Some Unions Grow Wary of Health Law They Backed

Some Unions Grow Wary of Health Law They Backed-wallstreetjournal: Labor unions enthusiastically backed the Obama administration's health-care overhaul when it was up for debate. Now that the law is rolling out, some are turning sour. Union leaders say many of the law's requirements will drive up the costs for their health-care plans and make unionized workers less competitive. Among other things, the law eliminates the caps on medical benefits and prescription drugs used as cost-containment measures in many health-care plans. It also allows children to stay on their parents' plans until they turn 26.

Idaho state Sen. Sheryl Nuxoll compares health care to Holocaust

Idaho state Sen. Sheryl Nuxoll compares health care to Holocaust-politico: BOISE, Idaho - A Republican state senator is drawing comparisons between the roles insurance companies are playing in the federal health care overhaul to the plight of Jews during the Holocaust.

Industry groups commit to war against medical device tax as 1st due date arrives

Industry groups commit to war against medical device tax as 1st due date arrives-massdevice: Medical device lobbying groups are remobilizing efforts to repeal a 2.3% sales tax as the industry scrambles to meet the 1st payment deadline this month. A trio of industry advocates banded together to urge Congress to take action on the tax, which they estimate will cost medical device makers about $194 million per month.

Specialty groups back IPAB repeal

Specialty groups back IPAB repeal-healthwatch: A coalition of medical specialties said Tuesday that it supports a bill to repeal the controversial cost-control board in President Obama's signature healthcare law. The Alliance of Specialty Medicine — a coalition of specialty groups including brain surgeons, plastic surgeons and heart doctors — said it wants Congress to repeal the Independent Payment Advisory Board (IPAB).

The Health-Care Law and Retirement Savings

The Health-Care Law and Retirement Savings-newyorktimes: Even though the Affordable Care Act is known as a health-insurance law, in effect it could be paying for a large portion of employer contributions to pension plans. This has the potential of changing retirement savings and the relative living standards of older and working-age people.

Dems Yet To Respond To Hatch On Medicare Reform Proposals

Dems Yet To Respond To Hatch On Medicare Reform Proposals-insidehealthpolicy: Sen. Orrin Hatch (R-UT) said Democrats have yet to respond to him on the five Medicare and Medicaid structural reforms he floated last week as ideas that could gain bipartisan backing, but a Hatch aide said the lack of response could also be viewed as a good sign in that Democrats at least have not attacked the ranking Finance Committee Republican for trying to “destroy Medicare.” Senate Republicans are urging their Democratic colleagues to immediately begin negotiating on Medicare reforms, but Democrats say they will only agree to Medicare changes if Republicans agree to increase tax revenue and cut defense spending.

Workforce panel unfunded as doctor ‘crisis’ looms

Workforce panel unfunded as doctor ‘crisis’ looms-politico: A panel charged with helping devise solutions to the nation’s health care workforce crisis is having a workforce crisis of its own: It hasn’t been funded and it’s never met.Created by Congress nearly three years ago under the health care law, the panelists were appointed, but that’s about as far as it has gone. The lack of action was noted at a Senate Aging subcommittee hearing on Tuesday.

Doctors Heavy Caseloads Put Patients at Risk, Study Shows

Doctors Heavy Caseloads Put Patients at Risk, Study Shows-bloomberg:  Almost half of hospital doctors said they routinely see more patients than they can safely manage, leading in some cases to unneeded tests, medication errors and deaths, according to a survey by researchers at Johns Hopkins University. Seven percent of 506 hospital-based physicians surveyed said their heavy workload likely led to a patient complication, and 5 percent reported it probably caused a death over the past year. The findings are published in a research letter released yesterday by JAMA Internal Medicine.

Researchers call for more stringent FDA oversight of medtech

Researchers call for more stringent FDA oversight of medtech-massdevice: MASSDEVICE ON CALL — A commentary co-authored by the California and Australian researchers called for the FDA to close the 510(k) "loophole" that allows medical devices considered a potentially "high risk" to patients to enter the U.S. market without undergoing clinical trials.

Hatch Lays Out Five Medicare, Medicaid Structural Reforms He Thinks Could Gain Bipartisan Backing

Hatch Lays Out Five Medicare, Medicaid Structural Reforms He Thinks Could Gain Bipartisan Backing-insidehealthpolicy: Senate Finance ranking member Orrin Hatch (UT) Thursday morning outlined five structural reforms to Medicare and Medicaid that he says could gain bipartisan backing and should be included in a serious deficit reduction package. Hatch’s list includes transforming Medicare into a “per capita cap” system, raising the Medicare eligibility age to 67, changing Medicare into a premium support-type system where plans bid against traditional Medicare, combining Part A and B deductibles and reforming “Medigap” coverage -- all reforms which he says have gained bipartisan backing in the past.

