Healthcare Committee

Committee Chairs:

Frank McDougall, Vice President, Government Relations, Dartmouth-Hitchcock Health

Laurel Sweeney, Senior Director, Global Health Economic & Reimbursement, Philips Healthcare

NEC Staff liaison:

David O’Donnell, dodonnell@newenglandcouncil.com

Navigating the Patient Protection & Affordable Care Act:

Policy Update: The Affordable Care Acts Employer Mandate (September 10,2014)

Policy Update – Agency Rules on Individual Shared Responsibility Payment Liability (February 13, 2013)

Notice of Coverage through the Exchange Employer Requirement Delayed (January 29, 2013)

NEC Foley Hoag Affordable Care Act Seminar – January 2013

Affordable Care Act:  Proposed Regulations on Employers Shared Responsibility ( January 14, 2013)

Summary of the Patient Protection & Affordable Care Act of 2010

Summary of the Supreme Court’s decision in NFIB v. Kathleen Sebelius (June 28, 2012)

Healthcare Reform Revisited: The Impact of NFIB v. Kathleen Sebelius on Employers (July 5, 2012)

Healthcare Reform Revisited:  The Impact of NFIB v. Kathleen Sebelius on Insurance Market Reforms (July 18, 2012)

Affordable Care Act: Guidance on Employers Shared Responsibility & Coverage Waiting Period (September 13, 2012)

NEC’s Guide to Employer-Related Affordable Care Act Provisions for 2013 (November 30, 2013)

Archived Email Updates:

December 15, 2015- FDA Workshop on Medical Device Cybersecurity

November 30, 2015- Final Rules for Grandfathered Plans, Preexisting Condition Exclusions, Lifetime and Annual Limits, Rescissions, Dependent Coverage, Appeals, and Patient Protections

November 17, 2015- EU-US Biopharmaceutical Trade Event Invite

November 17, 2015- Industry Conference on Integration, Consolidation and Competition

November 10, 2015- Final Shared Savings Program Waivers

November 5, 2015- The Bipartisan Budget Act of 2015

October 30, 2015- Medicare and Medicaid Electronic Health Record Incentive Program

October 23, 2015- Implementing the Medicare Access and CHIP Reauthorization Act of 2015

October 9, 2015- Proposed Rule for the Medicare Clinical Diagnostic Laboratory Tests Payment System

October 7, 2015- CMS Call on Implementing the Improving Medicare Post-Acute Care Transformation Act

October 5,2014- The Patient Engagement Advisory Committee

September 28, 2015- Medicare Payment Advisory Commission Public Meeting

September 24, 2015- Federal Policy for the Protection of Human Subjects

September 21, 2015- 340B Drug Pricing Program Omnibus Guidance

September 14, 2015- House Passes National All Schedules Prescription Electronic Reporting Act (NASPER Support Letter Kennedy)

September 11, 2015- Management Standards for Hazardous Waste Pharmaceuticals

September 10, 2015- CMS Releases Plan to Address Health Equity in Medicare

September 8, 2015- Proposed Rule on Nondiscrimination in Health Programs

September 1, 2015- The Impact of the Cadillac Tax on Employers in 2018

August 25, 2015- High Intensity Drug Trafficking Areas Funding

August 11, 2015- Federal Advisory Committee Applications

August 10, 2015- The 2-Minute Rule Update

August 7, 2015- Notice of Observation Treatment and Implication for Care Eligibility Act

August 6, 2015- Electronic Health Records on Mobile Devices

August 5, 2015- Additional Funding to Combat Opioid Abuse

August 4, 2015- Chronic Pain Study

July 29, 2015-  Nutrition Labeling of Menu Items in Restaurants and Retail Food

July 21, 2015- White House Conference on Aging

July 14, 2015- Electrically Powered Medical Equipment 

July 13, 2015- The Medicare Telehealth Parity Act of 2015

July 9, 2015- CMS and AMA Efforts to Help Providers Prepare for ICD-10

June 16, 2015- Interoperability Requirements of the Medicare Access and CHIP Reauthorization Act

