President Obama's healthcare law, saying it's the "primary driver" of increased spending.

Spending fights: House Minority Whip Steny Hoyer (D-Md.) has convinced 182 Democrats to oppose including any controversial policy riders — including efforts to defund the healthcare reform law — in the 2012 appropriations bills. The move is important because it could make it more difficult for Republicans to move 2012 spending measures. 

Missing are seven Democrats who voted against the healthcare reform law last year: Reps. Dan Boren (Okla.), Tim Holden (Pa.), Larry Kissell (N.C.), Daniel Lipinski (Ill.), Mike McIntyre (N.C.), Collin Peterson (Minn.) and Heath Shuler (N.C.). Read The Hill's story.

The stumbling block in the House comes as the Senate on Tuesday cleared a $20 billion spending bill for the Department of Agriculture and the Food and Drug Administration as part of its $182 minibus. The bill passed by a bipartisan 69-30, The Hill reports.

Short temper: Energy and Commerce Health subcommittee Chairman Joe Pitts (R-Pa.) lashed out at the administration for unveiling an executive order on drug shortages without warning his panel, which held a hearing on the issue in September.

"I am bewildered as to how the administration can claim that they can't wait for Congress to address drug shortages since we have been anxiously awaiting a report promised by the administration at our hearing over a month ago," Pitts said in a statement. "The issue is complex and witnesses, including HHS, testified at our hearing that there are multiple causes and as a result, it will require multiple solutions. I am disappointed that the administration has spent more time strategizing a press rollout to politicize this deadly issue than working with Congress to resolve the problem."

The issue is moving along more smoothly in the Senate, which is expected to consider drug shortage legislation from Sens. Amy KlobucharAmy Jean KlobucharFranken resignation could upend Minnesota races Avalanche of Democratic senators say Franken should resign Trump-free Kennedy Center Honors avoids politics MORE (D-Minn.) and Bob CaseyRobert (Bob) Patrick CaseyThe Hill's 12:30 Report Avalanche of Democratic senators say Franken should resign Dems look to use Moore against GOP MORE (D-Pa.) early next year as part its effort to reauthorize prescription drug user fees.

"Both Senators Klobuchar and Casey are part of the bipartisan working group developed as a part of the HELP Committee's efforts to reauthorize the FDA user fee agreements, and their ideas are very much in the mix," Tom HarkinTom HarkinDemocrats are all talk when it comes to DC statehood The Hill's 12:30 Report Distance education: Tumultuous today and yesterday MORE (D-Iowa), chairman of the Senate Committee on Health, Education, Labor and Pensions, told The Hill in a statement. "We can't say definitively what, if anything, might get marked up because the working group has not yet concluded its work."

Tough love: Medicare should toughen its oversight of hospitals, the Health and Human Services Department's inspector general said Tuesday.

The IG report details how state agencies and the federal Center for Medicare and Medicaid Services respond to allegations of serious adverse events at hospitals. Allegations are investigated promptly, the report says, but the responses could be improved. Healthwatch's Sam Baker has more.

Fear the needle: The consumer group Public Citizen on Tuesday slammed a proposal to test the anthrax vaccine on children, calling the idea unethical and illegal and accusing the pharmaceutical industry of fear-mongering. 

The letter to HHS Secretary Kathleen SebeliusKathleen SebeliusObama cabinet official: Clinton White House doubled down on 'abusive behavior' John Roberts has tough job of keeping faith in Supreme Court Price was a disaster for HHS — Time for an administrator, not an ideologue MORE comes after a panel of experts that advises the federal government on biodefense countermeasure issues voted Friday to recommend that the department pursue voluntary testing on children. Healthwatch's Julian Pecquet has more.

Drug-free poultry: The third-largest school district in the country on Tuesday began serving chickens raised without antibiotics, a major win for public health advocates who have been warning about the rising threat of antibiotic resistance. The Pew Campaign on Human Health and Industrial Farming said the announcement is part of a two-pronged strategy aimed at changing federal regulations and consumer behavior. Read the Healthwatch post here.

Wednesday's Agenda

It's Herman Cain's big day to talk about healthcare. The GOP presidential contender starts with a 10:40 press conference during the annual meeting of the free-market Docs4PatientCare organization in Alexandria, Va. Then at 1:15 it's on to Capitol Hill, where he'll lay out his healthcare vision at the invitation of the Congressional Health Care Caucus. Healthwatch has more on his record here.

