Health Industry Washington Watch : Washington DC Healthcare Industry Law Firm : Reed Smith : Health Industry Washington Watch : Regulations, Medicare/Medicaid, Governmental Organizations

President Obama has nominated Dr. Donald Berwick to be CMS Administrator. Dr. Berwick currently serves as President and CEO of the Institute for Healthcare Improvement, and is a professor at Harvard Medical School and the Harvard School of Public Health. Among many other appointments, Dr. Berwick has served as Chair of the National Advisory Council of the Agency for Healthcare Research and Quality as an elected member of the Institute of Medicine, and as a member of the Advisory Commission on Consumer Protection and Quality in the Healthcare Industry. Dr. Berwick’s nomination still must be approved by the Senate; the Senate Finance Committee has not yet scheduled a hearing on the nomination.

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The White House has proposed $313 billion in new Medicare and Medicaid cuts over 10 years, in addition to the provisions included in the Administration's proposed FY 2010 budget. Among other things, the Administration is endorsing: incorporating productivity adjustments into Medicare payment updates; reducing hospital subsidies for treating the uninsured as coverage increases; paying "better" prices for Medicare Part D drugs (including reducing reimbursement for beneficiaries dually eligible for Medicare and Medicaid); increasing the equipment utilization factor for advanced imaging from 50 percent to 95 percent; adopting MedPAC’s recommendations for 2010 payments to skilled nursing facilities, inpatient rehabilitation facilities, and long-term care hospitals; and cutting waste, fraud, and abuse (including prepayment review for physicians in high-risk areas or those that order a high volume of high-risk services such as durable medical equipment, home health, and home infusion services).

The following chart summarizes the Obama Administration's health reform financing proposals released to date:

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On May 11, 2009, the Department of Health and Human Services (HHS) published its semiannual regulatory agenda, outlining planned regulatory initiatives in a number of health policy areas. The notice points out that due to the timing of the release of the agenda, it does “not necessarily reflect the policy perspectives of the Obama Administration,” but the October 2009 agenda is expected to reflect the “current policy directions of the Obama Administration.”

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On May 18, 2009, the Senate unanimously confirmed Dr. Margaret "Peggy" Hamburg as FDA Commissioner.  Dr. Hamburg was sworn in as the FDA Commissioner by HHS Secretary Kathleen Sebelius on May 22, 2009.

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On May 7, 2009, the Obama Administration released its additional details on its proposed federal budget for fiscal year (FY) 2010, the outlines of which were unveiled in February 2009. Overall, the proposed budget would provide a total of $879 billion for the Department of Health and Human Services (HHS) in FY 2010, an estimated $63 billion increase over FY 2009. The Administration continues to advocate the establishment of a $635 billion reserve fund over 10 years to finance health reform, funded by Medicare and Medicaid savings in addition to new revenues. To strengthen Medicare's long-term sustainability, the budget seeks to align incentives toward quality, promote efficiency and accountability, and encourage shared responsibility. Key area for health program reforms include Medicare Advantage payments, hospital payments (including bundling payments to hospitals and certain post-acute providers for services provided within 30 days after discharge from the hospital, reduced payments for certain hospital readmissions, hospital pay-for-performance provisions, and restrictions on specialty hospitals), physician payments, imaging services, home health payments, Medicaid drug prices, among many others. In other areas, the budget stresses improvements in health quality and access to health care, increased funding for Medicare integrity and public health safety efforts.

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On May 7, 2009, the Senate Health, Education, Labor, and Pensions has scheduled hearings to examine the nomination of Margaret A. Hamburg to be Commissioner of Food and Drugs.

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On April 8, 2009, President Obama signed an Executive Order establishing a White House Office of Health Reform within the Executive Office of the President. The goal of the office is to provide leadership to the executive branch in establishing policies, priorities, and objectives for the federal government's comprehensive effort to improve access to health care, the quality of such care, and the sustainability of the health care system. The order also directs the HHS Secretary to establish within HHS an Office of Health Reform to coordinate closely with the White House Office of Health Reform.

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On April 21, 2009, the Senate Finance Committee voted to favorably report the nomination of Kansas Governor Kathleen Sebelius to be Health and Human Services (HHS) Secretary.  The 15 to 8 vote was largely upon party lines. The nomination is now pending before the full Senate.

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A number of Congressional panels have scheduled hearings on health policy issues, including the following:

• An April 21, 2009 Senate Finance Committee hearings on "Reforming America's Health Care Delivery System”;
• A Ways and Means Committee hearing on April 22 regarding reforming the health insurance market;
• An April 22 Senate Homeland Security and Governmental Affairs Committee hearing on "Eliminating Waste and Fraud in Medicare and Medicaid";
• An April 22 House Transportation and Infrastructure Aviation Subcommittee hearing entitled "Oversight of Helicopter Medical Services"; and
• An April 23 House Education and Labor Health Subcommittee hearing on "Ways to Reduce the Cost of Health Insurance for Employers, Employees and their Families."

In addition, on April 21, 2009, the Senate Finance Committee has scheduled a vote on the nomination of Kathleen Sebelius to be Secretary of Health and Human Services.

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The Senate Finance Committee held a hearing April 2, 2009 on the nomination of Kansas Governor Kathleen Sebelius to be Secretary of Health and Human Services. At the hearing, Governor Sebelius asserted that if confirmed, health reform “would be my mission – as it is the President’s.” The Committee has not yet scheduled a vote on her nomination.

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The Senate Health, Education, Labor and Pensions (HELP) Committee is holding a hearing March 31 on the nomination of Kansas Governor Kathleen Sebelius to be HHS Secretary. The Senate Finance Committee also has scheduled a hearing on the nomination on April 2. 

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On March 10, 2009, HHS proposed to rescind a controversial Bush Administration rule issued December 19, 2009 that implements and enforces certain federal nondiscrimination statutes protecting the conscience rights of health care providers and other entities. The Obama Administration is reviewing this rule to ensure its consistency with current Administration policy and to reevaluate the necessity for regulations in this area. Comments on the notice will be accepted until April 9, 2009. 

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On January 8, 2009, the Senate Health, Education, Labor and Pensions Committee held a hearing on the nomination of former Senate Majority Leader Tom Daschle to be Secretary of Health and Human Services in the Obama administration. 

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On January 8, 2009, the Senate Health, Education, Labor and Pensions Committee is holding a hearing on the nomination of former Senate Majority Leader Tom Daschle to be Secretary of Health and Human Services in the Obama administration. 

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