First Edition: April 16, 2015
Today's early morning highlights from the major news organizations.
The New York Times:
Doctors See Benefits And Risks In Medicare Changes
Dr. Robert Wergin, president of the American Academy of Family Physicians, made little effort to contain his glee Wednesday over the news that Congress had voted to end a reviled payment system for doctors, simultaneously averting a 21 percent physician pay cut and overhauling the way Medicare will pay doctors in the future. ... Then he added: “Now, what next?” ... Doctors and health policy experts have begun to take stock of the practical implications of the legislation, which seeks to move away from paying doctors solely on the volume of their services and toward reimbursing them based on the quality and value of the care they provide. Many said the legislation was short on details about how such quality will be measured, and others expressed apprehension about whether the system will be fair. (Thomas and Abelson, 4/15)
Los Angeles Times:
A Look At Key Parts Of Sweeping Bill Changing How Medicare Pays Doctors
The historic compromise legislation passed by the Senate this week will overhaul the way Medicare pays physicians and will create new systems to reward high-performing doctors. The bill, which drew unusual bipartisan support in both chambers of Congress, also includes new funding for state insurance programs for children and for thousands of community health centers nationwide. (Levey, 4/15)
Politico:
GOP Free-For-All Over Reconciliation
Maine Sen. Susan Collins wants to use it for a tax overhaul. Texas Sen. Ted Cruz, for entitlement reform and a massive “pro-growth” agenda. And Rep. Bill Flores of Texas, who chairs the conservative Republican Study Committee, insists it should be used only to gut President Barack Obama’s signature health law. The fast-track reconciliation process — a rare budget procedure that would allow Republicans to jam sweeping legislation through the Senate with a simple majority — is quickly turning into a free-for-all. Dozens of members have different ideas for how to take advantage of the powerful tool, but the two chambers’ leaders will have to settle on a single set of priorities if they want to deploy it. (Bade and Sherman, 4/16)
The Wall Street Journal:
Health Insurers Call For Stronger Rules On Medical Devices
The U.S. health-insurance industry is calling for tougher rules for approving and tracking medical devices, citing regulatory gaps exposed last year when a tool used for decades in hysterectomies was found to spread cancer. America’s Health Insurance Plans, a trade group, said in a letter to Sen. Bob Casey on Tuesday that the dangers of the laparoscopic power morcellator reveal weaknesses in how devices are cleared for use and monitored once they are on the market. The letter was reviewed by The Wall Street Journal. (Kamp, 4/15)
The Wall Street Journal:
Medicare Overpays As Hospital Prices Rise
New Jersey’s Christ Hospital collected $2.93 million in special payments for treating the sickest Medicare patients in 2013, more than quadruple what it had the prior year. Much of the increase didn’t come from treating more patients or providing more care. It came from higher list prices charged by the Jersey City hospital—markups of at least 60% from the prior year for many patients with common diagnoses, billing records show. List prices charged by hospitals aren’t supposed to matter to Medicare because the government doesn’t pay them. The federal program almost always pays fixed amounts based mostly on patients’ conditions. That is supposed to prevent hospitals from sticking the government with big price hikes. Nevertheless, jumps in list prices hit the government every year in one corner of the roughly $600 billion Medicare system: treating complicated cases known as “cost outliers.” (Weaver, Wilde Mathews and McGinty, 4/15)
The Associated Press:
Study: Needless Tests Given To Medicare Cataract Patients
Millions of older people are getting tests they don’t need to prove they are healthy enough to have cataracts removed, a new study finds. The excess testing before this quick, ultrasafe eye procedure is costing them and Medicare a bundle, and many patients don’t know they can question it, doctors say. (Marchione, 4/15)
The Washington Post:
Congress To VA About Denver Hospital: ‘How Are We Going To Pay For It?’
