February 28, 2005
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MHA's Monday Executive Briefing
February 28, 2005
In this week's edition...
State News
1. DNC chair Dean to visit Jackson for fund-raiser
2. Gov. taps Pierce to fill Chancery Court post
National News
3. CMS Announces Change To MA Rates, Reinsurance Demonstration
4. Report Forecasts Shift In Healthcare Spending From Private To Public Sector With MMA
5. Governors Urged to Reach Deal on Medicaid
6. Lawsuit dismissal trend continues in Illinois, Miami
7. Federal Medicaid Assistance Percentages (FMAP) and Enhanced FMAP for FFY 2006 available in the Federal Register
8. Bill would repeal Medicare outpatient therapy caps
9. Medicaid budget proposals would shift costs to states and be likely to cause reduction in health coverage
10. Senate bill calling for Medicaid Commission gets companion in House
State News
1. DNC chair Dean to visit Jackson for fund-raiser
Howard Dean, the new head of the Democratic National Committee, will be in Mississippi on March 1 to help raise money for his party and roll out his strategy to energize Southern Democrats.
Dean will be the keynote speaker in Jackson for the state Democratic Party's first Democratic Elected Officials Appreciation Dinner, a fund-raiser. Tickets for the dinner are $75.
For more information, contact the state party at (601) 969-2913 or visit www.msdemocrats.net.
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2. Gov. taps Pierce to fill Chancery Court post
Gov. Haley Barbour on Feb. 25 named House Education Committee Chairman Bubba Pierce, D-Leakesville, to fill a vacant chancery court judgeship. This will lead to two races: one for the chairmanship and the other for Pierce's House seat.
Pierce, who served in the House for five years, said he plans to serve the remainder of retired Judge Glenn Barlow's term, then put his name on the ballot in November 2006. He resigned his House seat on Feb. 25.
Pierce, a University of Southern Mississippi graduate, is a lawyer and a certified public accountant.
Candidate's expected to run for his House seat include Pierce's law partner Paul Walley of Richton; John Walley (no relation), a Greene County educator and brother of Sen. James Walley, D-Leakesville; and G. L. Dearman of Leakesville, a Greene County supervisor and businessman.
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National News
3. CMS Announces Change To MA Rates, Reinsurance Demonstration
CMS issued February 18 an advance notice that it is changing the methodology for determining the Medicare Advantage (MA) capitation rates for 2006. The agency said that the current estimate for the change in the national per capita MA growth percentage for elderly Medicare beneficiaries in calendar year 2006 is 4%. CMS also issued a draft notice for a Medicare Part D Reinsurance Payment Demonstration for 2006. The demonstration is intended to test whether methods of reimbursement will increase the efficiency of the program without adversely affecting quality.
To read CMS' notice about the 2006 MA rates, click here.
To read the draft notice about the demonstration, click here (PDF file).
To receive daily updates on Medicare issues, join the Medicare/Medicaid Community at MyMHA.
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4. Report Forecasts Shift In Healthcare Spending From Private To Public Sector With MMA
As the Medicare Modernization Act (MMA) is implemented, the public sector will pick up an increasing share of the nation’s healthcare spending tab over the next decade, according to a new report by the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary, which was published February 23 in the online journal Health Affairs. The report, "U.S. Health Spending Projections for 2004-2014," factors in the effects of the new Medicare prescription drug benefit under the MMA on the nation's health spending for the next ten years. The greatest impact of the new drug benefit, said the report, will be a significant shift in the source of payment for prescription drugs from the private sector, Medicaid, and consumers to the Medicare program. In 2006, Medicare funds will account for 28% of total drug spending, up from 2% in 2005, the report forecasts. The report also predicts that health spending will comprise 18.7% of GDP by 2014, up from 15.3% of GDP in 2003.
To read the report, "U.S. Health Spending Projections for 2004-2014," click here. To receive daily updates on Medicare issues, join the Medicare/Medicaid Community at MyMHA.
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5. Governors Urged to Reach Deal on Medicaid
The Bush administration is urging the nation's governors to reach early agreement on a restructuring plan for the Medicaid health program for the poor or risk steep budget cuts in the Republican-controlled Congress, according to governors of both parties meeting this week in Washington. For the full story from The Washington Post, click here.