U.S. companies face tax scrutiny overseas

U.S. companies face tax scrutiny overseas-politico: Foreign governments grappling with austerity budgets have found a new source of revenue for their public treasuries, and a target for their political ire: U.S. multinational companies. And the scrutiny is only going to intensify — even though most foreign politicians admit corporations seeking to keep their tax bills low are not breaking the law.

Primer on U.S. FDA's new 510(k) refuse to accept policy

Primer on U.S. FDA's new 510(k) refuse to accept policy-massdevice: The US Food and Drug Administration's revised Refuse to Accept (RTA) policy (links to PDF document) for 510(k) applications that lack all required documentation is now in effect. Medical device manufacturers planning to undergo the premarket notification process should familiarize themselves with steps necessary to get their applications back on track in the event that they receive an RTA notice from the FDA.

Groups Urge Feds to Issue Physician Payments Final Rule

Groups Urge Feds to Issue Physician Payments Final Rule-healthleadersmedia: Groups and coalitions representing physicians, labor unions, and distributors are expressing frustration that little progress has been made on a final rule outlining full disclosure procedures for medical device manufacturers and pharmaceutical companies.The Centers for Medicare & Medicaid Services set a deadline of October 2011. "We are now 15 months passed the statutory deadline for this vital regulation," said Curtis Rooney, president of the Healthcare Supply Chain Association in a media  statement last week. "The sooner the healthcare supply chain realizes full implementation of the Physician Payments Sunshine Act the sooner patients will realize the full benefits."

Device tax will "absolutely, directly, negatively influence job growth"

Device tax will "absolutely, directly, negatively influence job growth" -massdevice: MASSDEVICE ON CALL — The 1st payments for the 2.3% medical device tax which took effect this year are due at the end of the month, and the burden of those new fees will "absolutely, directly, negatively influence job growth," BioMimetic Therapeutics founder Sam Lynch told reporters.""The challenge of the tax is that it's on revenue, not earnings, so for companies that might not be profitable already, it will hit harder," Lynch told the Nashville Biz Blog.

Grassley pushes for 'Sunshine' rule release

Grassley pushes for 'Sunshine' rule release-politico: Sen. Chuck Grassley is demanding — once again — that CMS release a long-delayed rule that will require drug and device makers to disclose financial relationships with doctors. The Iowa Republican sent a letter Tuesday to White House chief of staff Jack Lew, arguing that the rule is 15 months past a deadline set by the Physician Payments Sunshine Act — a part of the 2010 federal health care law.

Gingrich: Attack ACA Bit by Bit

Gingrich: Attack ACA Bit by Bit-medpage: WASHINGTON -- Congressional Republicans should abandon an all-or-nothing approach and examine smaller aspects of the Affordable Care Act (ACA) to change or repeal, according to former Speaker of the House of Representatives Newt Gingrich. Lawmakers who want to repeal President Obama's signature health reform law would have better results if they go after the least effective and most disruptive aspects of the law, Gingrich told reporters after meeting with the Congressional Health Care Caucus -- a group of House Republicans interested in healthcare issues -- for more than an hour here Tuesday morning.

Device tax: Opponents in Senate look for new avenues for repeal

Device tax: Opponents in Senate look for new avenues for repeal-massdevice: Medical device tax opponents Sens. Amy Klobuchar (D-Minn.) and Al Franken (D-Minn.) discuss ways in which repeal efforts failed and look for new in-roads to bring back the fight.

Details of Russian medical device regulatory changes emerge

Details of Russian medical device regulatory changes emerge-massdevice: Revised regulations (in Russian only) for the Russian medical device market have been in effect since January 1, 2013, and Emergo Group has now learned more details of these changes, although some specifics of the new rules are still needed.All medical device registrations submitted to Russian medical device market regulator Roszdravnadzor after January 1, 2013 will fall under the new requirements; applicants seeking registration under the previous regulations must provide a written statement to Roszdravnadzor as soon as possible.

Mexico readies GMP, technovigilance requirements for medical devices

Mexico readies GMP, technovigilance requirements for medical devices-massdevice: The Mexican Ministry of Health now has in place two new processes that will impact medical device manufacturers registered or planning to register with COFEPRIS.

