Washington Watch - A Snapshot of Legislative, Regulatory and Policy Activity Affecting the Health Care Industry
February 12, 2009
Michael M. Gaba- Washington
MedPAC Advisory Committee
The Medicare Payment Advisory Committee (MedPAC) November 2008 meeting discussed establishing new financial reporting requirements between physicians, drug and medical device manufacturers, and other providers. This is just one of the many recommendations set forth in a MedPAC report issued in June 2008. The report is available at: http://www.medpac.gov/documents/Jun08_EntireReport.pdf
FDA Calls for New Warnings for Children’s Cold Medicine
The Food and Drug Administration (FDA) recently urged manufacturers of over-the-counter cold medicines to change the labeling on their products to state that the products should not be ingested by children under the age of four. This recommendation comes on the heels of a Centers for Disease Control and Prevention (CDC) study that illustrated the high prevalence of cold medicine related emergency room visits due to improper ingestion by children under the age of four. This is the second labeling change for cold medicines in the past year. Manufacturers recently modified labels so as to no longer market products for use by children under the age of two.
GAO Report About Medicare Cuts for Imaging Services
On September 26, 2008, the Government Accountability Office (GAO) released a report, “Medicare: Trends in Fees, Utilization, and Expenditures for Imaging Services before and after Implementation of the Deficit Reduction Act of 2005.” The Deficit Reduction Act (DRA) called for caps on certain types of medical imaging services. GAO found that there were over $1.7 billion of reimbursement cuts in 2007. Utilization of the services increased, despite the lower reimbursement rates. The Centers for Medicare and Medicaid Services (CMS) views this as successful, while industry asserts that the cuts have been harmful to medical imaging services. This report is available at: http://www.gao.gov/new.items/d081102r.pdf.
Medicare Improvement for Patients and Provider Act
Over the summer, Congress passed the Medicare Improvement for Patients and Providers Act which halted a 10.6 percent cut in physician reimbursement for Medicare services. The Act raised the financial threshold for Medicare assistance, allowing more senior citizens to qualify. Further, the Act created the same co-payments for mental health services as it does any other doctor’s visit. The Act also will deduct back taxes from any Medicare reimbursement from physicians and other medical service providers who are delinquent in paying their federal income taxes. The Act halted the competitive bidding program for DME providers.
Increase in CMS Oversight
In response to the discontinuation of the competitive bidding program for DME providers under the Medicare Improvement for Patients and Providers Act, CMS is increasing its anti-fraud initiatives. CMS intends to increase the focus of the recovery audit contractors (RACs) in particular states, namely Florida, California, Texas, Illinois, Michigan, North Carolina and New York. The RACs will focus their efforts on home health agencies and DME suppliers.
SCHIP Reauthorization
Democrats decided not to pursue a vote to expand the State Children’s Health Insurance Program (SCHIP) several weeks before the November 4, 2008 election. Legislation seeking to expand SCHIP was vetoed two times by President George W. Bush. SCHIP, formed in 1997, covers approximately 10 million children and is set to expire in March 2009 without additional legislative intervention. It is expected that Congress will resume debate on SCHIP and reauthorize the legislation in the new year.
For more information, contact:
Michael M. Gaba
202.419.2435
michael.gaba@hklaw.com
toll free: 1.888.688.8500
About Our Health Law and Life Sciences Practice
Related Practices