OVERNIGHT HEALTH: Republicans put together ‘doc fix’ offer

by Sam Baker and Julian Pecquet - 12/08/11 11:30 PM ET

House Republicans seem to be coalescing around a two-year “doc fix” paid for with Medicare cuts — including cuts that could directly affect seniors. As expected, a two-year fix was included in the larger tax proposal GOP leaders pitched to their caucus on Thursday.

Doctors will face a nearly 30 percent cut in their Medicare payments if Congress doesn’t act by the end of the year. Republican lawmakers told The Hill after Thursday’s caucus meeting that leadership discussed a plan to avert that cut and give doctors a 1 percent pay increase in 2012 and 2013.

{mosads}A two-year fix would cost roughly $38 billion, and Republicans might try to offset that cost by asking seniors to pay more for their Medicare benefits. Members said they’re looking at increased means-testing and other changes in Medicare’s premiums.

Asked about the GOP plan, Minority Leader Nancy Pelosi didn’t rule out means-testing as possible offset.

The Hill has more on the overall package Republicans are putting together. And also check out Healthwatch’s breakdown of the offsets that lobbyists believe are on the table.

SCOTUS schedule: The Supreme Court laid out its briefing schedule Thursday for the case over President Obama’s healthcare law. The court set deadlines for written briefs but did not say when it will hear oral arguments over the law’s individual insurance mandate. On the core question of the mandate’s constitutionality, the Justice Department must file its merits brief by Jan. 6. The states suing over the mandate must file their brief by Feb. 6. The government has until March 7 to respond.

The full schedule, including the specific deadlines for briefs on severability, the Anti-Injunction Act and the Medicaid expansion, is available here.

Plan B fallout: Democrats were divided over the Plan B contraceptive the day after Health and Human Services Secretary Kathleen Sebelius overruled the Food and Drug Administration and said the drug should not be available without a prescription to girls younger than 17. Rep. Henry Waxman (D-Calif.) said yesterday that Sebelius shouldn’t have gotten involved. But President Obama backed up Sebelius on Thursday, saying her decision reflected “common sense.”

Pelosi, when asked about the decision at her weekly news conference, declined to take a position. She said she trusted the FDA but did not criticize Sebelius.

Healthwatch has more on Obama’s comments here, and on Pelosi’s here.

Planned Parenthood wants to talk: The organization is requesting a meeting with Health and Human Services Secretary Kathleen Sebelius to talk about her decision on Plan B, which it strongly opposed.

“HHS’ decision to overrule the FDA hurts all women by imposing arbitrary restrictions on a product that is only effective when taken in a timely manner,” Planned Parenthood Federation of America President Cecile Richards said in a letter to Sebelius on Thursday.

MLR on the hot seat: The House Small Business Committee’s Oversight panel is holding a hearing next week on the medical loss ratio (MLR) rules in healthcare reform. The subcommittee is concerned about the MLR’s effects on insurance agents, as well as the possibility that it could keep smaller insurance companies from breaking into a new market.

The MLR is also getting a closer look from the Energy and Commerce Committee, as The Hill reported in yesterday’s Overnight Health. That panel is investigating whether HHS influenced the model MLR rules crafted by state insurance commissioners.

Berwick unplugged: Didn’t you always suspect that underneath the triple aim, Don Berwick just had to be holding back some anger about his nomination and the healthcare debate, generally? Well, he let it out. Berwick slammed Republican critics of the healthcare law in a speech this week, calling the discourse a “travesty” that scared seniors to a point “beyond cruelty.” He also suggested that the real threat of healthcare rationing comes from proposals to scale back Medicaid and other government health programs. Healthwatch has more on Berwick’s displeasure.

Spending bills: Lawmakers don’t just have to preserve those unemployment checks and payroll tax cuts — they also have a government they need to keep open.

Appropriators have just four days to pass a slew of spending bills, and major differences remain. The health spending bill in particular is so politically charged — Republicans want to slash spending on the healthcare reform law, for example — that lawmakers could punt and simply keep the 2010 spending levels in place. The Hill’s Erik Wasson has more on the funding fight here.

Drug abuse: A diverse group of panelists at Thursday’s OptumRx prescription drug abuse roundtable largely agreed on what the nation needs to do to tackle the growing epidemic: better data gathering and sharing between the private and public sectors; better education of patients and providers; better treatment options for addicts.

The five panelists shared their thoughts about what the government could do to achieve those goals.

{mossecondads}Louis Saccoccio, executive director of the National Health Care Anti-Fraud Association, called on the Centers for Medicare and Medicaid Services (CMS) to share more fraud information with private insurers. John Spiegel, director of the Medicare Program Integrity Group at CMS, agreed, because the same bad actors often defraud everyone and “it is costing us all.”

David Shurtleff of the National Institute on Drug Abuse focused his attention on educating doctors, whom he pointed out only received seven hours worth of pain management training in medical school.

Joshua Stein, a former federal prosecutor now with OptumRx, wants to require pharmacies to be bonded, similar to durable medical equipment companies. And Michael Theis, a former criminal healthcare fraud coordinator in Colorado, urged Congress to pass legislation to facilitate public/private partnerships, fund interdisciplinary task forces and share prescribing data.

State by state

Virginia Gov. Bob McDonnell (R) wants the state to run its own insurance exchange if the Supreme Court upholds the individual mandate.

Florida is still a “no” on setting up an exchange, but it’s moving ahead with its own exchange-like system.

Maine healthcare associations are reeling from proposed cuts to the state’s Medicaid program, MaineCare.

Reading list

Attorney General Eric Holder raised concerns with Congress’s requests for documents about Supreme Court Justice Elena Kagan, Politico reports.

VA hospital employee charged with selling the identities of disabled veterans.

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