Healthcare Update: But How Will They Pay For It?

by King & Spalding
Contact

The end of 2013 proved a remarkable, albeit brief, period of bipartisanship as the Committees of jurisdiction worked together to adopt legislative solutions to several pressing national health care concerns. While the last few months of the year were peppered by continued hearings into the troubled kickoff of the federal Health Insurance Exchanges, and the even more troubled kickoff of their state counterparts, there were at least two major bipartisan healthcare achievements of note: passage of the Drug Quality and Safety Act (DQSA), and each Committee's adoption of a permanent solution to the "Sustainable Growth Rate" (or "SGR") Medicare physician payment issue. As we move into an election year, with its shortened legislative schedule, can it continue?

In November, Congress passed the DQSA, which for the first time in decades revised FDA's oversight of large scale drug "compounding," and created an extensive "track and trace" regime for drugs and their ingredients. Congress had agreed to many of the core provisions for months – particularly on the compounding provisions after last year's New England Compounding Center story when over a hundred were injured by contaminated compounds. Yet, it still took months for the Congress to reach agreement, and pass the legislation, which has already begun to take effect.

Similarly, each of the Committees of jurisdiction undertook adoption of a proposal to (finally) solve the SGR problem that has plagued Congress for a decade. Starting in September, the House Energy and Commerce Committee adopted its solution to eliminate a mandated 25% cut in Medicare physician payments, which has been escalating for years. In December, both the House Ways & Means Committee and the Senate Finance Committee marked up similar bills, adopting them with near unanimous bi-partisan support. While each permanently eliminated the SGR cuts, they each adopted slightly different proposals (varying in physician pay increase from zero to .5% or more, to adopting different quality measure payments, and other differences), requiring further negotiation among the committees to come to a uniform proposal. More important, however, than what was in the three bills was what was missing – the pay-fors.

Normally, none of the three Committees is even willing to entertain legislation unless it will not increase the deficit over the next ten years. Given the difficulty of finding over 100 billion in cuts, commenters at the time praised the committees for their political savvy in keeping the most controversial aspect of the legislation for the very end, so that it could avoid political attack. However, we now have three bills to be reconciled – it is likely that there are also three different ideas on the pay-fors. Can the bi-partisanship continue?

We will know by the end of March, when the current "SGR extension" postponing physician fee reductions expires. The House will be out of Washington from March 15-23, and the Senate will be out March 17-21, leaving only March 24-27 to get this done. The latest Congressional Budget Office estimate is that it will take $116 billion dollars over ten years to solve the gap. Whether the pay-for is proposed from reductions in drug payments, hospital reimbursement, a new tobacco tax, or even war wind-down savings, it promises to be highly controversial. It is worth staying tuned.

-David Farber

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© King & Spalding | Attorney Advertising

Written by:

King & Spalding
Contact
more
less

King & Spalding on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:
Sign up using*

Already signed up? Log in here

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
Custom Email Digest
Privacy Policy (Updated: October 8, 2015):
hide

JD Supra provides users with access to its legal industry publishing services (the "Service") through its website (the "Website") as well as through other sources. Our policies with regard to data collection and use of personal information of users of the Service, regardless of the manner in which users access the Service, and visitors to the Website are set forth in this statement ("Policy"). By using the Service, you signify your acceptance of this Policy.

Information Collection and Use by JD Supra

JD Supra collects users' names, companies, titles, e-mail address and industry. JD Supra also tracks the pages that users visit, logs IP addresses and aggregates non-personally identifiable user data and browser type. This data is gathered using cookies and other technologies.

The information and data collected is used to authenticate users and to send notifications relating to the Service, including email alerts to which users have subscribed; to manage the Service and Website, to improve the Service and to customize the user's experience. This information is also provided to the authors of the content to give them insight into their readership and help them to improve their content, so that it is most useful for our users.

JD Supra does not sell, rent or otherwise provide your details to third parties, other than to the authors of the content on JD Supra.

If you prefer not to enable cookies, you may change your browser settings to disable cookies; however, please note that rejecting cookies while visiting the Website may result in certain parts of the Website not operating correctly or as efficiently as if cookies were allowed.

Email Choice/Opt-out

Users who opt in to receive emails may choose to no longer receive e-mail updates and newsletters by selecting the "opt-out of future email" option in the email they receive from JD Supra or in their JD Supra account management screen.

Security

JD Supra takes reasonable precautions to insure that user information is kept private. We restrict access to user information to those individuals who reasonably need access to perform their job functions, such as our third party email service, customer service personnel and technical staff. However, please note that no method of transmitting or storing data is completely secure and we cannot guarantee the security of user information. Unauthorized entry or use, hardware or software failure, and other factors may compromise the security of user information at any time.

If you have reason to believe that your interaction with us is no longer secure, you must immediately notify us of the problem by contacting us at info@jdsupra.com. In the unlikely event that we believe that the security of your user information in our possession or control may have been compromised, we may seek to notify you of that development and, if so, will endeavor to do so as promptly as practicable under the circumstances.

Sharing and Disclosure of Information JD Supra Collects

Except as otherwise described in this privacy statement, JD Supra will not disclose personal information to any third party unless we believe that disclosure is necessary to: (1) comply with applicable laws; (2) respond to governmental inquiries or requests; (3) comply with valid legal process; (4) protect the rights, privacy, safety or property of JD Supra, users of the Service, Website visitors or the public; (5) permit us to pursue available remedies or limit the damages that we may sustain; and (6) enforce our Terms & Conditions of Use.

In the event there is a change in the corporate structure of JD Supra such as, but not limited to, merger, consolidation, sale, liquidation or transfer of substantial assets, JD Supra may, in its sole discretion, transfer, sell or assign information collected on and through the Service to one or more affiliated or unaffiliated third parties.

Links to Other Websites

This Website and the Service may contain links to other websites. The operator of such other websites may collect information about you, including through cookies or other technologies. If you are using the Service through the Website and link to another site, you will leave the Website and this Policy will not apply to your use of and activity on those other sites. We encourage you to read the legal notices posted on those sites, including their privacy policies. We shall have no responsibility or liability for your visitation to, and the data collection and use practices of, such other sites. This Policy applies solely to the information collected in connection with your use of this Website and does not apply to any practices conducted offline or in connection with any other websites.

Changes in Our Privacy Policy

We reserve the right to change this Policy at any time. Please refer to the date at the top of this page to determine when this Policy was last revised. Any changes to our privacy policy will become effective upon posting of the revised policy on the Website. By continuing to use the Service or Website following such changes, you will be deemed to have agreed to such changes. If you do not agree with the terms of this Policy, as it may be amended from time to time, in whole or part, please do not continue using the Service or the Website.

Contacting JD Supra

If you have any questions about this privacy statement, the practices of this site, your dealings with this Web site, or if you would like to change any of the information you have provided to us, please contact us at: info@jdsupra.com.

- hide
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.