Today is the last day for individuals to enroll in Affordable Care Act health plans.
AARP pressures GOP on Medicare
AARP is launching a national ad campaign urging Republican lawmakers to oppose any legislation resulting in significant benefit cuts to Medicare. In the ads, AARP highlights President Trump’s campaign pledge to protect entitlement benefits, a promise White House Chief of Staff Reince Priebus has reaffirmed. Republican lawmakers, including Trump’s nominee for Health and Human Services (HHS) secretary Rep. Tom Price (R-GA), have long sought entitlement reform, arguing Medicare programs are not financially sustainable. Jessie Hellman of The Hill has the story.
Executive order targeting regulations could have outsized effect on health care industry
An executive order signed by President Trump requires federal agencies to lift two existing regulations for each new rule written. Adam Rubenfire of Modern Healthcare explains the rule could have a significant impact on health care due to a vast network of interrelated federal regulations designed to work together and govern most aspects of the industry, including licensure rules, insurance regulations and payment models for federal health care programs.
Hospitals fear effects of ACA repeal
Hospitals are concerned repealing the Affordable Care Act (ACA) and rolling back the Medicaid expansion will lead to increased costs and a spike in the number of uninsured patients, according to Bob Herman of Axios. Medicaid has helped hospitals better support low-income patients, who otherwise might not be able to pay their medical bills. Hospitals are also concerned patients may take longer to seek medical support if they have higher out-of-pocket expenses or do not have insurance, leading to aggravated health conditions and more costly treatment in the future.
ACA repeal could lead to more short-term health plans
Loosening the coverage requirements of the ACA could lead to more consumers purchasing short-term health plans. These plans tend to be cheaper based on limited benefits, often lacking coverage for prescription drugs or pre-existing conditions. Michelle Andrews at Kaiser Health News shares consumer advocates worry the growing popularity of short-term plans could be bad for patients.
CMS faces revived legal challenges over physical therapy coverage
Patients advocates are renewing a legal struggle with the Center for Medicare and Medicaid Services (CMS) over reimbursement for physical therapy and other skilled care. Four years ago, the Center for Medicare Advocacy and Vermont Legal reached a settlement acknowledging physical therapy and skilled coverage was not predicated on the “potential for improvement from the therapy but rather on the beneficiary’s need for skilled care.” CMS and Medicare contractors have at times denied claims to beneficiaries, sometimes due to providers’ usage of improper billing codes reports Susan Jaffe of NPR. In August, CMS and the plaintiffs agreed to draft an education program on coverage requirements and billing, but could not agree on the best method or channel.
Company’s claim it gave Price special stock offer draws calls for delay on confirmation vote from Democrats
Company officials from Innate Immunotherapeutics Ltd., an Australian biotech company, allege Rep. Tom Price (R-GA) received a special offer to purchase stock at a discount. During Congressional hearings, Price has acknowledged he traded stock in health care companies while serving in Congress, but asserted he received no special treatment or discounts. According to company officials, Price was offered a private invitation to purchase stock at more than a 10 percent discount to raise funds for a clinical trial. James Grimaldi of The Wall Street Journal notes stock in the company has tripled since mid-June, when the offer supposedly occurred (subscriber’s content).
Senate Democrats are arguing Price’s stock trading while serving in the House deserves more scrutiny before he goes to the full Senate for a vote. The Senate Finance Committee votes on Price today, writes MJ Lee of CNN.