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6. Lawsuit dismissal trend continues in Illinois, Miami
The U.S. District Court for the Southern District of Illinois on Feb. 23 granted motions to dismiss filed by Protestant Memorial Medical Center, Inc. of Belleville, IL and the AHA. The court and hospital are located in the same part of Illinois that President Bush visited in January, when he talked about the need for tort reform and cited a study that named Belleville and its surrounding areas one of the most plaintiff- and trial lawyer-friendly areas of the country.
The judge dismissed federal claims with prejudice and state claims without prejudice, which allows those state claims to be refiled in state court.
In other cases still in play, plaintiffs on Feb. 18 voluntarily dismissed the AHA from cases filed against Phoebe Putney Memorial Hospital in Albany, GA, and John D. Archbold Memorial Hospital in Thomasville, GA.
The U.S. District Court for the Southern District of Florida on Feb. 23 ruled in favor of Baptist Hospital of Miami Inc., Baptist Health South Florida and the AHA, dismissing all but one of the federal claims with prejudice. In dismissing the EMTALA claim, the court said, "The plaintiffs have neither alleged nor have they shown that they suffered anything other than 'economic injury and other damages,'" which do not meet the personal harm required for an EMTALA claim. The court dismissed the federal Fair Debt Collection Practice Act claim without prejudice, permitting the plaintiffs to amend the complaint and replead that claim. As in other cases, the court declined to exercise jurisdiction over state claims and dismissed them without prejudice. Those state claims can be refiled in state court.
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7. Federal Medicaid Assistance Percentages (FMAP) and Enhanced FMAP for FFY 2006 available in the Federal Register
The Federal Medical Assistance Percentages and Enhanced Medical Assistance Percentages for Federal Fiscal Year 2006 have been calculated (effective October 1, 2005 through September 30, 2006), and will be used to determine the amount of Federal matching for State medical assistance (Medicaid) and State Children's Health Insurance Program (SCHIP) expenditures, Temporary Assistance for Needy Families (TANF) Contingency Funds, the federal share of Child Support Enforcement collection, Child Care Mandatory and Matching Funds of the Child Care and Development Fund, Foster Care Title IV-E Maintenance payments and Adoption Assistance payments.
The "Enhanced Federal Medical Assistance Percentages" are for use in the State Children's Health Insurance Program under Title XXI, and in the Medicaid program for certain children for expenditures for medical assistance described in sections 1905(u)(2) and 1905(u)(3) of the Social Security Act. There is no specific requirement to publish the Enhanced Federal Medical Assistance Percentages but they are included in this notice for the convenience of the States.
To access this information as it is reported in the Federal Register, click here.
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8. Bill would repeal Medicare outpatient therapy caps
Legislation introduced in the House and Senate recently would permanently repeal the cap on outpatient therapy services under Medicare. A congressionally approved moratorium on the annual cap on occupational, physical and speech therapy services is set to expire at the end of this year, at which time a Balanced Budget Act provision would impose an annual limit of about $1,700 per beneficiary on the services. Sponsors of the legislation (S. 438/H.R. 916) include Sens. John Ensign, R-NV, and Blanche Lincoln, D-AR, and Reps. Roy Blunt, R-MO, and Phil English, R-PA.
To receive daily updates on Medicare issues, join the Medicare/Medicaid Community at MyMHA.
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9. Medicaid budget proposals would shift costs to states and be likely to cause reduction in health coverage
The President's budget for fiscal year 2006 includes major proposals relating to Medicaid, the health care and long-term care program for low-income Americans that is jointly funded by the federal government and the states. The Administration proposes to reduce net federal funding for Medicaid by $45 billion over the next ten years. For the full story, click here.
To receive daily updates on Medicaid issues, join the Medicare/Medicaid Community at MyMHA.
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10. Senate bill calling for Medicaid Commission gets companion in House
Rep. Heather Wilson (R-NM) recently introduced a bill (H.R. 985) in the House that calls for the creation of a bipartisan commission to study how best to reform Medicaid. The legislation, with 57 cosponsors, is a companion bill to one introduced in the Senate (S. 338) by Sens. Gordon Smith (R-OR) and Jeff Bingaman (D-NM), and which has 19 cosponsors so far. As Congress debates President Bush's proposal to slash $60 billion from Medicaid, this legislation would provide the right setting to carefully deliberate needed policy changes and ensure the long-term financial stability of the program.
To receive daily updates on Medicaid issues, join the Medicare/Medicaid Community at MyMHA.
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