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Health Care Edge

Medicare Advantage Cuts Reversed - Health Care Edge

April 8, 2014

Medicare Advantage Cuts Reversed

By Sam Baker, Sophie Novack and Clara Ritger

ANOTHER YEAR, ANOTHER REVERSAL: For the second year in a row, the federal Medicare agency has changed course on proposed cuts to private Medicare Advantage plans. CMS said yesterday that its proposed 2 percent cut would turn into a 0.4 percent increase for Medicare Advantage plans. The hitch: Insurers say the proposed cut was closer to 6 percent, so it's not entirely clear how big a break the plans received. Meanwhile, the House Ways and Means Committee's health care panel will turn its attention today to the latest delays in Obamacare's employer mandate, which has now been pushed back two years for certain businesses. The subcommittee is scheduled to hear from a senior Treasury Department official about the reasons for the delay and the effects on employers' bottom lines.

 

Top Health Care News

MEDICARE ADVANTAGE: The insurance industry lobbied hard against the cuts proposed in February, gathering support from more than 270 members of Congress, including a number of Democrats. (Sam Baker and Clara Ritger, National Journal)

  • America's Health Insurance Plans' President and CEO Karen Ignagni said the group is still reviewing the final 2015 payment rate announcement and released the following statement: "The changes CMS included in the final rate notice will help mitigate the impact on seniors, but the Medicare Advantage program is still facing a reduction in payment rates next year on top of the 6 percent cut to payments in 2014. We remain concerned about the impact year-over-year cuts to Medicare Advantage would have on the high-quality, affordable coverage millions of seniors like and rely on today."

AMERICANS CAN'T BUY THE LATEST SUNSCREEN THAT HAS BEEN AVAILABLE IN OTHER COUNTRIES FOR YEARS: The FDA has not approved -- or issued a decision on -- any sunscreen ingredients since a new procedure was implemented in 2002, putting the U.S. nearly two decades behind many other countries in available sunscreen technology that could help address rising skin cancer rates. There is currently a backlog of eight pending applications, but Congress is pushing legislation it says will clear the way. (Sophie Novack, National Journal)

WHY SENATE DEMOCRATS SHOULD BRACE FOR THE WORST IN MIDTERMS: "Pretending that the ACA is not going to be a liability this year would be ill-advised. Even considering that some people may like and benefit from the new law, the enthusiasm and intensity in this election is all on the Republican side, and that is very unlikely to change." (Charlie Cook, National Journal)

States

HOW THE DISTRICT'S OBAMACARE EXCHANGE IS UNLIKE ANY OTHER: Young adults are signing up at the highest rate in the beltway. But district enrollees are less likely to get help from the government in paying premiums. (Jason Millman, Washington Post)

PATHS TO MEDICAID EXPANSION IN VIRGINIA END IN THE HOUSE: "The Senate Finance Committee, as expected, revived its plan for a private insurance marketplace in its version of the two-year state budget that the House adamantly opposes. Hours later, Gov. Terry McAuliffe's administration testified that it has met the requirements of a budget agreement last year to reform Virginia's Medicaid program before expanding it — a contention that House members of the Medicaid Innovation and Reform Commission quickly rejected." The Senate will consider the Marketplace Virginia plan today as part of the 2014 to 2016 state budget. (Michael Martz, Richmond Times-Dispatch)

BOTH SIDES AT "BREAKING POINT" OVER MEDICAID EXPANSION IN PENNSYLVANIA: "[Gov. Tom Corbett] submitted the plan to [CMS] in February, and the agency is accepting public comment on it until Friday. After that, negotiations over the proposal will begin in earnest, Corbett administration officials say...Corbett's plan requests more expansive changes to the Medicaid expansion than any other state has sought so far. Last week, he suggested that, if the federal government rejected all or some of his conditions, it would leave him with the decision of whether to accept what the federal government is willing to allow." (Marc Levy, Associated Press)

Enrollment

THE BEST OBAMACARE DATA COMES FROM A HOME OFFICE IN MICHIGAN: Charles Gaba's enrollment totals are remarkably accurate. (Sarah Kliff, Vox)

Prevention and Treatment

NEW BLOOD TESTS MAY REPLACE BIOPSIES TO DIAGNOSE CANCER: "Telltale traces of a tumor are often present in the blood. These traces — either intact cancer cells or fragments of tumor DNA — are present in minuscule amounts, but numerous companies are now coming to market with sophisticated tests that can detect and analyze them. While the usefulness of the tests still needs to be proved, proponents say that because liquid biopsies are not invasive, they can be easier to repeat periodically, potentially tracking the disease as it evolves and allowing treatments to be adjusted accordingly." (Andrew Pollack, New York Times)

PANEL RECOMMENDS ASPIRIN FOR SOME PREGNANT WOMEN: The drug is generally not suggested during pregnancy because it can cause maternal and fetal bleeding, but the federal task force Monday backed daily use of low-dose aspirin for some pregnant women to prevent preeclampsia, which can lead to pre-term birth and other issues. (Thomas Burton, Wall Street Journal)

Regulations

SENATE DEMOCRATS DEMAND OVERSIGHT OF FALSE E-CIGARETTE MARKETING: "Currently, the $1 billion-plus e-cigarette industry is mostly unregulated at the federal level. Public health advocates and some lawmakers, however, are calling on the FDA to bring the industry under its supervision via authority granted to the agency by the 2009 Tobacco Control Act. 'We recognize that the FDA has been working to regulate these products,' the lawmakers wrote in the letter sent Monday. 'However, the FDA's Center for Drug Evaluation and Research does not need this regulation or any new authority in order to investigate companies making unsubstantiated and potentially false therapeutic claims.'" (Benjamin Goad, The Hill)

HOW SAFE IS YOUR FOOD? The Natural Resources Defense Council released a report about the potentially unsafe chemicals that are in food due to gaps in federal oversight.

Happening Today

HOUSE HEARING ON IMPLEMENTATION OF THE TOBACCO CONTROL ACT: The House Energy and Commerce Health Subcommittee will hear testimony from Marcia Crosse, Director of Health Care at the U.S. Government Accountability Office at 10:15 a.m.

HOUSE HEARING ON ACA EMPLOYER MANDATE: The House Ways and Means Health Subcommittee hearing will focus on changes made to the employer mandate and reporting requirements at 2 p.m.

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