A project of the George Washington University's Hirsh Health Law and Policy Program and the Robert Wood Johnson Foundation

Archive: January 2011

Legislation Introduced to Repeal Independent Payment Advisory Board

Posted on January 27, 2011

Representative Phil Roe, M.D. (R-TN), along with 23 other House Republicans, introduced legislation yesterday to repeal the Independent Payment Advisory Board (IPAB). The IPAB, a 15-member commission appointed by the President and scheduled to begin operation in 2014, was enacted as part of the Affordable Care Act (ACA) and is designed to slow the growth rate of Medicare costs. During Senate debate on the ACA, supporters of the Board argued that having an independent board make recommendations would make reimbursement decisions less political. Opponents argued that it removes authority from Congress and gives it to unelected officials.

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New study examines employer-based coverage and health reform

Posted on January 25, 2011

A new paper authored by researchers from the Urban Institute and funded by the Robert Wood Johnson Foundation examines how the Affordable Care Act (ACA) affects employer-sponsored insurance. The paper, “Employer-Sponsored Insurance under Health Reform: Reports of Its Demise Are Premature,” finds that the ACA will have little overall effect on employer-based health coverage.

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Value-Based Health Care Purchasing: Essential Health Benefits and State Health Insurance Exchanges

Posted on January 25, 2011

Bringing down the overall cost of health care while improving its quality for all Americans represents one of the central goals of health reform. Although reducing the number of people without health insurance will provide relief by curtailing much of the estimated $50 billion in annual cost-shifting onto the insured, the longer term challenges are more complex, because they involve structural change in how health care is organized, delivered, and paid for. Specifically, improving health care quality while reducing costs means doing two things simultaneously: moving away from a fragmented system oriented toward what has been termed a “piecework” approach to health care; and introducing new approaches that reward greater clinical integration and efficiencies aimed at creating equally effective but lower-cost care. To achieve these results, the concept of “value-based purchasing” has received increased attention.

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HHS/DOJ issue annual report on fraud and abuse

Posted on January 25, 2011

The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ) have issued their annual report on health care fraud and abuse. The report shows that the Federal Government’s Health Care Fraud and Abuse Control Program recovered more than $4 billion of taxpayer dollars during fiscal year 2010. HHS Secretary Kathleen Sebelius said, “Thanks to the President’s leadership and the new tools provided by the Affordable Care Act, we can focus on stopping fraud before it happens.”

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CRS releases various reports on health reform

Posted on January 24, 2011

The Congressional Research Service (CRS) has issued three reports on specific aspects of the Affordable Care Act (ACA). These reports address (1) upcoming rules and actions required by the ACA; (2) the Federal Government’s involvement in private insurance premium and rate review; and (3) Community Living Assistance Services and Supports (CLASS) Act provisions.

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House passes bill repealing health reform

Posted on January 20, 2011

The U.S. House of Representatives has passed a bill repealing the Affordable Care Act. The bill, H.R. 2: Repealing the Job-Killing Health Care Law Act, passed 245 – 189 in the House, but is not expected to pass in the Senate.

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Obama issues executive order to improve regulatory system

Posted on January 18, 2011

President Barack Obama issued an Executive Order today aimed at “enhancing effectiveness and efficiency in Government.” The Executive Order was issued jointly with a memo from the President to all heads of executive departments and agencies, giving them 120 days to make their regulatory compliance activites publicly available online.

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IOM holds first meeting on essential health benefits

Posted on January 14, 2011

The Institute of Medicine’s (IOM) Committee on the Determination of Essential Health Benefits held its first meeting this week to discuss essential benefits under the Affordable Care Act (ACA). The IOM is charged with making recommendations to the Secretary of HHS on the criteria for determining what constitutes essential health benefits for insurance plans sold in exchanges. For more information on essential benefits, click here.

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New report offers strategies for state implementation of health reform

Posted on January 14, 2011

A new report, funded by The California Endowment through a grant to Community Catalyst, proposes strategies for effective state implementation of health reform. The report, “Where the Rubber Meets the Road: Strategies for Successful State Implementation of the Affordable Care Act,” is a collaborative effort between multiple national organizations and foundations, and lays out a specifc plan for succesful state implementation of the ACA.

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Essential Benefits

Posted on January 12, 2011

Prior to the enactment of the Affordable Care Act (ACA), federal law did not specify a standard minimum benefit package that must be covered by private health insurance and group health plans. The ACA not only bars discrimination in enrollment or the availability of coverage based on health status, but also establishes a minimum standard of coverage that must be satisfied by individual and small group health plans sold in both exchange and non-exchange markets, as well as by any qualified health plan sold in the state exchange market, regardless of group size.

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