Twin Cities Medical Society

Legislative Updates
Health Reform Passes the US House
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March 22, 2010

The House was on course late Sunday night to pass the largest expansion of health care coverage since the enactment of Medicare in 1964 and to deliver to President Obama his top domestic priority.

A Senate-passed health care overhaul (HR 3590) was cleared by the House on a 219-212 vote, with 34 Democrats joining all 178 of the chamber’s Republicans in opposition. Lawmakers were expected to pass a short time later an accompanying package of revisions (HR 4872) that the Senate is expected to begin debating Tuesday.

Not one House Republican voted for the measure, and the same partisan divide is all but certain when the Senate takes up the amendments package this week. The chamber will act under budget reconciliation rules that require a majority vote instead of the usual filibuster-proof 60 votes. The House defeated, 199-232, the GOP motion to send that bill (HR4872) back to the Budget Committee to add tougher language on abortion funding that was part of a House-passed health bill (HR3962). Senate Republicans are expected to try to block the reconciliation bill on procedural grounds or, failing that, to create fissures between liberal and centrist Democrats to sink it. Those efforts are expected to draw out the debate through the end of the week, perhaps even extending into the spring recess scheduled to begin March 26. Still, on Friday, House Majority Leader Steny Hoyer D-MD, said that more than 50 senators have signed a letter committing to support a package of House revisions, which aided in gaining the support of wavering Democrats in his chamber.

Taken together, the Senate bill and the House revisions would extend coverage to about 32 million people — meaning that about 94 percent of the population would have insurance.

The Congressional Budget Office estimates that implementation of the overhaul package will cost $940 billion over 10 years. But thanks to reductions in Medicare spending and tax increases, the bill would reduce the deficit by a net $138 billion during that period and by $1.2 trillion in its second decade, the CBO found.

Documents prepared by the House Committees on Ways & Means, Energy and Commerce, and Education & Labor

Reconciliation Bill Documents prepared by the House Committees on Ways & Means, Energy and Commerce, and Education & Labor

 
Health Care Legislative Update - March 19, 2010
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General Assistance Medical Care

The House and Senate moved identical GAMC proposals through the respective finance committees this week. Neither body amended the proposal with any significance, with only technical clarifications being made to the bill. Late Thursday night the Senate heard the bill on the floor where it was passed on a vote of 50-17 with most of the no votes coming from rural Democrats. During the floor debate there were numerous questions raised by rural members about how GAMC patients in their areas would receive medical care without a CCO participating hospital in their region.

Although the House is likely to take up the bill on the floor next week with passage of the bill expected, a number of unanswered questions remain. There continue to be questions about how hospitals participating as a CCO will coordinate with independent providers in their area to provider services the hospital may not be able to provide. Additionally, there are concerns about providing the necessary prescriptions drugs to these individuals with limited financial resources. Previous history has shown this population is heavily reliant on prescription drugs given the high percentage of individuals inflicted with mental illness.

Despite the work being done on this compromise proposal over the last week, a vote in Washington D.C. over the weekend on federal health reform has the potential to change things drastically. As Rep. Huntley (D-Duluth) addressed in a press conference a week ago Friday, there is a provision in the federal health reform bill which allows Minnesota to expand eligibility of individuals on Medicaid to 133% of poverty as early as April of this year. This expansion would allow Minnesota to cover the current GAMC population under Medicaid as well as move a number of individuals from MinnesotaCare onto Medicaid. However, as the last five months have shown, little can be counted on at the federal level until the bill has reached the President’s desk.

Budget Update

The House Ways and Means committee met on Wednesday night this week to pass a resolution setting the targets for this year’s supplemental budget. Currently, all but two of the omnibus budget bills have been passed by the House Finance committee and will be heard Monday on the House floor. The two remaining budget bills to be worked out include K-12 education and Health and Human Services, the two largest portions of the state’s budget.

