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The Congressional Budget Office (CBO) has released reports on two Republican proposals regarding the Affordable Care Act: One which would repeal much of the law while delaying some of those effects for two years and another which replaces it with the Senate's Better Care Reconciliation Act (BCRA).

Enrollment in the individual market would increase while premiums would decrease under Sen. Ted Cruz’s, R-Texas, controversial “Consumer Freedom” amendment, according to an HHS analysis obtained by the Washington Examiner.

Senate Republicans' latest Affordable Care Act replacement plan was introduced on July 13. Four days later, it was declared dead, as four Republican senators had publicly announced they wouldn’t support even holding a vote on the legislation.

Whenever Republicans in the House or Senate have released a new version of an Affordable Care Act (ACA) replacement plan in 2017, healthcare industry reaction has been almost uniformly negative. The same can largely be said for the newest version of the Better Care Reconciliation Act (BCRA), with the notable exception of the American Medical Association (AMA) when it comes to two provisions. 

Senate Republicans have released a new version of their Affordable Care Act (ACA) replacement plan, adding new funding for stabilizing the individual market and keeping more of the ACA’s taxes, while also including a controversial proposal to allow insurance plans which don’t comply with ACA regulations on benefits and community rating.

 

Recent Headlines

Cantor loss changes picture for healthcare lobbying efforts

News media and pundits have largely focused on what House Majority Leader Rep. Eric Cantor’s Virginia Republican primary loss to David Brat means for immigration reform, but Cantor was also heavily involved in drafting the Republican alternative to the Affordable Care Act (ACA).

3 priorities of Burwell’s WalMart past that could inform her HHS future

Sylvia Mathews Burwell, President Obama’s pick to replace Kathleen Sebelius as Secretary of the U.S. Department of Health and Human Services (HHS) sailed through her Senate confirmation with a vote of 78 to 17 in favor of confirming her nomination.

AHA to Sebelius: Stop “Kafkaesque” OIG audits of hospital claims

Whether it is the heights of hyperbole or an accurate description may depend on your perspective, but Rick Pollack, executive vice president of the American Hospital Association (AHA) did not mince words in his 10-page letter to outgoing U.S. Department of Health and Human Services Secretary Kathleen Sebelius about the many problems with the Office of Inspector General (OIG) getting into the act of reviewing Medicare Part A payment claims for short-stay hospital admissions.

Study finds newly insured will not make up for ACA cuts to Disproportionate Share Hospitals

The expansion of health insurance under the Affordable Care Act (ACA) should mean fewer uninsured patients at Disproportionate Share Hospitals (DSHs), but estimates for just how many fewer such patients would need care might have been overly optimistic finds a new study on California hospitals appearing in Health Affairs.

OIG: Physicians make mistakes in more than half of E/M claims

According to the OIG’s review of a random sample of 657 evaluation and management (E/M) Medicare claims from 2010, more than half (55 percent) had coding and/or documentation errors. Of these, vastly more were upcoded rather than downcoded. If the sample’s findings hold true for all Medicare E/M claims, it means the government is probably overpaying for E/M services by around $6.7 billion, the OIG concluded.

Rep. Blumenauer tries once more for Medicare benefit expansion into hospital-to-home transition services

House Rep. Earl Blumenauer (D-Ore) re-introduced his bipartisan Medicare Transitional Care Act in the 113th Congress on Thursday. The bill seeks to create a new benefit to support and coordinate care for Medicare beneficiaries as they move from the hospital setting to their homes or other care setting.

Register now to check accuracy of industry payments CMS will attribute to you under Sunshine Act

Physicians and teaching hospitals that want the chance to review information about payments or other transfers of value they’ve received from pharmaceutical, medical device and other industry groups before this information is made public should register with the Centers for Medicare and Medicaid Services (CMS) starting Sunday, June 1, 2014.

Court ruling ends some hospitals’ discount on orphan drugs

Rudolph Contreras, judge for the U.S. District Court for the District of Columbia, has ruled the U.S. Department of Health and Human Services acted outside of its regulatory authority when it interpreted the law covering payments for pharmaceuticals with “orphan drug” status as not applying to payments when the drug was prescribed for a condition for which it was not an “orphan drug,” such as Prozac prescribed for depression (its most common use) instead of either of Prozac’s two orphan indications.

Journalists sue HHS for access to Medicare Advantage data

Last year, the U.S. Department of Health and Human Services (HHS) made Medicare hospital payment data public, followed this year by individual physician payment data. Now journalists want data on the private Medicare Advantage plans and have filed suit to get it.

AHA and three hospitals sue Sebelius over appeals backlog

The backlog of appeals of recovery audit contractor (RAC) decisions “has reached a crisis point” says the American Hospital Association (AHA) and three hospitals who have brought suit against outgoing U.S. Department of Health and Human Services Secretary Kathleen Sebelius over the length of time it now takes to have an appeal of a reimbursement claim denial decided by an adiminstrative law judge.

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