While the Bush administration is pleased that the House budget reconciliation bill achieves "substantial" Medicaid savings, a Statement of Administration Policy (SAP) on the measure takes issue with other health care provisions of the legislation (HR 4241), which the House passed Nov. 18. For example, the administration has offered its own plans for changing the basis for Medicaid prescription drug reimbursement or expanding the state long-term care partnership program. The administration is also concerned with provisions in the bill that "manipulate the Federal medical assistance percentage (FMAP)." The provisions, according to the administration, "may unnecessarily increase spending." Read more »
The Centers for Medicare and Medicaid Services announced a proposal to end Medicare coverage of "bariatric surgery" for beneficiaries 65 and older following a recent study showing an elevated risk to the procedure for older patients. However, the proposed "national coverage determination" could lead to more rather than less coverage of the procedure for Medicare's under-65 population. Stomach-stapling and other forms of "bariatric" surgery have consistently helped patients achieve sustained weight loss and have become increasingly popular as the problem of obesity increases, according to a study published in October in the Journal of the American Medical Association. Read more »
The new Medicare prescription drug benefit does not deliver on its promise of reducing drug prices for the program's more than 40 million elderly and disabled beneficiaries, according to an analysis prepared for Rep. Henry A. Waxman, D-Calif. The report concluded that the average drug prices offered by 10 leading Medicare drug plans are higher than prices of the same drugs available from Canada, through the Department of Veterans Affairs, or from traditional U.S. retail pharmacies. Read more »
As the first session of the 109th Congress enters its final few weeks, appropriators are close to achieving their goal of passing all of the fiscal 2006 spending bills individually. But the last steps could prove the hardest. President Bush on Nov. 19 signed into law the energy–water development bill (HR 2419), along with a second continuing appropriations resolution (H J Res 72) to keep funds flowing through Dec. 17 to agencies whose spending bills have not yet been enacted. Only the Defense (HR 2863) and Labor-HHS-Education (HR 3010) bills remain to be completed when Congress returns from its Thanksgiving recess....The House last week rejected the conference report (H Rept 109-300) accompanying the Labor-HHS bill by 209–224, after 22 Republicans rebelled against the measure. Some of the dissenters were upset about the lack of earmarks in the bill; others criticized cuts to rural health care programs and insufficient money for education. Read more »
The cost of health benefits is predicted to increase 6.7 percent next year, continuing a three-year slowdown in cost increases, according to an annual study of employer-sponsored health plans. The report, compiled by Mercer Health & Benefits LLC, also shows that employers limited their health plan increases to 6.1 percent in 2005 through a variety of initiatives, such as cost-shifting and changing vendors. Nearly 3,000 employers participated in the survey, with results representing about 600,000 employers and more than 90 million full- and part-time employees. Read more »