There is some indication that the HHS budget bill will see around $170 million in cuts. This takes into account some $420 million expected from a six month extension in enhanced federal matching funds for Medicaid. In addition, the budget target factors in the reduced cost of the GAMC program from $500 million down to around $160 million. Both the House and Senate HHS budget divisions will spend the next month putting together their budgets to meet this expected $170 million dollar target. Although the Governor has previously laid out his projected cuts in HHS, House and Senate leaders are likely to look at different options for coming up with the necessary cuts.

Provider Peer Grouping

The Senate Health policy committee took up consideration of SF2815 early Friday morning after laying it over following Monday afternoon’s hearing. During Monday’s hearing the Minnesota Department of Health spoke about the work currently being done with this initiative but did not directly oppose the bill. Following a week of discussion between the MMA and MDH, the parties were able to come to some agreement on additional language in the bill. The new language states that by October 15, 2010, MDH will give providers information on their total cost of care measures and by January 1, 2011, providers will be given information on their condition specific measures. Providers will be given a 30 day time frame within which to review the data and initiate an appeal if necessary. However, one potentially change in the amended language is returning to mandatory use of the peer grouping information rather than optional use of the information as was reflected in the original bill.

Fair Contracting Bill

With the Senate having acted on SF2700 last week, the House took up consideration of the companion bill, HF3042, in both the House Health policy and Commerce and Labor committees this week. The bill quickly passed through both committees with little discussion. The one significant change between the House version of the bill and Senate version of the bill is the removal of provision allowing providers to collect payments including deductibles and coinsurance at the time a patient is seen by a physician or other provider. This provision remains in the Senate language and will likely be ironed out in a potential conference committee once final passage happens in both the House and Senate.

Controlled Substances Registration Bill

Sen. Berglin introduced SF3201 earlier this week and the bill was heard during Friday’s Senate Health policy committee. The bill sets up a new controlled substances registration system for all providers who administer or handle controlled substances. Although not reflected in the language in the bill, Dr. Cody Wieberg, with the Minnesota Board of Pharmacy suggested there will be a fee for registration. There were concerns raised by the Minnesota Medical Association, amongst others, that this proposal attempts to recreate what is already required of providers at the federal level who must register with the Drug Enforcement Agency for administering and handling controlled substances. The bill was passed and referred to the Senate Health and Human Services Budget division. There is no companion bill in the House.

Federal Health Care Reform Conformity

Building off his press conference last Friday, Rep. Huntley introduced a bill, HF3709 late this week outlining some of the conforming changes in Minnesota law that would take place should a federal health care reform bill pass in Washington D.C. The bill would make several changes to the state’s health care programs. First, the bill would take any excess funds in the Health Care Access Fund not being used to fund individuals on MinnesotaCare and provide subsidies to individuals and families for health insurance coverage. Second, the bill attempts to set up a means for implementing accountable care organizations in the state by next year and seems to require the use of accountable care organizations in the state’s health care programs by July, 2011. Third, eligibility under MinnesotaCare would be eliminated for all adults, leaving only children on the program. Fourth, the bill would reduce the provider tax effective October 1, 2013, with a complete repeal of the taxes by October 2, 2019. The bill also allows for the establishment of a private sector health insurance exchange program through which individuals and families would be given the opportunity to purchase health insurance coverage with subsidies. Similar to the federal bill, the language of the bill sets in place an individual mandate for the carrying health insurance coverage beginning in 2012 as well as requiring guaranteed issue in the individual market. The companion bill in the senate, SF3296,is being carried by Sen. Lynch (D-Rochester).

These changes are all contingent on the passage of federal health reform at the national level which may happen as early as this weekend. Should passage of a federal health bill happen, much of the focus at the Capitol, particularly in the area of Health and Human Services will turn to determining what impacts such changes may have on this years budget and how soon many of the policy changes could be put into place.

This update comes from our lobbyists at Lockridge Grindal Nauen.

 
Health Care Legislative Update - March 12, 2010
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Legislature Begins Discussion on Supplemental Budget

With a tentative deals struck on the GAMC issue (See article below for details) and the bonding bill, members of the Minnesota Legislature are now directing their attention to the budget deficit in the current biennium.

