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Senate ACA replacement efforts stall
Despite efforts to bridge the gap between conservative and moderate Republicans, Senate Majority Leader Mitch McConnell (R-Ky.) has called off plans to vote on the Senate GOP’s bill to repeal and replace the ACA due to a lack of necessary Republican votes to pass it. Sens. Susan Collins of Maine and Rand Paul of Kentucky were early critics of the bill who stated they would not vote to support it. Sens. Mike Lee of Utah and Jerry Morgan of Kansas joined the opposition on July 18, effectively killing any plans to pass the ACA replacement bill out of the Senate.
Senate Republicans had returned to the drawing board on their ACA repeal-and-replace bill with the hope of rewriting it to make it more palatable to both conservative and moderate Republicans. Senate GOP leaders on July 13 released an updated version of their health reform bill after spending several weeks revising their original draft bill, which was released last month.
While the core of the revised bill remained largely unchanged, including retaining significant overhauls to the Medicaid program, Senate GOP leaders made some changes designed to entice holdout conservatives and moderates. Some of the changes included adding $70 billion for state cost-sharing assistance to stabilize the exchanges; creating a fund to aid insurers providing coverage to high-risk individuals; allowing insurers to offer, in certain instances, plans that don’t cover the full essential benefit categories; adding another $45 billion in opioid crisis response funding; and allowing HSAs to be used for premium payments.
At press time, McConnell has made plans to hold a vote in the coming days on a 2015 House bill that would implement a full-scale repeal of the ACA with a two-year implementation delay. This bill was passed by both the Senate and the House in 2015 but was vetoed by former President Obama. That bill is likely to fail as it is now considered less comprehensive than the Senate draft repeal/replace bill. Assuming the bill fails, McConnell will then move to work with Democrats on a bipartisan bill to stabilize the insurance market – a move he previously insisted would be necessary if the GOP proposal failed. Other details on post-repeal efforts have yet to be released.
Medical malpractice reform legislation passes House
The House on June 28 passed medical malpractice reform legislation, the “Protecting Access to Care Act of 2017” (HR 1215), by Rep. Steve King (R-Iowa). It passed by a 218-210 vote. HR 1215 is one of AAOMS’s legislative priorities, and it was advocated by 2017 Day on the Hill participants in Washington, D.C., as well as by OMSs who sent letters to their respective representatives through AAOMS’s grassroots campaign.
As HR 1215 moves to the Senate, please take the time to ask your Senator to support this important legislation through AAOMS’s grassroots campaign.
Trump Administration nominates Surgeon General
President Trump nominated Indiana Health Commissioner Jerome Adams, MD, to be the next Surgeon General, following the resignation of Surgeon General Vivek Murphy in April. Dr. Adams was appointed to run Indiana’s Department of Health in 2014 by former Indiana Governor and current Vice President Mike Pence. Dr. Adams is a practicing anesthesiologist who also serves as an assistant professor at the Indiana University School of Medicine.
Dr. Adams is known for his work to combat the HIV outbreak and opioid epidemic in Indiana, with work on the latter issue being significantly relevant as the country battles the opioid epidemic. He will face confirmation by the Senate at an undetermined date.
HHS Secretary Price announces CDC director nominee
HHS Secretary Tom Price officially named Brenda Fitzgerald, MD, as the 17th director of the CDC and administrator of the Agency for Toxic Substances and Disease. Dr. Fitzgerald was previously the commissioner of the Georgia Department of Public Health as well as state health officer for the past six years. She will replace acting director Dr. Anne Schuchat.
Fifth circuit affirms dental specialty advertising ruling
The Fifth Circuit of the U.S. Court of Appeals affirmed a 2016 ruling by the U.S. District Court for the Western District of Texas on a 2-1 vote in June. The original ruling in American Academy of Implant Dentistry vs. Parker found the state’s dental specialty recognition regulations, which allow only ADA-recognized dental specialties to advertise as specialists, to be unconstitutional and in violation of the First Amendment. The American Academy of Implant Dentistry, American Society of Dentist Anesthesiologists, American Academy of Oral Medicine and American Academy of Orofacial Pain brought forward the original lawsuit.
Louisiana makes it easier to recognize ERISA plans
Louisiana Gov. John Bel Edwards (D) signed a bill that will make it easier for providers to know if a patient’s insurance plan is a state-regulated or ERISA plan. HB 165 requires insurance identification cards to prominently include the phrase “Non-ERISA” if the plan is regulated by state’s insurance laws and subject to state coverage and reimbursement mandates. The Louisiana Dental Association championed this legislation, which takes effect Jan. 1.
Florida, Wisconsin strike down liability caps
The Florida Supreme Court and the Wisconsin First District Court of Appeals both recently struck down as being unconstitutional laws in their respective states that cap malpractice claims. In a 4-3 decision, Florida’s $500,000 cap for doctors and $1 million cap for catastrophic injury were found to “unreasonably and arbitrarily limit recovery of those most grievously injured by medical negligence.”
Meanwhile, the Wisconsin First District Court of Appeals ruled unanimously that “severely injured medical malpractice claimants are unduly burdened by the ($750,000) cap without a rational basis.” Currently, 32 states have some form of liability cap, which varies in amount from state to state.
Health Information Technology
ONC updates database of certified EHRs
The Office of the National Coordinator for Health Information Technology (ONC) recently updated its website hosting the list of Certified Health IT Products, which must be utilized under the Meaningful Use program and MACRA. The revised page provides information on which EHRs are eligible for use under these programs and which systems are under corrective action, decertified, inactive or banned from the program.
Medicare enrollment revalidation cycle 2 to begin
The Affordable Care Act requires all enrolled providers to revalidate their Medicare enrollment information every three to five years.
CMS completed its initial round of revalidation requirements for Medicare providers in March 2015, and it will be returning to its regular revalidation cycles. CMS has established due dates for providers to submit a completed revalidation application to the Medicare carrier in their area within six months of its specified due date. By successfully doing this, providers will avoid a possible hold on Medicare payments and a possible deactivation of Medicare billing privileges.
The list of due dates is available at go.CMS.gov/MedicareRevalidation and will include all enrolled providers/suppliers.
For more information and instructions on Medicare revalidation, visit the CMS website.
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