June 12, 2015- Medicare Shared Savings Program Final Rule

June 9, 2015- Committee Supports Medicare Advantage Legislation

June 4, 2015- Medicare Reimbursement Data

June 3, 2015- Menu Labeling Rule Delay Requested

June 1, 2015- CMS Should Improve Medicare Physician Rate-Setting

May 27, 2015- Proposed Rule to Strengthen Managed Care for Medicaid and CHIP Enrollees

May 19, 2015- Committee Meeting May 21

May 13, 2015- Risk Corridor Pool Possibly Underfunded

May 11, 2015- Federal Response to Opioid Abuse Epidemic

May 7, 2015- Legislation to Increase Graduate Medical Education Residency Limits

May 6, 2015- Changes to the Requirements for Part D Prescribers

May 4, 2015- Pioneer ACO Model Saves $384 Million

May 1, 2015- Updated 21st Century Cures Act

April 30, 2015- Legislation to Strengthen Personal Care Product Oversight

April 22, 2015- Subcommittee Hearing on Telehealth Advancements

April 15, 2015- Final Medicare Advantage Rates

April 13, 2015- FTC v. St. Luke’s Health System

April 8, 2015- Next Generation ACO Model

April 8, 2015- Alliance for Health Reform Briefing

April 7, 2015- NIH Working Group on Precision Medicine

April 3, 2015- FDA Issues Guidance on Mobile Medical Devices

April 2, 2015- HHS Launches Initiative Aimed at Reducing Opioid Abuse

April 1, 2015- House of Representatives Repeals the Sustainable Growth Rate Formula

March 30, 2015- Electronic Health Record Incentive Programs and 2015 Edition Health IT Certification Criteria

March 27, 2015- Medicare Payment Advisory Commissions Report to Congress

March 11, 2015- FDA Approves First Biosimilar

March 9, 2015-  Innovation for Healthier Americans

March 6, 2015- Meeting Notice for March 26, 2015

March 5, 2015- 21st Century Cures Reference Sheet

March 5, 2015- Childrens Health Insurance Program Extension Discussion Draft

March 3, 2015- Request for Information on Advanced Primary Care Model Concepts

February 12, 2015-  Wellness Devices and Medical Device Accessories Guidance

February 11, 2015- FDA Commissioner Hamburg to Resign

February 5, 2015- Healthcare Legislation

February 5, 2015- Committee Meeting in DC

February 4, 2015- Administration’s FY 2016 Budget Proposal

February 3, 2015- CMS to Modify Meaningful Use Requirements

January 30, 2015- Value-Based Purchasing

January 30, 2015- The 21st Century Cures Act

January 29, 2015- Sustainable Growth Rate Hearing

January 26, 2015- Public Health Legislation

January 21, 2015- House Energy and Commerce Health Subcommittee Hearing on Permanent SGR Fix

January 21, 2015- Legislation to Repeal Medical Device Tax

January 9, 2015-  Final Regulations for Tax-Exempt Hospitals

January 7, 2015- Generic Drug Use in the Medicare Part D Program

January 6, 2015- Healthcare Related Spending in the “Cromnibus”

December 23, 2014- Marketplace Enrollment Reaches Nearly 2.5 million by December 12

December 22, 2014- Report on Access, Use of Generic Drugs in Medicare Part D

December 5, 2014 – Proposed Rule to Strengthen Accountable Care Organizations

December 2, 2014 – New Hampshire Medicaid Waiver

December 1, 2015 – EHR Meaningful Use Attestation Deadline Extended

November 15, 2014 – Discussion Draft of Hospital Payment Reform Legislation

November 19, 2014 – Summary of NEC Healthcare Committee meeting with Congressman Neal

October 30, 2014 – The ACO Investment Model

October 28, 2014 – New Ebola Guidance for Emergency Room Workers

October 27, 2014 – Additional Congressional Hearings on Ebola

October 23, 2014 – Transforming Clinical Practice Initiative

October 22, 2014 – Health Plan Innovation Initiatives

October 21, 2014 – Updated Safety Standards for Healthcare Workers Handling Ebola