The Governor and Minnesota Legislature are currently facing a $994 million budget deficit which will need to be solved before adjournment in May. The Governor released his budget fix in February, and several House and Senate budget divisions released supplemental budget proposals for all departments of Government except Health and Human Services and K-12 Education. That supplemental budget includes about $313 million in budget cuts leaving a remaining $613 million which is expected to come largely out of Human Services.

The Legislature opted to wait until after they reached a compromise with the Governor regarding preservation of coverage for GAMC enrollees before crafting a Health and Human Services supplemental budget. Details on the human services budget will emerge in the coming weeks.

With that said, reimbursement rate cuts for all health care providers including physicians are expected to be included in the legislative budget proposal. Health Committee members in the House and Senate, to include Senator Linda Berglin (DFL-Minneapolis) have acknowledged that the Legislature’s budget cuts combined with the Governor’s unallotment disproportionately targeted physicians to the point where there is concern that the cuts will create access problems for Minnesotans who receive their health coverage through Medicaid, MinnesotaCare or as state employees.

However, there is still concern that history will repeat itself again and physicians of all specialties will again find themselves in the crosshairs of the supplemental budget.

General Assistance Medical Care (GAMC):

Late last week, House and Senate Leaders reached a deal with the Governor’s office restoring a portion of the funding for the GAMC program. The Governor’s office and key legislators subsequently spent the better part of this week ensuring the language for the new bill (HF802 / SF460) reflected the terms of their agreement. Additionally, multiple questions about the cost of the bill surfaced, which also delayed the process.

Upon reaching an agreement on the bill language, the Senate Health and Human Services Budget Division passed the bill on Thursday, but not without controversy. DFL legislators on the Division felt the original GAMC bill which the Governor vetoed was an ideal compromise and felt the new compromise did not provide adequate funding to health care providers. Sen. Yvonne Prettner Solon (DFL-Duluth) made a motion to table the bill, which failed on a 5-3 vote. Senators Tony Lourey (DFL-Kerrick) and Mary Olson (DFL-Bemidji) voted in favor of tabling the bill because they wanted to speak directly with the Governor.

The House Health and Human Services Finance Division passed its version of the GAMC fix Thursday afternoon with less controversy. An emotional Rep. Erin Murphy (DFL-St. Paul) acknowledged the funding shortfalls in the bill, but pointed out that the bill would hopefully send a message to those GAMC enrollees “who live in the shadows [that they] are welcome in Minnesota.” Rep. Paul Thissen (DFL-Minneapolis) expressed the same concerns voiced by Sen. Prettner Solon in the Senate. The House Finance committee quickly took up consideration of the bill Friday afternoon passing the bill on a voice vote.

The new bills would cut the current funding levels on GAMC by almost 77 percent. To help ease the transition on to the new program, the current GAMC program would be extended for an additional two months up until June 1.

Reimbursement would be cut to 37 percent of current levels for this two month period. The two month extension would cost the Health Care Access Fund around $28 million dollars. The compromise leaves only $34 million in the Health Care Access Fund (HCAF) at the end of the biennium as opposed to a projected deficit of -$169 million – the projected result of transferring all GAMC enrollees to MinnesotaCare.

The crux of the bill centers on the creation of a hospital-based coordinated care delivery systems for 17 hospitals which met the threshold requirements of at least 1.5 million dollars of GAMC spending in the previous year and/or GAMC spending of at least 1.3% of the hospital’s net patient revenue. The seventeen hospitals include: Hennepin County Medical Center, Regions Hospital, University of Minnesota Medical Center – Fairview, North Memorial Hospital, Abbott Northwestern Hospital, United Hospital (St. Paul), Mercy Hospital (Coon Rapids), Fairview Ridges Hospital, North County Hospital (Bemidji), Immanuel St. Josephs Hospital, St. Mary’s Duluth Clinic, St. Mary’s (Detroit Lakes), Rice Memorial Hospital (Willmar), Mercy Hospital (Moose Lake), St. Mary’s Hospital (Rochester), and Mahnomen Regional Hospital, St. Cloud Medical Center.

