House to Vote on Debt Limiting Extension, Fate of Sequestration Unknown

After returning from its annual retreat last week, House Republican leaders announced capitol webplans to vote on legislation to raise the debt limit until mid-May. The move comes as House Republicans look for ways to pressure the democratically controlled Senate to pass a budget for Fiscal Year 2014. A provision in the House Republican bill would require the Senate to develop a budget by April 15, something the chamber has been unable to do in four years, or lose its pay until it is done.

Noticeably missing from the debt-limit conversations are any talk of the looming 2% cuts to Medicare providers as a result of sequestration. As reported previously, the President signed into law H.R. 8, which delays until March 1 the across-the-board cuts to defense and domestic programs as outlined in the Budget Control Act. House Speaker John Boehner (R-OH) recently said that Republicans were willing to accept the sequester to emphasize their position in the imminent budget debate. It is “as much leverage as we’re going to get,” he said.

Meanwhile, last week, newly appointed House Ways and Means Sub-Health Committee Chairman Kevin Brady (R-TX) vowed to use his new role to repeal the Sustainable Growth Rate formula. Rep. Brady said that along with the Energy and Commerce Committee, he will work on find a solution to replace the SGR with a formula that rewards quality in this Congress. In addition, Rep. Brady has indicated that he will continue to press forward with a Republican strategy to spotlight provisions and regulations within the Affordable Care Act that have a negative impact on health care providers and their patients.

CRS Report Examines Physician Supply as A Result of the Affordable Care Act

A new report released by the Congressional Research Service (CRS) on January 15 finds that the Patient Protection and Affordable Care Act (P.L. 111-148) may affect the demand for physician services once the law is fully implemented. The CRS report titled, “Physician Supply and the Affordable Care Act,” says the ACA will affect demand because it expands insurance coverage to those who were previously uninsured. The report suggests that while specific measures within the law seek to address physician shortage problems, it is currently unclear whether these provisions will address physician supply.

The report highlights specific provisions within the law that may change the composition of the physician population by making modifications to physician training and compensation in different geographic regions. For example, one provision in the ACA authorizes “loan repayments for pediatric medical, surgical, and mental health subspecialists (including psychiatrists) in return for providing care in a medically underserved or health professional shortage area.”

A copy of the report can be found here.

OMB Pressured to Release Final Rule on Physician Payment Sunshine Act

On January 10, device makers and drug manufacturers sent a letter to Office of Management and Budget Director (OMB) Jacob Lew, calling on the Administration to release a final rule on the Physician Payment Sunshine Act. Under the Affordable Care Act (ACA) the Centers for Medicare and Medicaid Services (CMS) “applicable manufacturers of drugs, devices, biologicals, or medical supplies covered by Medicare, Medicaid, or the Children’s Health Insurance Program” are required to report monetary associations with physicians, and certain investment and ownership benefits. The group argues in their letter to OMB that the data collected over the past year that is required to be submitted to CMS in March 2013 cannot be done because the final rule is currently being held up at the OMB.

PCORI Announces Third Cycle of Funding

The Patient Centered Outcomes Research Institute (PCORI) announced last week that its online application system is open for the third cycle of funding for PCORI Funding Announcements (PFAs). These PFAs are designed to solicit applications for proposals to support a portfolio of comparative clinical effectiveness research based on four of PCORI’s National Priorities for Research, which are: Assessment of Prevention, Diagnosis, and Treatment Options; Improving Healthcare Systems; Communication and Dissemination Research; and Addressing Disparities. There are three funding cycles each year. The application deadline for this cycle is April 15, 2013. Application materials and other future funding opportunities can be found here.