Kaiser Health News Original Stories

3. Political Cartoon: 'In Touch?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'In Touch?'" by Chris Wildt .

Here's today's health policy haiku:

SAFE OR SORRY?

House debates ‘Cures Bill’
That will speed drug approvals.
But will it be safe?

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Medicare

4. Medicare To Change How It Pays Hospitals For Knee, Hip Replacements

Under the plan, hospitals will not bill individually for surgical and recovery services but will instead get a single payment for the procedure and follow-up care.

The Wall Street Journal: Medicare Plans To Fix Rates On Knee, Hip Replacements
Medicare wants to start paying hospitals fixed amounts for hip and knee replacements, rather than letting providers bill individually for each surgical and recovery service provided to older Americans, health officials said Thursday. The proposal, which would apply to two of the most common procedures for Medicare beneficiaries, is another step by the Obama administration to try to curb costs in the insurance program for people 65 years old and older as well as the disabled. (Radnofsky and Armour, 7/9)

The Washington Post: Medicare Proposes Payment Changes To Hospitals For Hip, Knee Replacement
Federal health officials are proposing a major change in the way Medicare pays for hip and knee replacements, requiring hospitals to partly repay the government if patients get avoidable infections and other complications but rewarding them with extra payments if patients do well. The proposal announced Thursday by the Centers for Medicare and Medicaid Services is part of the Obama administration’s efforts to overhaul the health-care system, in part by using the payment system to reward quality of care rather than volume of services. Under the current system, doctors and hospitals typically get paid set fees for every procedure they perform, regardless of how patients fare. (Sun, 7/9)

Reuters: U.S. Proposes Bundling Some Medicare Knee, Hip Replacement Payments
The U.S. agency that runs federally funded health insurance programs has proposed restructuring payments for hip and knee replacement surgeries, some of the most common surgeries received by patients covered by the plans. The Centers for Medicare and Medicaid Services (CMS) invited providers on Thursday to comment on a proposal that would hold hospitals in 75 geographic areas accountable for the quality of care they deliver to Medicare fee-for-service beneficiaries for hip and knee replacements from surgery through recovery. (Beasley, 7/9)

USA Today: Feds Want To Penalize Hospitals With Too Many Hip, Knee Surgery Problems
Federal health care regulators on Thursday proposed cutting Medicare payments to hospitals with high rates of complications for hip or knee replacements. The proposed rule, announced by the Centers for Medicare and Medicaid Services, will affect more than 800 hospitals in both large and small cities, including New York City, Los Angeles, Flint, Mich., and Lubbock, Texas. (O'Donnell, 7/9)

Also, a look at payments for Medicare Advantage -

NPR/Center for Public Integrity: Federal Audits Of Medicare Advantage Reveal Widespread Overcharges
Government audits just released as the result of a lawsuit detail widespread billing errors in private Medicare Advantage health plans going back years, including overpayments of thousands of dollars a year for some patients. Since 2004, private insurers that run Medicare Advantage plans, an increasingly popular alternative to traditional Medicare, have been paid using a risk score calculated for each patient who joins. Medicare expects to pay higher rates for sicker people and less for those in good health. But the internal audits, never before made public, provide striking new evidence of billing mistakes — mostly overcharges — in the Medicare Advantage plans. (Schulte, 7/10)

The administration also announces its choice to head the agency overseeing Medicare, Medicaid and the federal health law -

Reuters: Obamacare Acting Administrator Slavitt Nominated To Head Agency
Andy Slavitt, the acting administrator of the Centers for Medicare and Medicaid Services, which oversees the Obamacare healthcare program, has been nominated as head of the agency, the White House said on Thursday. Slavitt, who joined CMS last year to oversee the once-troubled HealthCare.gov website, has been acting administrator since March following the resignation of Marilyn Tavenner as head of the agency that also manages the Medicare and Medicaid government healthcare programs. He was previously an executive at a government contractor working on the HealthCare.gov site and a leader of the rescue team that turned it around after a botched rollout. (Cooney, 7/9)

Health Law Issues And Implementation

5. FDA Delays Menu Calorie Count Requirements For A Year

The mandate is part of the federal health law. Restaurants, movie theaters and other affected retails outlets have asked for more time to make the changes.