The coordinated care organizations (CCO) would operate under a capped block grant based on 2007 GAMC spending levels. The CCO’s would be required to manage and provide the entire spectrum of medical care for those Minnesotan’s eligible for the program. CCO’s would receive an appropriation of $71 million dollars in the current biennium and $131 million in the next biennium, 2012-13.

For those hospitals without a current network of outpatient clinics, hospitals would able to contract with other outpatient facilities and clinics in order to provide the comprehensive set of benefits required under the new program. Those clinics and facilities contracting with the hospital would receive reimbursement out of that respective hospital’s block grant based on a negotiated rate with that hospital. Additionally, the bill states that if a patient within a designated CCO receives care from a provider who has not contracted with that CCO, the CCO would be allowed to refuse payment to that provider except in cases of an emergency.

The CCO’s would also provide prescription drugs to the individuals on the program with a capped appropriation of $45 million dollars in this biennium and $83 million in the next biennium.

For those hospitals that are not designated as CCO’s, the bills set up a six month uncompensated care pool that would be funded with a $20 million appropriation from the Health Care Access Fund.

House bill was passed by Finance Committee. Senate bill was passed by Health and Human Services Budget Division and re-referred to Finance committee.

Rep. Huntley News Conference on Impacts of Federal Health Reform in MN

Earlier this morning, Rep. Huntley along with Reps. Murphy and Thissen, held a news conference to address the potential impacts passage of a federal health reform bill and other additional federal dollars would have on the state’s current year deficit, as well as the impacts on future budgets. Rep. Huntley also laid out his health reform agenda should no federal health bill pass.

Although many of these ideas are contingent on activity at the federal level, which as the last six months has shown is far from a guarantee, Rep. Huntley laid out three sources of budget relief this year. The first comes in the form of $81 million dollars the state will receive from Medicare part D clawback payments. This additional money was announced in a press release by the federal Center for Medicare and Medicaid Services three weeks ago and was previously accounted for in the state’s revised February forecast. The second form of budget relief would be an estimated additional $415 million dollars the state would receive from a six month extension in the enhanced federal matching fund percentages for the Medicaid program passed as part of the stimulus bill last February. The Governor also included this additional money in his supplemental budget released at the end of last month. At this point it appears both the House and Senate are calculating receipt of these additional dollars as they set their overall budget targets. Rep. Huntley indicated this extension is currently included in a jobs bills passed by the U.S. Senate awaiting a conference committee hearing. Finally, Rep. Huntley remained optimistic that the state could get an additional $250 million this year for an early expansion of the Medicaid program to cover those individuals up to 133% of federal poverty guidelines. This expansion would consist largely of single adult males who are on the state’s GAMC program and MinnesotaCare program. Any hopes of getting this additional $250 million are contingent on passage of the federal health reform bill.

Rep. Huntley also used the news conference to lay out his plans for health reform this year should a federal health bill not pass. The ideas include further movement towards the use of accountable care organizations in private and public health programs, the creation of an insurance exchange, and the elimination of preexisting conditions exclusion. Rep. Huntley indicated his desire to reconvene the Governor’s health care transformation task force to address these issues and others.

Provider Peer Grouping Bill

On Wednesday, the House Health and Human Services Policy committee took up consideration of HF3056, relating to the provider peer grouping initiative passed as part of the 2008 health reform legislation. The bill as introduced would delay the publishing of physician data on quality and cost obtained from provider peer grouping measure until September 2011, originally set to be published in September 2010. Additionally, the bill makes many of the requirements for using the data originally included in the 2008 legislation optional rather than mandatory. The bill was passed out of the House Health policy committee without any significant opposition. Bill was passed and referred to Health and Human Services Finance Division. Senate Hearing scheduled on companion bill Monday March 15.

Surgical Technologist Certification

Earlier this week, the House Health and Human Services Licensing Division met briefly to resume consideration of HF1094 dealing with the certification of surgical technologists. The bill would have required any health care facility that employs surgical technicians to only hire surgical technicians who have received certification through one of multiple national accreditations. The bill was opposed by the Minnesota Hospital Association along with other hospitals. Following a failed attempt to amend the bill by making the employment requirement permissive, the bill was defeated on a 3-2 vote. Bill was defeated in Health and Human Services Licensing Division. No action was taken before 1st deadline in Senate.