The Energy and Commerce Health subcommittee rekindles debate over the healthcare reform law's contraception coverage with a hearing on conscience rights. Federal regulations exempt group health plans sponsored by certain religious employers from having to cover contraceptive services, but critics say they don't go far enough. More on the controversy here.

The co-chairmen of the Senate Diabetes Caucus, Sens. Susan CollinsSusan Margaret CollinsOvernight Health Care: 3.6M signed up for ObamaCare in first month | Ryan pledges 'entitlement reform' next year | Dems push for more money to fight opioids Study: ObamaCare bills backed by Collins would lower premiums Right scrambles GOP budget strategy MORE (R-Maine) and Jeanne ShaheenCynthia (Jeanne) Jeanne ShaheenDems demand Tillerson end State hiring freeze, consult with Congress The Hill Interview: GOP chairman says ‘red flags’ surround Russian cyber firm Schumer celebrates New York Giants firing head coach: ‘About time’ MORE (D-N.H.), will call on the FDA to issue "clear and reasonable guidance" on the artificial pancreas that avoids unnecessary delays in the delivery of a medical technology. The senators will join with diabetes patients to unveil a petition with more than 100,000 signatures urging the FDA to issue the guidance by Dec 1.

The Washington Legal Foundation hosts a panel of experts from the food and beverage industries to promote industry self-regulation over government regulation of marketing to children.

HHS Secretary Kathleen Sebelius touts the health benefits of affordable housing at a National Building Museum conference on innovative solutions to meet housing needs and improve the lives of low-income families and communities.

Reg Watch

Doctors will see a 27.4 percent cut in Medicare reimbursements next year unless lawmakers step in to override the Sustainable Growth Rate formula, as they have 11 times in the past, according to the final rule for physician payments released Tuesday. 

HHS Secretary Kathleen Sebelius accompanied the rule with a statement urging Congress to act before the end of the year to prevent the cut.

"Earlier this year," she said, "President Obama presented a deficit reduction plan in which he once again called for a permanent fix to the sustainable growth rate (SGR) provision so that our nation's physicians would no longer have to face the threat of draconian cuts year after year. Today we again call on the Congress to quickly and permanently pass the so-called ‘doc fix’ and we pledge to work with legislators on both sides of the aisle to address this issue once and for all."

New regulations increase Medicare payment rates for outpatient hospital care by 1.9 percent in 2012 and payment rates to ambulatory surgical centers by 1.6 percent. The regulations also establish a quality reporting program for ASCs.

Medicare is increasing payment rates for dialysis treatments by 2.1 percent in 2012, for a total of $8.3 billion. New regulations also tighten quality reporting standards.

State by State

One percent of Medicaid spending in Massachusetts during the past fiscal year — $93 million out of $9.6 billion — benefited immigrants who couldn't prove their legal status.

HHS signed off on Kentucky's new Medicaid managed care plans, allowing the program to be launched on Tuesday.

Illinois could take up legislation to create a health insurance exchange by the end of the month.

Bill Tracker

Rep. Lois Capps (D-Calif.) and Edward MarkeyEdward (Ed) John MarkeyNet neutrality supporters predict tough court battle over FCC's repeal plan Avalanche of Democratic senators say Franken should resign Driverless car bill hits Senate speed bump MORE (D-Mass.) will announce Wednesday the re-introduction of Capps's bill to improve the public health response to climate change through research, surveillance, planning and interagency coordination.

Rep. Maurice Hinchey (D-N.Y.) introduced legislation to allow parents who have healthcare coverage through retiree health plans to extend that coverage to their adult children up to the age of 26. Retiree-only plans were exempted from many provisions in the Democrats' healthcare reform law.

Sen. Kay HaganKay HaganPolitics is purple in North Carolina Democrats can win North Carolina just like Jimmy Carter did in 1976 North Carolina will be a big battleground state in 2020 MORE (D-N.C.) introduced a bill calling for HHS to provide grants to strengthen the healthcare system's response to domestic violence, dating violence, sexual assault and stalking (S. 1765).

Fraud Fight

The owner and operator of a Houston durable medical equipment company was sentenced to 41 months in prison for submitting Medicare claims for orthotics that were medically unnecessary and/or not provided.

Reading List

Chinese police arrested 114 people in a crackdown on a counterfeit drugs ring, seizing $30 million worth of fake medications and more than 65 million medicine bottles, The Associated Press reports. The arrests came as a top FDA official was visiting Shanghai to discuss the importance of safe drugs and China's role as a major supplier to the U.S. market.

The Rhode Island Department of Health has suspended the license of a dermatologist it says "abandoned" his patients to run for office in Nigeria, The Associated Press reports.

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

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

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