May 18, 2012
Medicare/Medicaid Overhaul Not Expected During Lame Duck Session
The Chairman and Ranking Member of the House Budget Committee agreed this week it is very unlikely that Congress will make significant changes to Medicare and Medicaid during the lame duck session that follows the November election. Rep. Paul Ryan (R-WI) and Rep. Chris Van Hollen (D-MD) agreed that a compromise to overhaul these federal health care programs, which both believe are the biggest cause of federal debt, is not likely to occur until 2013. In a joint appearance, the Budget Committee leaders both said they expect Congress to pass an extension of current policies for six months or more before the end of this session of Congress.
House GOP Post-Supreme Court ACA Plan Leaked
Regardless of how the Supreme Court rules on the constitutionality of the Affordable Care Act ("ACA") next month, the House Republican Leadership is developing a plan for moving forward. Details of a closed door meeting that were leaked to the public this week show House Republicans will move to strike the ACA's most controversial provisions, like the individual mandate, if the Supreme Court upholds the health law in its entirety. If the justices choose to partially or fully overturn the law, House Republicans will introduce bills to keep those provisions the public has embraced, such as allowing children to remain covered by a parent's health insurance plan. While the House Leadership believes there is great political risk in not keeping the law's most popular provisions, news of the plan has already come under fire from conservatives who have pledged to only support a full repeal.
House Committee Holds Hearings on ACA Tax Provisions
The House Ways and Means Subcommittee on Oversight held a hearing this week that focused on issues related to tax-exempt organizations, including the new IRS compliance measures stemming from the ACA. The hearing was a follow-up to the October 2011 letter Subcommittee Chairman Charles Boustany (R-LA) wrote to the IRS regarding Form 990 compliance. The new IRS provisions enacted as part of the ACA also include:
Section 9007(a) added new statutory requirements for all hospitals seeking exemption as a 501(c)(3) and contained in Internal Revenue Code(IRC) §501(r).
9007(b) added a new penalty excise tax (IRC §4959) to enforce these new requirements.
Section 9007(c) mandated IRS review of each 501(c)(3) hospital and its community benefit activities at least once every three years.
Section 9007(d) imposed new reporting and disclosure requirements on 501(c)(3) hospitals filing the annual 990(h).
Michael J. Regier, Senior Vice President of Legal and Corporate Affairs for Voluntary Hospitals of America, provided testimony at the hearing regarding concerns over Form 990 compliance. Mr. Regier told committee members Form 990 is complex, redundant and has significantly increased paperwork requirements for hospitals. One concern in particular focused on the Form 990 reporting scheme, which makes it difficult for hospital systems to demonstrate that each individual hospital is satisfying the community benefit requirement. Mr. Regier's written testimony can be read here. Republican and Democrat subcommittee members were receptive to the idea of 990 reform, and this hearing builds momentum for possible legislation regarding the current requirements for non-profit hospitals. Look for another hearing where IRS officials will be called to testify in the coming months.
Catholic Bishops Threaten Lawsuit over Contraception Mandate
The United States Conference of Catholic Bishops ("CCB") announced this week that it will sue the Obama administration if it doesn't exempt religiously affiliated insurance plans from the contraception mandate contained in the ACA. While religious employers, like churches, were exempted from the mandate earlier this year, no exemption has yet been made for religiously affiliated employers, like Catholic hospitals and insurance companies. In a comment letter sent to the Department of Health and Human Services on a proposed rule to accommodate the objections of religiously affiliated employers, the CCB said religiously affiliated health insurance companies "...will face a choice. They can drop out of the health insurance marketplace altogether, or offer or provide the objectionable coverage." Earlier this year, White House Press Secretary Jay Carney said the Obama Administration is "not trying to win an argument here ... We're trying to implement a policy that will affect millions of women." Read the CCB comment letter here.
AHA Survey Supports Short-Term Delay to ICD-10 Implementation
The American Hospital Association ("AHA") released the results of a survey of almost 1,000 hospitals regarding the transition to ICD-10. In a letter to CMS that was part of its comments on a proposed rule to delay ICD-10 implementation until October 2014, AHA told the agency that 70% of those hospitals surveyed thought a short-term delay of no more than 12 months would make the transition to ICD-10 easier by giving the providers a chance to handle different and often competing priorities. However, the survey also revealed that larger hospitals are having a much easier time with the transition than small hospitals, which reported a lack of resources and trained personnel to complete the transition. Read the AHA comment letter here.
Tavener May Not Receive Confirmation Hearing
Senate Finance Committee Chairman Max Baucus told reporters yesterday that he believes it is "virtually impossible" for Acting Administrator Marilyn Tavenner to get 60 votes in the Senate. Therefore, he doesn't have plans to hold a confirmation hearing at this time.
Congress is out of session for a scheduled district work period.
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