Provider Fair Contracting Bill

On Monday the Sen. Marty’s Health Housing and Family Security committee took up consideration of SF2700. The bill, originally put forward by the Minnesota Medical Group Management Association (MMGMA), sought to help level the playing field between clinics and health plans when it comes to provider contracts and claims submission. Following multiple meetings with the major health plans around the state, an agreement was reached on almost all portions of the original bill. Negotiations were still being worked out when the bill was passed by the Senate health policy committee Monday, but a final agreement was reached in Sen. Scheid’s Senate Commerce Committee Thursday.

 
Health Care Legislative Update - March 5, 2010
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General Assistance Medical Care (GAMC):

Late Friday afternoon, House and Senate Leaders reached a deal with the Governor’s office restoring the GAMC program. After efforts to override the Governor’s veto of the GAMC bill in the House of Representatives were unsuccessful on Monday, negotiations between the Governor’s office and key legislators went on day and night throughout the week.

The details of the proposal were released at a press conference Friday afternoon. The current program will be extended for two months to allow for the implementation of coordinated care programs by those hospitals eligible for the funding. The deal would cut the current funding levels on GAMC by almost 77 percent. To help ease the transition on to the new program, the current GAMC program would be extended for an additional two months up until June 1. Funding for this two month extension would come from the Health Care Access Fund costing around $28 million dollars.

The main aspect of the proposal creates a hospital based coordinated care delivery system. The coordinated care organizations (CCO) would operate under a capped block grant and would be required to manage the medical care for those Minnesotan’s eligible for the program. These CCO’s would receive an appropriation of $71 million dollars in the current biennium and $131 million in the next biennium, 2012-13.

The CCO’s would also provide prescription drugs to the individuals on the program with a capped appropriation of $45 million dollars in this biennium and $83 million in the next biennium.

For those hospitals that are not designated as CCO’s, the proposal sets up a six month uncompensated care pool that would be funded with a $20 million appropriation from the Health Care Access Fund.

More details are likely to follow early next week as the legislation is drafted and as the new bill moves through the House and Senate finance divisions. Sen. Berglin predicted the new proposal could be on the Senate floor as early as late next week.

Surgical Technologist Certification:

Late Thursday night the House Health and Human Services Licensing Division met and took up consideration of HF1094 dealing with the certification of surgical technicians. The bill would have required any health care facility that employs surgical technicians to only hire surgical technicians who have received certification through one of multiple national accreditations. The bill was opposed by the Minnesota Hospital Association along with other hospitals. Following lengthy discussion on the bill, the bill was ultimately laid on the table. It is unclear whether Rep. Thao’s Licensing Division will meet again next week before the first committee deadline on March 12th to take up further consideration of this bill and other licensure bills laid over in previous meetings.

Birthing Centers Legislation:

Both the House and Senate Health and Human Services Policy Committees took up consideration of legislation allowing for the licensure of free standing birthing centers this week (HF3046) (SF2072). The legislation was changed this year by not imposing a rate cut on hospitals for delivery. This change helped garner the support of hospitals.

Both bills were referred to their respective House and Senate Health Finance divisions.

Interstate Sale of Health Insurance:

Two bill allowing Minnesotans the option to purchase health insurance from outside Minnesota were heard in the House Health and Human Services Policy committee earlier this week. The Governor made this issue one of the key health care talking points of his State-of-the-State address a couple weeks ago. The Governor’s proposal, authored by Rep. Laura Brod (R- New Prague) (HF2901) would give consumers the option to purchase health insurance from carriers outside Minnesota in the hopes of generating more competition to help bring down the cost of health care. However, concerns were expressed during the committee hearing because the bill does not require out of state health insurance products to comply with the multiple layers of protections required under Minnesota law. The bill was passed without recommendation by the committee to the House Commerce committee.