FDA: Don’t Rely On Device Labeling To ‘Design Out’ Product Risks

FDA: Don’t Rely On Device Labeling To ‘Design Out’ Product Risks-thegraysheet: Manufacturers shouldn’t make the mistake of using product labeling to mitigate device risks, according to a recent FDA draft guidance. Instead, firms should “design out” those risks to ensure that they only make quality products, an agency official says.

New EU electronic labeling rules for medical devices coming in March 2013

New EU electronic labeling rules for medical devices coming in March 2013-massdevice: The EU Commission Regulation on electronic labeling will come into effect on 1 March, 2013.This regulation outlines how Instructions for Use may be provided in electronic format to professional users for certain medical devices under the Medical Device Directive and Active Implantable Medical Device Directive. 

Opinion: Don’t give up on tax reform

Opinion: Don’t give up on tax reform-politico: Some observers were quick to conclude that the New Year’s Eve fiscal cliff agreement “killed” tax reform for 2013. It’s certainly true that President Barack Obama’s insistence on a tax rate hike as the price for preventing trillions of dollars in tax increases on all Americans was a huge missed opportunity. But reports of the death of tax reform are greatly exaggerated. As a new member of the Senate Finance Committee, I am confident that an overhaul of our broken tax system remains not only doable but essential for job creation and economic growth.

Dems have few options for taking House in 2014

Dems have few options for taking House in 2014-politico: Democrats are promising an all-out blitz to win the House in 2014. There’s just one lingering question: Which Republicans can really be unseated? The problem: Republicans used the once-a-decade redistricting process to shore up many of their members, leaving Democrats with few ripe GOP targets. Only four Republican incumbents are in seats that tilt toward Democrats — a fraction of the 17 seats Democrats need to net in order to seize the majority.

Clamor for Sunshine Act Rules Continues

Clamor for Sunshine Act Rules Continues-medpage: Demand is growing for the Obama administration to issue regulations implementing the Physician Payments Sunshine Act (PPSA), a provision of the Affordable Care Act that requires drug and device makers to publicly disclose their financial relationships with physicians, including how much money they are being paid. On Tuesday, a group of prominent physicians including former New England Journal of Medicine editors Marcia Angell, MD, and Jerome Kassirer, MD, wrote to outgoing White House Chief of Staff Jack Lew expressing their concerns about the lack of action.

FDA Weighs Special Medical Use Pathway As Legislative Activities Continue

FDA Weighs Special Medical Use Pathway As Legislative Activities Continue-insidehealthpolicy: FDA's new effort to establish a new limited use drug approval pathway -- one mimicking the Limited Population Antibacterial Drug approval mechanism floated during user fee debates last year -- is viewed by many stakeholders as a way to supplement legislative efforts to set up an LPAD scheme. FDA next month will hold a public meeting to gather input on a “potential new pathway to expedite” the development of drugs limited to smaller populations that address unmet medical needs.

Harry Reid: Obama Was Willing To Give Up Presidency For Health Care Reform

Harry Reid: Obama Was Willing To Give Up Presidency For Health Care Reform-huffingtonpost: As President Barack Obama begins a second term, Senate Majority Leader Harry Reid (D-Nev.) offered candid observations on the president's leadership style, noting that Obama was willing to risk his presidency to pass health care reform. During an interview with KSNV, an NBC affiliate in Las Vegas, Reid reflected on Obama's struggle to pass the Affordable Care Act, one of the signature accomplishments of his first term.

House GOP's fiscal split looms large for President Obama

House GOP's fiscal split looms large for President Obama-politico: The fiscal cliff deal that raised taxes on the wealthy split the House GOP Conference between red-state and blue-state Republicans and delivered a big win for President Barack Obama on his signature campaign issue. But it left unanswered a question with big implications for Obama’s second term: If the president could divide and conquer House Republicans on tax increases, can he do it again on the debt ceiling, guns and immigration?

In Kerry’s Departure From Senate, Device Industry Will Lose A Well-Positioned Friend

In Kerry’s Departure From Senate, Device Industry Will Lose A Well-Positioned Friend-thegraysheet: Sen. John Kerry’s expected departure from the Senate to become President Obama’s second secretary of state will mean the loss of an important advocate for medical imaging and device interests, industry sources say.
The Massachusetts Democrat, chair of the Senate Foreign Relations Committee and a longstanding member of the Senate Finance Committee, was tapped by President Obama Dec. 21 to succeed Hillary Rodham Clinton as secretary of state. He is expected to undergo Senate confirmation before the end of February.