The New York Times: F.D.A. Extends Deadline For Calorie Counts On Menus
The Food and Drug Administration has delayed by a year the deadline for the nation’s chain restaurants, pizza parlors and movie theaters to post calorie counts on their menus in what some consumer advocates said was a setback for public health but others contended would simply give companies enough time to comply. Pressure had been growing to delay the rule, which was proposed in November and would have taken effect at the end of this year. ... Menu labeling became law in 2010 as part of the Affordable Care Act, and the F.D.A. issued a proposal for how it should be carried out the next year. But the final rule was delayed for three years, due in part to fierce opposition from some national chains, including pizza restaurants and movie theaters.(Tavernise, 7/9)

The Associated Press: FDA: Calories On Menus, Menu Boards Delayed Until 2016
FDA said it is extending the deadline after restaurants and other retailers said they needed more time to put the rules in place. The agency said those businesses are in the process of training workers, installing menus and menu boards and developing software and technology for more efficient and specific calorie label displays. (Jalonick, 7/9)

The Washington Post: The FDA Has Delayed Menu Calorie Count Rules
The move comes amid persistent pressure on the agency from various corners of the food industry to delay enforcement of the rules. The FDA said that since February, it has received numerous requests from for a postponement, including from groups such as the Food Marketing Institute, the National Association of Theater Owners, the American Beverage Association and Publix Super Markets. (Dennis, 7/9)

The Wall Street Journal: FDA Extends Deadline For Listing Calories On Menus
The Food and Drug Administration is giving restaurants and other food purveyors an additional year to comply with new rules that require calorie counts on menus, a response to concerns by some food establishments that the requirements are confusing and broad. ... The agency said it would post a draft guidance document in August to answer some of the frequently asked questions from the industry, and Mr. Taylor said the agency now and after the Dec. 1, 2016, compliance date “will work flexibly and collaboratively with individual companies making a good-faith effort to comply with the law.” (Gasparro, 7/9)

The Hill: FDA Delays ObamaCare's Menu Labeling Rule
The Food and Drug Administration is delaying a controversial ObamaCare rule that requires restaurants to list the number of calories in the food they sell. Restaurants and grocery stores will not have to comply with the contentious new rule until after the 2016 presidential election — at which time a Republican president could choose to scrap the rule altogether. (Devaney, 7/9)

6. Few Takers For Obamacare's Small Business Exchanges

Fewer than 11,000 employers nationwide have enrolled their workers in coverage through the small business exchanges set up under the federal health law. Other stories look at the law's coverage of nutrition and obesity counseling and how Novartis might bundle health-care services, along with its new heart-failure drug, to win over increasingly cost-conscious insurers.

The St. Louis Post-Dispatch: Small Business Insurance Exchanges Are off To A Rocky Start
Millions of Americans have health insurance because of the Affordable Care Act, but there’s one area where enrollment has significantly dragged. Few small businesses are getting coverage through the law’s online insurance exchange. Only 10,700 employers are currently enrolled in coverage through the Small Business Health Options Program, or SHOP, exchanges, the federal government announced this month. That figure represents about 85,000 Americans, the government said. Officials did not provide a state-by-state breakdown. (Shapiro, 7/9)

ABC News: Affordable Care Act Will Cover Weight Loss Medical Services
Losing weight is a universal struggle but now some weight loss efforts may not cost you as much money out of pocket. Weight loss programs that involve professional weight loss doctors or nurses and registered dieticians are now covered under the Affordable Care Act, legislation that expanded health coverage to millions of Americans and was upheld for a second time last month by the U.S. Supreme Court. The ACA, signed into law by President Obama in 2010, requires insurers to pay for nutrition and obesity screening. (Good Morning America, 7/9)

The Wall Street Journal: Novartis Looking At Ways To Win Over Cost-Concerned Health Insurers
Novartis AG might offer a bundle of health-care services alongside its promising new heart-failure drug to win over increasingly cost-conscious insurers, its chief executive said. The drug, called Entresto, has been shown to reduce the rate of hospitalization and cardiovascular death in heart failure compared with the current standard treatment. The U.S. Food and Drug Administration approved it earlier this week .... But at $12.50 per patient a day, it also carries a substantially higher price tag than the older drugs, which cost less than a dollar a dose. ... Chief Executive Joe Jimenez said Thursday Novartis was “looking hard” at going to insurers with add-on services intended to further improve outcomes for patients on Entresto. He said this could involve providing a device that allowed doctors to monitor patients remotely so they could pick up on early signs of deterioration. (Roland, 7/10)

Meanwhile, Illinois lays off Obamacare outreach workers ahead of the third enrollment period -

The Chicago Tribune: Illinois Slashes Obamacare Outreach Staff
Get Covered Illinois, the organization created to promote health insurance sold under the federal Affordable Care Act, said Wednesday it is eliminating most of its staff in a move the group attributed to decreased federal funding. The organization led efforts to sign people up for coverage through the health law's first and second open enrollment periods, producing commercials and overseeing hundreds of federal enrollment specialists known as navigators. (Venteicher, 7/9)