A similar bill was introduced this week and given a hearing immediately following Rep. Brod’s bill. The bill, HF3245, introduced by Rep. Atkins (D-Inver Grove Heights) is a pared down version of the Governor’s proposal. The key difference between the proposals is that Rep. Atkins bill requires any out of state insurance carrier wishing to sell health insurance within Minnesota must comply with Minnesota law. Rep. Atkin’s bill was also passed by the Health and Human Services Policy Committee and referred to the House Commerce Committee, which Rep. Atkins chairs.

Other Hearings Next Week:

With the first committee deadline coming next Friday, March 12, the Health and Human Services Policy committees in both the House and Senate have full agendas. At this point two bills of interest will be heard next week.

The first bill HF3042 / SF2700

 
Health Care Legislative Update - February 26, 2010
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General Assistance Medical Care (GAMC):

Following the Governor’s veto of the GAMC bill late last week, this week was relatively quiet at both the House and Senate positioned themselves for their next move in either attempting to override the veto or come up with a compromise solution. On Thursday, the Senate moved first in overriding the Governor’s veto. During the Senate floor debate Senator Berglin brought up the provider tax and the integrity of the Health Care Access Fund even going as far as to equate a vote to sustain the veto with a willingness to increase the provider tax. The override attempt was ultimately successful on a count of 45-21.

The next move in the House is a different story. Without enough votes to override the veto, it is unclear whether House Democrats will even attempt an override at this point or simply look to work out a feasible compromise with the Governor’s office. On Wednesday, Sen. Berglin and Rep. Murphy met with the Governor in multiple closed door meetings to try to work out a compromise bill. The meetings continued on into Thursday without any word on a compromise arising.

Initial reports from the meetings indicated that there was movement in the direction towards a compromise. However, without specifics, many points coming out of the meetings remain speculative. The Governor seems to be wedded to the position of using MinnesotaCare as the primary health care program for much of the population currently served by GAMC, although there remain several issues around individuals losing coverage under MinnesotaCare or not being able to maintain their eligibility on the program. Sen. Berglin was attempting to come up with a solution for hospitals to serve those individuals who would fall off MinnesotaCare or not be eligible for the program, similar to the inpatient reimbursement levels in her original proposal.

The Governor also indicated his willingness to support a version of the coordinated care program called for under the original proposal. The original proposal passed by the House and Senate allowed for counties to participate in a coordinated care program to serve the GAMC patients in their county. The bill originally used the term Accountable Care Organization, but Rep. Murphy said they moved away from that term given the outcome measurement reporting required under an ACO model. Additionally, the fact that the program was only temporary in nature, 16 months, made creation of ACO models for this population a difficult administrative task. There was word that the Governor wanted to go as far as making participation in a coordinated care program mandatory; however, mandatory participation across a large county like Hennepin or Ramsey is almost entirely unfeasible given the number of separate hospital systems and independent provider practices who see patients on the GAMC program within those counties.

Despite the continued talks, another week has gone by without an agreed upon health care solution for these individuals. The meetings with the Governor’s office will likely continue into next week as the April 1st deadline for cutting off funding for GAMC moves ever closer.

Governor’s Health and Human Services Budget Recommendations

Much of the committee time this week in both the House and Senate Health and Human Services budget committees was devoted to further testimony from the Department of Human Services as well as public testimony from interested stakeholders on the impacts of the Governor’s proposed budget recommendations. Testimony will continue next Tuesday in Rep. Huntley’s House Health and Human Services Finance Division.

One piece of note that emerged this week during testimony by Brian Osberg, Minnesota’s Medicaid Director at the Department of Human Services, is that the state will be receiving an additional 81 million dollars from the federal government for repayments in the state’s share of the federal Medicare part D prescription drug program. Under federal law Minnesota is required to make “clawback payments” to the federal government to help share the cost of individuals who are dually eligible under both Medicare and Medicaid and use the Medicare part D program for their prescription drug coverage. The additional payments were made available as part of the increase in federal matching funds Minnesota received from last February’s stimulus bill. The additional 81 million dollars will be reflected in the state’s budget forecast set to be released next week and will likely have the net effect of helping to lower the projected deficit for the current year.