Health Insurers to Obama: Make Obamacare's Individual Mandate Stronger

Health Insurers to Obama: Make Obamacare's Individual Mandate Stronger-Forbes: One of Obamacare’s dark secrets is that its individual mandate—forcing nearly all Americans to buy health insurance—is too weak. If you’re going to double the cost of health insurance for young people, and thereby increase premiums by thousands of dollars, many people will be better off going without insurance and paying the mandate’s fine. Insurers have always understood this problem. Today, Politico reports that some insurers are asking the Obama administration to impose additional penalties and fees on top of the mandate, so that more people are forced to buy Obamacare’s costly products.

CMS Unveils 106 More ACOs; Estimates They Save $940M In Four Years

CMS Unveils 106 More ACOs; Estimates They Save $940M In Four Years-insidehealthpolicy: As accountable care organizations catch on, they could save up to $940 million over four years, CMS said Thursday (Jan. 10) as it announced 106 new ACOs, bringing to about 250 the number of ACOs formed since passage of the health reform law, which applied the ACO concept to Medicare. CMS also unveiled a report finding that Medicare spending per beneficiary grew only 0.4 percent in fiscal 2012, and a few health care lobbyists say that as the growth in health care spending slows, it becomes increasingly difficult for lawmakers to squeeze additional savings from Medicare.

Fiscal Deal Lets Physicians Participate In Clinical Data Registries In Lieu Of PQRS

Fiscal Deal Lets Physicians Participate In Clinical Data Registries In Lieu Of PQRS-insidehealthpolicy: Medical specialty societies that have been urging the administration and Congress to allow provider participation in qualified clinical data registries to count towards the Physician Quality Reporting System (PQRS) requirements are thrilled that their proposal made it into the “fiscal cliff” deal. Inside Health Policy has also learned that CMS intends to examine ways that clinical registries could be used to satisfy meaningful use requirements, and plans to seek public input on the concept sometime in the next few weeks as part of a request for comments on the development of criteria for a “qualified” registries.

MedPAC, Facing Industry Pressure, Clarifies Its Intent For Hospital Pay Hike In 2014

MedPAC, Facing Industry Pressure, Clarifies Its Intent For Hospital Pay Hike In 2014-insidehealthpolicy: Congress' Medicare payment advisors Thursday (Jan. 10) reassured hospitals that they support a 1 percent payment update for the industry in 2014 after lawmakers' cuts to offset the Medicare physician payment patch and potential upcoming payment reductions from sequestration are taken into account. It's Congress' prerogative to set the final payment rates, MedPAC Chairman Glen Hackbarth said, but the Medicare Payment Advisory Committee will recommend an overall positive update for hospitals. Hospital groups had appealed to MedPAC to clarify that its proposed 1 percent payment update would not be voided by the “doc fix” offset and looming sequestration cut.

FDA Expands Network Of Experts After Successful Pilot

FDA Expands Network Of Experts After Successful Pilot-thegraysheet: The Network of Experts, which connects CDRH scientists with outside professional societies, has been made a permanent program within the device center.The device center’s Network of Experts program has grown from a three-organization pilot in 2011 to a permanent program with 19 professional societies participating as of this month. Due to its success, FDA is considering expanding the program to other review centers in the future.

FDA, NIH withdraw rules shielding documents

FDA, NIH withdraw rules shielding documents-politico: The FDA and NIH withdrew regulations Thursday afternoon that would have shielded records of scientific misconduct investigations from disclosure, citing “significant adverse comment.” First issued Aug. 28, the direct final rules would have exempted records from “certain provisions of the Privacy Act of 1974” to protect the integrity of such investigations and “to protect confidential sources,” according to the FDA  and NIH withdrawal notices posted in the Federal Register.

Nancy Pelosi's claim that the GOP would raid Medicare for tax cuts

Nancy Pelosi's claim that the GOP would raid Medicare for tax cuts-washingtonpost: “We already have an Affordable Care Act. We found savings of over $700 billion by slowing the increase and the rate of reimbursement to certain providers. We used that $700 billion to increase benefits to seniors and the Republicans took the same money and used it for a tax cut at the high end and said that we were cutting benefits, which we weren’t.”— House Democratic Leader Nancy Pelosi (Calif.), on CBS’s “Face the Nation,” Jan. 6, 2013
We are reluctant to re-litigate the rhetoric of the 2012 presidential campaign, but this comment by Rep. Nancy Pelosi about the House GOP budget jumped out at us.