October 20, 2014 – Interstate Medical Licensure Compact

October 16, 2014 – Ebola Coordination and Response Hearing in Texas

October 9, 2014 – 2015 Medicare Part B Premiums and Deductibles

October 6, 2014 – House Oversight Subcommittee Hearing on Ebola Containment

October 3, 2014 – Committee Activity

October 1, 2014 – Open Payments Website

September 30, 2014 – The FDAs Purple Book

September 30, 2014 – Congress Passes Legislation to Collect Standardized Data from Post- Acute Care Providers

September 29, 2014 – Proposed New Efficiency Standards Would Impact Healthcare Facilities

September 26, 2014 – Physicians Surveyed on Use of Electronic Health Records

September 25, 2014 – Affordable Care Act Results in $5 7 billion Reduction in Uncompensated Care Costs

September 24, 2014 – Fiscal Transparency on Affordable Care Act Spending

September 23, 2014 – Health Insurance Marketplace Expands in 2015

September 22, 2014 – HHS Announces Agency’s Strategy to Improve Care Delivery

September 18, 2014- Medicare ACO Quality and Savings Improve in Second Year

September 9, 2014 – Hearing on the Status of Affordable Care Act Implementation

September 8, 2014 – Examining the Regulation of Laboratory Developed Tests

September 2, 2014 – ICD-10 Coding Implementation Date Delayed

August 28, 2014 – Medical Device Tax Implementation

August 27, 2014 – Medicare Fraud Legislation

August 26, 2014 – FDA Guidance on Unique Medical Device Identification System

August 18, 2014 – Commerce Secretary Pritzker To Lead Trade Mission to Japan and Korea

August 13, 2014 – Groups Seek CMS Assistance with Sunshine Act Requirements

August 11, 2014 – Comparative Effectiveness Grants Awarded

July 30, 2014 – Report Finds That Millions Obtain Health Insurance through Affordable Care Act

July 29, 2014 – HHS Launches Medicaid Innovation Accelerator Program

July 17, 2014 – UnitedHealthcare Study Finds Cancer Costs Reduced by Changing Physician Incentives

July 14, 2014 – Medicare Physician Fee Schedule Proposed Rule

July 10, 2014 – Health Care Innovation Awards

July 10, 2014 – The Sick and Weak Enrolling in Exchanges

July 7, 2014 – Legislation Strengthens Medicare’s Post-Acute Care

June 25, 2014 – Study Claims Exchange Plans Cheaper than Off-Exchange Plans

June 10, 2014 – Funding for Expanded Services at Community Health Centers

June 4, 2014 – Extension of Deadline for EHR Compliance

June 2, 2014 – Legislation to Study Impact of Affordable Care Act on Small Businesses

May 30, 2014 – Exchange and Insurance Market Standards Final Rule

May 28, 2014 – Final Rule on Medicare Advantage and Medicare Prescription Drug Benefit Programs

May 27, 2014 – Health Care Innovation Awards Round Two

May 14, 2014 – Prescription Monitoring Program for Hydrocodone-Only Medications

May 8, 2014 – House Energy and Commerce Committee “21st Century Cures” Initiate

May 7, 2014 – State Ban on Zohydro ER Invalid

May 1, 2014 – Prospective Payment System for Federally Qualified Health Centers

April 23, 2014 – FDA Releases FDASIA Health IT Report

April 14, 2014 – State Basic Health Programs for Lower-Income Individuals

April 9, 2014 – Medicare Payment Advisory Commission’s March 2014 Report to Congress

March 5, 2014 – Administration’s FY 2015 Budget Request – Medicare Provisions

March 4, 2014 – Annual Fee on Health Insurance Providers

March 3, 2014 – CMS Proposed Changes to Medicare Part D Generate Opposition

February 6, 2014 – Agreement Reached on Sustainable Growth Rate Repeal Legislation

February 3, 2014 – Final Rule on State Plan Home and Community-Based Services

December 5, 2013- Health Insurance Marketplace Enrollment Report

December 2, 2013- Extension of Non-Compliant Individual and Small Group Health Plans

November 21, 2013- Third Party Payments of Premiums for Qualified Health Plans in the Marketplaces

