IOM Essential Benefits Recommendations Draw Criticism
A letter sent to Health and Human Services Secretary Kathleen Sebelius from more than 2,400 health care providers and advocates offered objections to the Institute of Medicine's recommendations regarding what benefits must be covered in state health insurance marketplaces. Additionally, Sen. Orrin Hatch, R-Utah, offered a warning regarding an Internal Revenue Service proposal on premium assistance in the health law's insurance exchanges.
Boston Globe: Health Providers, Advocates Criticize Institute Of Medicine On Insurance Recommendations
More than 2,400 health care providers and advocates sent a letter to Secretary of Health and Human Services Kathleen Sebelius today objecting to recommendations made by a panel of the Institute of Medicine regarding what benefits must be covered in state health insurance marketplaces developed under the Affordable Care Act. ... The critics objected to the group's decision to start with a typical small business plan rather than a more comprehensive plan offered by larger employers (Conaboy, 12/1).
The Hill: HHS Urged To Reject Report On Essential Benefits
Doctors and health care executives on Thursday slammed a set of expert recommendations on how to define "essential" health benefits. More than 2,400 people signed a letter urging the Health and Human Services Department to reject recommendations from the Institute of Medicine as it defines the essential benefits that all health plans will soon have to cover (Baker, 12/1).
Modern Healthcare: Letter To Sebelius Criticizes IOM's 'Essential Benefits' Recommendations
More than 2,400 people have signed an open letter to HHS Secretary Kathleen Sebelius protesting the Institute of Medicine's recommendations for defining "essential benefits," which the signers said give more weight to "cost rather than medical need." The letter, signed mostly by doctors — including IOM members — and circulated by the Physicians for a National Health Program single-payer advocacy group, also stated that the IOM committee that drafted the report was "riddled with conflicts of interest" as several members had "amassed personal wealth" through association with insurance companies and other for-profit health care ventures (Robeznieks, 12/1).
The Hill: Hatch IRS Can't Offer Tax Credits In Federal Insurance Exchange
The IRS is extending the health care law's insurance subsidies to millions of people who shouldn't get them, Sen. Orrin Hatch (R-Utah) charged Thursday. The health care law establishes exchanges where individuals and small businesses can shop for insurance, and most people who use an exchange will receive tax credits to help make insurance more affordable. The law directs states to set up their own exchanges and authorizes a federally run "fallback" in any state that doesn't (Baker, 12/1).
CQ HealthBeat: Hatch Issues Warning On IRS Proposal On Premium Assistance In Exchanges
The ranking Republican on the Senate Finance Committee said Thursday that the Obama administration doesn't have the legal authority to change language in the health care law dealing with premium assistance to state exchanges. Orrin G. Hatch of Utah wrote to Treasury Secretary Timothy Geithner and IRS Commissioner Douglas Shulman protesting a proposed rule that would extend premium assistance to federally operated exchanges. Hatch said any such changes have to be made by Congress, not the executive branch (Norman, 12/1).
Meanwhile, on the subject of accountable care organizations —
Kaiser Health News: ACOs Are Bursting Out All Over
ACOs, as defined in the 2010 health law, are a delivery model that offers doctors and hospitals financial incentives to provide good quality care to Medicare beneficiaries while keeping costs down. But that program hasn't even launched yet, and already there are 164 'ACO entities' in the country, according to the Leavitt report" (Gold, 12/1).
And in the states —
Politico Pro: Rhode Island Lawsuit Tries To Block Exchange
The group Rhode Island Right to Life and 28 state lawmakers filed a lawsuit Thursday against Gov. Lincoln Chafee over his decision to issue an executive order establishing a state insurance exchange. The complaint, filed in Rhode Island Superior Court, says Chafee is overreaching his powers as governor by bypassing the Legislature to set up an exchange under the federal health care law. Exchange legislation failed this summer after anti-abortion provisions were attached to the Senate bill by Senate President Teresa Paiva-Weed — language that was considered a nonstarter in the House. Chafee became the first governor in the nation to establish an exchange via executive order in September (Nocera, 12/1).
Kansas Health Institute News: Feds Extend Grant Deadline For Health Insurance Exchanges
[The six-month extension] move, along with others announced Tuesday by the U.S. Department of Health and Human Services, would appear to give Kansas officials a bit more breathing room as they weigh the options of the state running its own exchange versus letting the federal government do it for them. Kansas Insurance Commissioner Sandy Praeger said ... state officials would still need to beat the new deadline by about two months, if Kansas is to have enough time to develop and certify its own exchange (Shields, 12/1).