Laboratory Technician Licensure

Late Thursday night the House Health and Human Services Licensing Division met and took up consideration of HF1249 addressing new licensure requirements for laboratory technicians. The division heard testimony on both sides of the issue but at the end of the night, the author, Rep. Murphy, chose to lay the bill on the table for later consideration. With only three of four meetings of the licensing division likely to occur this session it is unclear whether or not the bill will be taken off the table for a vote.

Birthing Centers Legislation

Legislation was introduced last week in both the House (HF3046) and Senate (allowing for the licensure of free standing birthing centers. This issue came up last session, particularly in the Senate, where Sen. Berglin viewed the legislation as a way to help generate savings in the Health and Human Services budget. Additionally, the issue was highlighted last Sunday in a front page story of the Minneapolis Star Tribune.

Next week, both the Senate Health Housing and Family Security Committee and the House Health and Human Services Policy Oversight Committee, will be holding hearings on the legislation.

Other Hearings Next Week

In addition to the birthing center bills being heard in the House and Senate next week, a number of other bills of interest are being heard in the House. On Tuesday, Rep. Thissen’s Health and Human Services Policy Oversight committee is hearing a yet to be introduced bill authored by Rep. Huntley on electronic health record technology, as well as the Governor’s Health Insurance Choice Act, allowing consumers to purchase out of state health insurance plans, authored by Rep. Brod.

Federal Health Care Reform

On Thursday, President Obama held a nearly seven-hour health care summit with top Democrat and Republican lawmakers. The President made it clear that his administration and its Democratic allies intend to move forward, with or without GOP support. Of the 40 Members of Congress who were asked to attend, Congressman John Kline (R-MN02) was the only Minnesota Member invited to the Summit.

Congressional Republicans again urged President Obama to scrap his plans for overhauling the health care system and restart the debate on how best to control medical costs and expand insurance coverage. The White House structured the summit to focus on four issues: controlling costs, overhauling insurance regulations, reducing the deficit and expanding health coverage. But lawmakers from both parties, as well as the President, appeared to use the forum to rehash old talking points.

In his opening remarks, the President said attendees had to determine whether it is still possible to find consensus on a contentious issue. Should participants prove unable to bridge their differences, Obama said, it would be necessary to “proceed from there.” The White House on February 22nd released a health care overhaul proposal that it said would extend coverage to more than 31 million people, at a 10-year cost of $950 billion. The administration says the cost would be more than offset by spending reductions and tax increases, resulting in approximately $100 billion of deficit reduction. Should the proposal fail to win enough votes, the administration is said to be considering a fallback plan that would extend coverage to about 15 million people through a narrower expansion of Medicaid and the Children’s Health Insurance Program. That plan would cost about $240 billion over 10 years.

One of the issues that has been overshadowed recently, with the Health Care Summit and the White House’s release of their proposed health care reform package taking center stage, is the 21% cut in Medicare rates to medical providers set to take affect March 1st.

Back in December, the House passed a resolution, delaying the 21% cut in Medicare physician payments, according to the sustainable growth rate (SGR) formula's suggestion, till March 1st. However, with the health reform debate on hold for the past month, nothing had been done to address the March 1st deadline.

Late Thursday evening, the House again passed a resolution delaying the proposed cuts for an additional 28 days until March 28th. The Senate had a more difficult time passing a similar resolution. Like the House, the Senate moved quickly on Thursday night to attempt to pass a similar resolution through a process called unanimous consent. However, Sen. Jim Bunning (R – KY) objected to the measure in effect defeating the resolution until next week. The Senate is expected to take up debate on the SGR formula early next week with the hopes of passing a longer term delay in the proposed 21% cuts.

This is an issue physicians and other medical providers around the country are watching very closely given the already low reimbursement for public programs and the potential impact such a drastic cut would have to their bottom line.

This update comes from our lobbyists at Lockridge Grindal Nauen.

 
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