HHS Releases Hospital Price Information for Common Procedures
On May 8, HHS released publicly available information about hospital charges. The data set includes information on the 100 most common inpatient procedures. The data shows that hospital fees vary widely – sometimes 10 to 20 times what Medicare normally reimburses, for the same procedure. The release of this data is expected to intensify the debate in Congress about how hospitals determine prices and why they differ so widely.
On May 9, CMS announced the agency is considering making the remainder of inpatient rates along with outpatient rates public. It is not clear whether CMS also plans to publish physician charges.
CMS also announced $87 million in grants to states to improve their rate reviews and health care pricing transparency programs. States can apply through August 1, 2013 for up to $5 million each.
PCORI Awards Second Round of Research Funds
On May 7, the Patient Centered Outcomes Research Institute (“PCORI”) awarded $88.6 million in comparative effectiveness research funds to institutions in 21 states.
The grants are for 51 research projects over three years and include studies of care for kidney disease, cancers, obesity, asthma, diabetes and mental health conditions. Details on the funded projects can be found here. The awards are part of PCORI’s second cycle of research funding and were selected from 400 applications.
White House Announces Funding for Community Health Centers
On May 9, the White House announced 1,200 community health centers will receive $150 million in Affordable Care Act (“ACA”) funding to sign up patients for insurance exchanges, Medicaid or the Children’s Health Insurance Program. Interested health centers must apply for funds through the Health Resources and Services Administration. The funding is for fiscal year 2013 with minimum awards at $50,000.
Bills Introduced This Week
On May 9, Rep. John Lewis (D-GA) introduced legislation that would delay for two years cuts to the Medicare and Medicaid Disproportionate Share Hospital programs under the ACA.
H.R. 1853: Rep. Bill Cassidy (R-LA) introduced legislation that would move Medicaid toward a beneficiary-based payment system. The bill would divide the Medicaid population into four categories: the elderly, the blind and disabled, children and other adults. There would then be a per-beneficiary payment in each category based on the cost of that category. The bill also addresses the disparity in federal payments between states.
Last week, the House Energy and Commerce Chairman and Senate Finance ranking Republican released a Medicaid blueprint endorsing the beneficiary-based payment system.
S. 867: Sen. Mark Pryor (D-AR) introduced a bill to amend Title XVIII of the Social Security Act to provide for pharmacy benefits manager standards under the Medicare prescription drug program. The bill would also establish basic audit standards of pharmacies and further transparency of the payment methodology to pharmacies.
Next Week in Congress
The House will take a vote on full repeal of the ACA. The vote is largely symbolic because a full repeal of the ACA is a nonstarter in the Senate.
For more information, please contact John F. Williams, III at 317-977-1462 or jwilliams@hallrender.com.
Please visit the Hall Render Blog at http://blogs.hallrender.com/ for more information on topics related to health care law.