November 6, 2013- Repeal of Sustainable Growth Rate Formula – Discussion Draft

October 3, 2013- Government Shutdown

September 10, 2013- Final Rule on Individual Shared Responsibility Payment

September 6, 2013-  HIPAA News

August 13, 2013- Principles and Strategy for Accelerating Health Information Exchange

August 7, 2013- Pioneer Accountable Care Organizations

July 22, 2o13- Sustainable Growth Rate Legislation

July 3, 2013 – Final HHS Health IT Safety Plan

June 12, 2013 – National Conference on Mental Health

May 31, 2013 – Legislation to Block ICD-10 Implementation Filed

May 22, 2013 – Community Health Needs Assessments for Charitable Hospitals

May 17, 2013 – Senators Request Ideas to Improve Medicare Physician Payment System

May 1, 2013 – Qualified Health Plans, Hospitals and Patient Safety Organizations

April 18, 2013 –HHS Delays Implementation of SHOP Exchange Provision

April 12, 2013 – President’s FY 2014 Budget: Department of Health & Human Services

April 3, 2013 – House Committees Update Sustainable Growth Rate Proposal

April 1, 2013 – Decreased Satisfaction with Electronic Health Records

January 22, 2013 – HIPAA Privacy, Security, Enforcement, and Breach Notification Rules

January 3, 2013 – The “American Taxpayer Relief Act of 2012” – Healthcare Related Provisions

January 3, 2013 – Final Medicare Payment Regulations for Physicians and Other Providers Issued

November 29, 2012 – House Hearing on Healthcare Waste, Fraud, and Abuse

November  6, 2012 – Final Medicare Payment Regulations for Physicians and Other Providers Issued

November 3, 3012- Health and Human Services Office of Inspector General Work Plan

October 22, 2012- Stage 2 “Meaningful Use” Regulations for the Medicare and Medicaid Electronic Health Records Incentive Program

September 17, 2012- Meeting with Senior Advisor for Disability Policy to HHS Secretary Sebelius

September 17, 2012- Administration Releases Report on Sequestration

July 25, 2012 – Proposed Regulations for Tax-Exempt Hospitals

July 5, 2012 – Impact of Supreme Court Healthcare Decision on Employers

June 28, 2012 – U.S. Supreme Court Upholds Affordable Care Act, Individual Mandate

May 31, 2012 – Medical Loss Ration Notice Requirements

May 18, 2012 – Establishment of Exchanges & Qualified Health Plans

May 1, 2012 – Technical Guidance on the Medical Loss Ratio Regulation

April 19, 2012 – Supreme Court Rules for Generic Drug Manufacturers

April 9, 2012 – Certain Medical Diagnostic Methods Not Patent Eligible

Recent Committee Work:

Impact of Sequestration on New England’s Healthcare Sector

In late 2012, as Congress worked to address the so-called “fiscal cliff” and looming sequestration cuts, the New England Council urged the New England delegation to fight devastating cuts to the health care sector.  In a letter to the New England Congressional delegation in December 2012, the Council stressed the critical impact of the healthcare sector on the New England economy.  The letter specifically urged the delegation to work to preserve funding for the National Institutes of Health (NIH),to avoid cuts in payments to hospitals, avoid cuts in payments to doctors under the Medicare Advantage program, protect residency programs at teaching hospitals and replace the expiring “doc fix” to avoid cuts in Medicare payments.

Independent Payment Advisory Board

NEC Health Care Committee members had several concerns about the creation of the Independent Payment Advisory Board (IPAB), one component of last year’s Patient Protection and Affordable Care Act (PPACA).  The IPAB is tasked with reducing the per capita rate of growth in Medicare spending.  Under the PPACA, the IPAB will make proposals that are to be implemented by the Secretary of Health and Human Services.

Committee members were particularly concerned that the PPACA restricts the ability of Congress to change fiscal targets set by the IPAB, and that the new law further restricts the ability of future congresses to enact certain Medicare-related policy changes unrelated to the IPAB.  In short, the Council is concerned that Congress needlessly delegated authority to an executive branch agency.

In June 2011, the Health Care Committee wrote to members of the New England Congressional delegation urging them to either repeal the creation of the IPAB, or to amend the IPAB to function as a more traditional advisory board.

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