How is the Department of Veterans Affairs going to pay for it? That was just one of the woes tackled at a tense, nearly three-hour congressional hearing on Wednesday on the most expensive construction project in the VA’s history: a still uncompleted $1.7 billion hospital in suburban Denver, which a number of lawmakers again and again said was causing “bipartisan heartburn and angst.” (Wax-Thibodeaux, 4/15)
The Associated Press:
VA Employee Says He Was Fired After Warning Of Hospital Cost
A whistleblower said he was fired by the Veterans Affairs Department after warning of cost overruns at the Denver VA hospital, prompting a rebuke Wednesday from members of Congress who questioned why higher-ranking executives haven't been punished. VA contract specialist Adelino Gorospe warned department executives in 2011 that the hospital would cost more than official estimates, The Denver Post reported. Gorospe told the newspaper that he was fired in 2012 for allegedly disobeying a supervisor. (Elliott, 4/15)
The Wall Street Journal:
HCA Holdings Raises Full-Year Guidance
Hospital operator HCA Holdings Inc. on Wednesday reported better-than-expected preliminary results for the March quarter and raised its full-year guidance amid higher admissions and emergency-room visits. Shares of HCA, up 62% over the past year, rose 3.1% to $79.70 in morning trading. (Chen, 4/15)
The Associated Press:
UnitedHealth Tops Street 1Q Forecasts
UnitedHealth Group Inc. (UNH) on Thursday reported first-quarter profit of $1.41 billion. On a per-share basis, the Minneapolis-based company said it had net income of $1.46. The results surpassed Wall Street expectations. The average estimate of 16 analysts surveyed by Zacks Investment Research was for earnings of $1.33 per share. (d4/16)
The Associated Press:
FDA Approves New Type Of Heart Failure Drug From Amgen
Patients with chronic heart failure, a disabling, deadly disease that worsens as the heart gradually pumps less efficiently, are getting a much-needed new option with U.S. approval Wednesday of a novel drug from Amgen Inc. Corlanor is the first medication in a dozen years for heart failure, which is becoming more common with obesity — and more people surviving heart attacks due to better treatments. (Johnson, 4/15)
The Wall Street Journal's Pharmalot:
Will A New Vertex Drug For Cystic Fibrosis Become A Budget Buster?
As the national debate over the cost of prescription medicines intensifies, a pharmacy benefits manager is warning that a forthcoming combination treatment for cystic fibrosis may become the latest example of a budget-busting drug. In an analysis of insured patients, Prime Therapeutics estimates that it may cost as much as $4.5 billion annually for the nation’s health care system to pay for a combination medicine that includes Kalydeco – an existing and treatment sold by Vertex Pharmaceuticals – along with another Vertex compound. (Silverman, 4/15)
The Wall Street Journal:
Eye Doctor With Ties To Sen. Menendez Arrested
Federal authorities arrested a Florida eye doctor who faces bribery charges with New Jersey Sen. Robert Menendez and held him in custody after he was indicted in a separate fraud case. Salomon E. Melgen, of North Palm Beach, Fla., was charged with 46 counts of health-care fraud for, among other things, allegedly submitting false claims to Medicare between 2004 and 2013, receiving $105 million in payments over six of those years from the federal program for the elderly and disabled. (Stewart, 415)
The Associated Press:
Doctor Tied To Menendez Remains Jailed On Medicare Charges
A Florida doctor charged with corruption alongside New Jersey Sen. Robert Menendez was sent back to jail for a second night Wednesday while his lawyers try to negotiate his bond over allegations of Medicare fraud. (Sedensky, 4/15)
The Washington Post's Wonkblog:
These States Leave The Most Mentally Ill Adults Untreated. Guess What Else They Have In Common.
The politics of Obamacare have produced a geographic divide in mental health care. Uninsured, low-income Americans in the east, mid-Atlantic and Pacific are receiving more treatment through the Medicaid expansion, while those in the south and central U.S. are not, according to a new report. Nearly 568,000 uninsured people who have been diagnosed with a serious mental health condition would have received treatment in 2014 if their states had chosen to expand Medicaid, according to the American Mental Health Counselors Association, a professional organization that does advocacy and education. (Swanson, 4/14)
USA Today:
Half The States Look At Right-To-Die Legislation
More than a dozen states, plus the District of Columbia, are considering controversial medically assisted death legislation this year. The laws would allow mentally fit, terminally ill patients age 18 and older, whose doctors say they have six months or less to live, to request lethal drugs. (Monir, 4/15)
The Washington Post:
A New Fetal Homicide Bill In Colorado Resurrects An Old Abortion Debate
On Tuesday, a new bill was introduced to the Colorado Senate directly in response to the horrific attack. The bill, its supporters say, would make it easier for prosecutors to bring murder charges against those, like Lane, who are accused of killing a fetus. The new measure’s opponents, however, have argued that the bill is too similar to previous proposals in the state that would have included fetuses in the state’s definition of a person. (Ohlheiser, 4/15)
The Wall Street Journal:
N.J. Cities Pass Paid-Sick-Leave Laws Despite Opposition From Christie
Gov. Chris Christie opposes requiring businesses to give workers paid sick days, calling it another onerous regulation that deters companies from investing in New Jersey. That hasn’t stopped officials in nine municipalities, including Newark, Jersey City and Montclair, from passing paid-sick-leave laws and enforcing them—without the consent of Mr. Christie or the state Legislature. (Dawsey, 4/15)