Hospitals Urge MedPAC To Rethink Pay Proposals Due To $11B Cut In Fiscal Cliff Law

Hospitals Urge MedPAC To Rethink Pay Proposals Due To $11B Cut In Fiscal Cliff Law-insidehealthpolicy: Hospitals are appealing to Congress' Medicare payment advisors to rethink draft payment proposals they plan to take up Thursday (Jan. 10), saying the proposals when taken in conjunction with the $11 billion hit to hospitals in the fiscal cliff law's “doc fix” and upcoming sequestration cuts would equate to an unwarranted payment cut across the industry. In a letter to the commissioners, the American Hospital Association and the Federation of American Hospitals say hospitals need much bigger payment updates than called for by the draft recommendations.

Lew announcement set for Thursday afternoon

Lew announcement set for Thursday afternoon-politico: President Barack Obama on Thursday afternoon will announce that White House chief of staff Jack Lew is his nominee to be the next Treasury secretary, according to the White House.The announcement is set for 1:30 p.m. in the East Room, and Treasury Secretary Timothy Geithner, who plans to leave his post at the end of the month, will be in attendance.

The Corporate-Tax Change That Could Raise $114 Billion

The Corporate-Tax Change That Could Raise $114 Billion-nationaljournal: Just one tweak to the way the United States taxes corporations could raise $114 billion over 10 years, according to a new report from the Congressional Budget Office, the agency that provides economic analysis to Congress.

The costs of not-so-shared decision making

The costs of not-so-shared decision making-massdevice: This week's New England Journal of Medicine contains a perspective piece by Emily Oshima Lee, M.A., and Ezekiel J. Emanuel, M.D., Ph.D. entitled "Shared Decision Making to Improve Care and Reduce Costs." The original paragraph of the piece sets the tone:

Consumers Met With OMB Dec. 27 To Seek Issuance Of Strict Sunshine Rule

Consumers Met With OMB Dec. 27 To Seek Issuance Of Strict Sunshine Rule-insidehealthpolicy:  Consumer advocates met with White House officials Dec. 27 to urge them to quickly review the long-overdue physician-payment disclosure regulation and reject several revisions sought by the American Medical Association, according to consumer representatives who attended the meeting. CMS officials last year said they hoped to release the regulation by the end of 2012, and a couple of physician groups pointed out to the agency last week that it missed that goal.

Berwick eyeing run for Massachusetts governor

Berwick eyeing run for Massachusetts governor-politico: Former Obama administration Medicare chief Don Berwick — vilified by Senate Republicans who made his confirmation impossible — is considering a run for Massachusetts governor in 2014, he told POLITICO late Tuesday

Obamacare Guarantees Higher Health Insurance Premiums -- $3,000+ Higher

Obamacare Guarantees Higher Health Insurance Premiums -- $3,000+ Higher-Forbes: President Obama will deliver a second inaugural address later this month. He’ll no doubt reflect on what he’s done during his first four years in office — and on his signature healthcare law in particular.

PCORI Chooses Initial Projects, With Minimal Device/Diagnostic Focus

PCORI Chooses Initial Projects, With Minimal Device/Diagnostic Focus-thegraysheet: Only four projects have a device- or diagnostic-related implication.

CMS misses its own Sunshine Rule deadline

CMS misses its own Sunshine Rule deadline-massdevice: The Centers for Medicare & Medicaid Services misses its own deadline for issuing a final rule on the Physician Payments Sunshine Act.

Medtech outlook 2013: Major environmental factors for the year ahead

Medtech outlook 2013: Major environmental factors for the year ahead-massdevice: 2013 looks to be a challenging year for medical device makers, with muted growth for the big players, longer roads to profitability for the smaller players and pricing and reimbursement pressures remaining stable at best, according to Leerink Swann analysts.

Medical device tax: Rep. Paulsen plans to re-introduce repeal vote

Medical device tax: Rep. Paulsen plans to re-introduce repeal vote-massdevice: With a new Congress comes another crack at repeal of the medical device tax in the House of Representatives.

FDA Finalizes 510(k), PMA, eCopy Guidances

FDA Finalizes 510(k), PMA, eCopy Guidances-thegraysheet: FDA spells out its acceptance policies for 510(k) and PMA submissions, as well as guidelines for submitting electronic copies of submissions. The guidances all aim to make the device review process more efficient and speedy.

