2015 Legislative Update Week Ending April 17 2015
Federal prosecutors recently announced the biggest-ever one-day takedown of a phony Medicare billing scheme. One hundred seven people were charged, including doctors and nurses in seven U.S. cities, with taking part in a scheme to steal 2 million from Medicare. About the same time, the Inspector General of the Department of Health and Human Services reported that federal investigators have uncovered questionable billings at 2,600 drugstores nationwide. A pharmacy in Kansas billed Medicare for more than 1,000 prescriptions each for just two patients. Medicare paid .6 billion to the drugstores whose billings are now being questioned. While those announcements generated great election year headlines, the fact is that seniors and taxpayers can only hope to see a tiny fraction of Medicare's money recovered. .The judge's order stops the implementation of the rule until the completion of the notice and comment process. .Baicker, the public policy school dean, thinks public scrutiny will prevent outrageous pricing. The industry has made various pledges, trying to balance corporate citizenship against making eager investors happy: Astra Zeneca has promised 1 billion doses for low- and middle-income countries. Johnson & Johnson says it would make the COVID-19 vaccine available on a "not for profit basis" at for "emergency pandemic use." … Continued
Denials Coverage Highest Medicare Advantage Plans
Support for the IPAB at both hearings was scarce. Some Members, including the Ranking Member of the House Budget Committee, Chris Van Hollen (MD), called the IPAB a necessary "failsafe" measure that will stabilize healthcare costs. He stressed the fact that the experts on the IPAB will make recommendations, but Congress will ultimately have the final say in whether or not they become law. .In April, House lawmakers voted on a balanced budget amendment to the constitution that would have been disastrous for Social Security and Medicare beneficiaries if adopted. Did you support this drastic measure, and if so, why? .But achieving bipartisan consensus on the next packages appears more difficult. House Speaker Nancy Pelosi (D- Calif.) says her starting point is up to trillion in aid that cash-strapped states and local governments need to prevent layoffs of first responders and other workers, and to help make up for lost revenues amid business closures. She also wants an infusion of funds for the postal system, which President Trump previously blocked. Also, on her list are provisions to expand voting by mail. … Continued
Most people who spend the night in the hospital would say they have been an inpatient. But over the past six years, rapidly growing numbers of Medicare beneficiaries have learned that they were never admitted as an inpatient — even though they have stayed in a hospital bed, received treatment, diagnostic tests, and drugs. .The proposal to switch to the chained CPI has come up numerous times during past budget negotiations over lifting the federal debt limit. Most recently the proposal appeared last December in a 2016 House bill that would reform Social Security, and in an alternate fiscal year 2017 budget proposed by the Republican Study Committee. The proposal remains a key provision of debt reduction plans, because so many federal benefit programs and the tax code are adjusted using the CPI. The CPI-U has recently been proposed to index Medicaid payments in the Senate health bill. Economists have estimated that adopting the chained CPI would cut Social Security by 0 billion over ten years. .Mary: Who tends to use anchors to influence our decisions, and when should we be wary? .Last week, in a last ditch attempt to try and come up with new legislation, Secretary of the Treasury Mnuchin and White House Chief of Staff Meadows met with the leaders of the House and Senate see if they could reach a compromise. They could not. One of the big reasons was the overall cost of the legislation and in the amount of money that would be given to those who are unemployed because of the pandemic. .Three Key Senate Bills Gain Support .The article continued, "The NBER study zeros in on how increases in prescription drug costs among Medicare recipients affect patient choices and comes to a stark finding: ‘Patient cost-sharing introduces large and deadly distortions into the cost-benefit calculus,' the report said." .Economists are saying that cost-of-living adjustments (COLAs) overpay seniors and that recipients don't need so much money to maintain their standard of living. Cuts to annual cost-of-living adjustments (COLA) are a key provision of the deficit reduction plans on Capitol Hill, and TSCL is fighting the plans that would cut the benefits of more than 60 million beneficiaries. .No change to 401(k)s or IRAs: Prior to enactment, concerns were high that tax reform would restrict the amount of pretax contributions working people could make to workplace retirement accounts. Congress did not do this, and the tax rules affecting these accounts, for the most part, remain the same. .Sources: 0.3% COLA Announced, The Social Security Administration, October 19, 201"Long Term Impact of Low COLA Growth," Mary Johnson, TSCL, August 31, 2016.