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WeeklyDigest8.17-8.27fordistribution

WeeklyDigest8.17-8.27fordistribution

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Health Reform Weekly Digest
August 17 – August 27 | 2010
Issue 13
FEDERAL REGISTER NOTICES
Health Resources and Services Administration Statement of Organization, Functions and Delegations
of Authority
http://edocket.access.gpo.gov/2010/pdf/2010-20425.pdf
Centers for Disease Control and Prevention (CDC) Expanded Human Immunodeficiency Virus (HIV)
Testing for Disproportionately Affected Populations (funding from PPACA)
http://edocket.access.gpo.gov/2010/pdf/2010-20572.pdf
Draft Guidance for Industry: Questions and Answers Regarding Implementation of the Menu Labeling
Provisions of Section 4205 of the Patient Protection and Affordable Care Act of 2010; Availability
http://edocket.access.gpo.gov/2010/pdf/2010-21065.pdf

Guidance for Industry: Questions and Answers Regarding the Effect of Section 4205 of the Patient
Protection and Affordable Care Act of 2010 on State and Local Menu and Vending Machine Labeling
Laws; Availability

http://edocket.access.gpo.gov/2010/pdf/2010-21065.pdf
Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B
for CY 2011;Cor r ect ions
http://edocket.access.gpo.gov/2010/pdf/2010-21255.pdf
Availability of Interim Procedures for Federal External Review and Model Notices Relating to Internal
Claims and Appeals and External Review under the Patient Protection and Affordable Care Act; Notice
http://edocket.access.gpo.gov/2010/pdf/2010-21206.pdf
Medicare Program; Listening Session Regarding the Implementation of Section 10332 of the Patient
Protection and Affordable Care Act, Availability of Medicare Data for Performance Measurement
http://edocket.access.gpo.gov/2010/pdf/2010-21369.pdf
BE ON THE LOOK OUT:
August 27th: Comments are due forr ules relating to Medicare and Medicaid Programs: Changes to the
Hospital and Critical Access Hospital Conditions of Participation To Ensure Visitation Rights for All
Patients
August 27th: Comments are due forr ules regarding Preexisting Condition Exclusions, Lifetime and
Annual Limits, Rescissions, and Patient Protections it is also the date they become effective
August 31st: Comments are due forr ules regarding the Medicare Program; Proposed Changes to the

Hospital Outpatient Prospective Payment System and CY 2011 Payment Rates; Proposed Changes to
the Ambulatory Surgical Center Payment System and CY 2011 Payment Rates; Proposed Changes to
Payments to Hospitals for Certain Inpatient Hospital Services and for Graduate Medical Education
Costs; and Proposed Changes to Physician Self-Referral Rules and Related Changes to Provider
Agreement Regulations

September 1st: Applications are due for the Exchange State Planning and Establishment Grants
September 7th: Comments are due for thenot ice for the Disclosure of Nutrient Content Information for
Standard Menu Items Offered for Sale at Chain Restaurants or Similar Retail Food Establishments and
for Articles of Food Sold From Vending Machines
September 10th: Comments are due for the request for comment on Current State Practices Related to
Payments to Providers for Health Care-Acquired Conditions
September 20th: listening session to receive comments regarding implementation of section 10332 of
the Patient Protection and Affordable Care Act (the Affordable Care Act), which amended section 1874
of the Social Security Act: Availability of Medicare Data for Performance Measurement
Only 27 days until September 23rd
1
Prepared by HELP and Finance Republican Committee Staff
LETTERS TO THE ADMINISTRATION
August 26: CMS Administrator Donald Berwick sent a letter to Sen. Grassley responding to Sen.

Grassley's July 29 letter to Dr. Berwick regarding potential conflicts of interest. The letter did not
comply with Senator’s Grassley request that Berwick disclose information regarding the donors who
funded the Institute for Healthcare Improvement (IHI) during Dr. Berwick’s time as its CEO. See the

Grassley press release for more information.
August 25: Senator Coburnr esponse to Secretary Sebeliusr esponse to the August 3rd letter regarding
the Andy Griffith Medicare promotional advertising campaign. (CQ Article on this issue)
August 3: Senators Coburn, Barrasso, Burr, McCain, and Thune sent alet t er to Secretary Sebelius
regarding the Medicare promotional advertising campaign
August 3: Senator Ensign sent a letter to Secretary Sebelius, Secretary Geithner, and Secretary Solis
regarding the Interim Final Rules For Group Health Plans and Health Insurance Issuers Related to
Coverage of Preventative Services under the Patient Protection and Affordable Care Act.
August 2: Senator Grassley sent a letter to Mr. Berry of the U.S. Office of Personnel Management
(OMP) regarding the OPM’s decision to forgo the retiree drug subsidy included in the Medicare
Prescription Drug, Improvement, and Modernization Act of 2003.
July 22: Senators Grassley and Enzi sent alet t er to Secretary Sebelius requesting additional
information on the Secretary’s claim that premiums would rise by less than one percent as a result of
the new health law.
July 28: Senators Enzi, Coburn, and 9 other Republican members sent alet t er to Secretary Sebelius

regarding federal funding for abortions in the new high-risk pools established under the new health law. The letter follows the release of a Congressional Research Servicer eport indicating that neither current law (Hyde Amendment), nor the health care law, nor the Executive Order signed by the President, nor HHS’ contract solicitation for the high-risk pool program specifically prevent federal funds from being used to finance abortion coverage in state high-risk pools. A response was received the next day.