Coburn Leaves Finance As Toomey, Portman, Isakson Enter Committee

Coburn Leaves Finance As Toomey, Portman, Isakson Enter Committee-insidehealthpolicy: In a decision that surprised health care stakeholders, Sen. Tom Coburn (R-OK) will not sit on the powerful Senate Finance Committee in the 113th Congress, a change that comes as lawmakers are expected to tackle deficit reduction and reforms to the tax code and federal health care programs -- which all fall under the committee's jurisdiction -- over the coming year.

Health Sector Braces For Cuts As Sequester Looms, Entitlement Reform Calls Persist

Health Sector Braces For Cuts As Sequester Looms, Entitlement Reform Calls Persist-insidehealthpolicy: While the “fiscal cliff” and a one-year “doc fix” are behind them, health care stakeholders are bracing for lawmakers to again go after the sector in the coming weeks as a part of larger deficit reduction efforts, especially now that Congress has less than two months to figure out how to stop the automatic spending cuts called for by sequestration as well as raise the debt ceiling, sources tell Inside Health Policy.

Obama's debt ceiling gambit

Obama's debt ceiling gambit-politico: The fiscal cliff deal is two days old, and the conventional wisdom is already hardening: President Barack Obama won this round, but Republicans claim the upper hand in the next one.

Not-So-Happy New Year: Device Tax Not Addressed In Fiscal Cliff Bill

Not-So-Happy New Year: Device Tax Not Addressed In Fiscal Cliff Bill-thegraysheet: There’s no mention of a device tax delay or repeal in a fiscal cliff-delaying bill agreed to by Congress Jan. 2 to restore tax breaks for middle-class families, but the bill does contain some significant cuts to Medicare imaging, radiation payments and diabetic test strips sold in retail outlets as one-year “Doc Fix” pay-fors.

One-Year 'Doc Fix' Muddies Physicians' Call For Permanent SGR Repeal

One-Year 'Doc Fix' Muddies Physicians' Call For Permanent SGR Repeal-insidehealthpolicy: Now that Medicare provider pay cuts have been delayed for a year, and lower tax rates are permanent for some 99 percent of Americans, physicians are scrambling to ensure lawmakers remain focused on enacting a permanent repeal of the embattled Sustainable Growth Rate formula, but they face new hurdles. The decision by Congress and the White House to tackle fiscal issues in a piecemeal fashion instead of pursuing a “grand bargain,” which could have masked the near $250 billion cost of a permanent SGR repeal, may make it more difficult for physicians to push for a permanent SGR replacement, sources say.

Device Industry Resumes Press To Repeal ACA Tax, Touts Bipartisan Support

Device Industry Resumes Press To Repeal ACA Tax, Touts Bipartisan Support-insidehealthpolicy: The medical device industry is resuming its lobby for Congress to scrap the health reform-created medical device tax, now hoping that a repeal of the law's $30 billion excise tax will be taken up as lawmakers deal with broader tax and budget issues in the coming months. The device industry, having failed to get Congress to address the issue as part of its New Year's fiscal cliff deal, continues to play up the impact of the 2.3 percent device tax on jobs and patient care and touts bipartisan support in both chambers to repeal the fee, which went into effect Jan. 1

The Year Ahead: Health Care In Cross-hairs As Fiscal Talks Resume, ACA In Full Swing

The Year Ahead: Health Care In Cross-hairs As Fiscal Talks Resume, ACA In Full Swing-insidehealthpolicy: The New Year's Eve clash over 'doc fix' offsets will most certainly be dwarfed by a major battle expected in the weeks ahead as lawmakers again target health care cuts and dive into entitlement reform in their bid to avert the delayed, but still-looming budget sequester and to raise the debt limit. The new year already started with a bang when Congress in the first hours of 2013 pushed through a high-stakes bill that averts budget sequestration for two months and patches Medicare physician payments for one year, but targeted hospitals, pharmacies, medical imagers and Medicare Advantage plans to pay for the physician patch.

The fiscal cliff deal that almost wasn't

The fiscal cliff deal that almost wasn't-politico: House Speaker John Boehner couldn’t hold back when he spotted Senate Majority Leader Harry Reid in the White House lobby last Friday. It was only a few days before the nation would go over the fiscal cliff, no bipartisan agreement was in sight, and Reid had just publicly accused Boehner of running a “dictatorship” in the House and caring more about holding onto his gavel than striking a deal.

The year ahead in health care: What to watch in 2013

The year ahead in health care: What to watch in 2013-politico: If 2012 was the year the Affordable Care Act had to face its external challengers, 2013 is going to be the year it has to confront built-in challenges.