July 29: Senator Grassley sent alet t er to Dr. Berwick regarding potential conflicts of interest and
information requested by the Finance Committee.
ADMINISTRATION MATERIALS
WH blog posts
o
T he health insurance finder tool at healthcare.gov
o
Seniors Already Seeing Lower Prescription Drug Costs
o
An Unexpected Answer on the Affordable Care Act and the Deficit
o
Protecting Medicare Benefits and Offering Clear Choices for Seniors
Healthcare.gov blog posts:
o
The Affordable Care Act & Mental Health by Pamela S. Hyde, J.D., Administrator, SAMHSA
o
What is a preexisting condition? by Jay Angoff
o
Making Sure Your Premiums Pay for Care by Secretary Sebelius
o
Reining in Excessive Health Insurance Premium Increases by Jay Angoff
Healthcare.gov web chats
o
Creating a fairer insurance market with HHS Secretary Kathleen Sebelius, Jay Angoff, and Liz
Fowler
Health and Human Services Press Releases
o
New Insurance Finder Tool
o
Announcement of $32 million to support rural health priorities
Web Portal
o
Training materials
Secretary SebeliusResponse to Senator Coburn’s letter asking about funding on the Andy Griffith
Medicare & Mayberry ads.
Annals of Internal Medicine Article: The Affordable Care Act and the Future of Clinical Medicine: The
Opportunities and Challenges by Robert Kocher, MD; Ezekiel J. Emanuel, MD; and Nancy-Ann M.
DeParle, JD
2
Prepared by HELP and Finance Republican Committee Staff
CMS HILL NOTIFICATIONS
(For additional information on these please contact Finance staff)
August 27: Rural Community Hospital Demonstration Expanded
August 26: Medicare Imposes Stronger Protections on Medical Equipment Suppliers
August 25: HHS Announces Expanded Medicare Coverage of Tobacco Cessation Counseling
August 24: CMS Issues Reminder about January 2011 Target for Testing Transaction Standards
August 20: CMS Releases Guidance on Operational Changes to the Payment Error Rate
Measurement (PERM) Program
August 18: CMS Announces the 2011 Average Part D Premium Estimate and the 2011 Part D
Benchmarks
August 17: Guidance on States' Access to HIT Incentive Payment Administrative Match
CBO REPORTS
CBO Letter to Sen. Crapo regarding certain health care provisions and the “net deficit impact would be
if certain provisions of PPACA and the Reconciliation Act that were estimated to generate net savings
were eliminated”
CBO Budget and Economic Update
CBO August Baseline- Medicare (attached)
UPDATED CRS REPORTS
Individual Mandate and Related Information Requirements under PPACA
Health Care: Constitutional Rights and Legislative Powers
PPACA Regulations Issued During the First Four Months of the Act’s Implementation
Temporary Federal High Risk Health Insurance Pool Program
Preexisting Exclusion Provisions for Children and Dependent Coverage under the Patient Protection
and Affordable Care Act (PPACA)
Grandfathered Health Plans Under the Patient Protection and Affordable Care Act (PPACA)
RESOURCES
NAIC’s special section on their website on Health Care Reform Implementation
August Issue of Health Affairs
o
Robert Wood Johnson Foundation policy brief on High Risk pools
American Action Forum: Operation Health Care
Operation Health Care Poll: Health Care Law Opposed by Midwest Voters
National Business Group on Health Survey
Thompson Reuters Health Care Sentiment Index
New England Journal of Medicine : Underinsurance among Children in the United States
Annals of Internal Medicine : Comparative Effectiveness Research
IN THE NEWS
Politics of Implementation

In the next few days a massive ad campaign, aimed at countering anti healthcare efforts will be unveiled,
according to a story in the LA Times. This, “effort is up against an intense Republican campaign that has
painted the healthcare bill as a symbol of all that's wrong with Democratic-dominated Washington.”Polit ico has
a story on the Administration’s efforts to take the focus away from the cost associated with theUnaffordable
Care Act. The story reports that, “Key White House allies are dramatically shifting their attempts to defend

health care legislation, abandoning claims that it will reduce costs and deficit and instead stressing a promise
to "improve it.”
3
Prepared by HELP and Finance Republican Committee Staff

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