Can the GOP win the Senate on Obamacare?

Can the GOP win the Senate on Obamacare?-washingtonpost: The National Republican Senatorial Committee is blasting out e-mails about vulnerable Democratic incumbents, calling them to account for their votes for Obamacare. A sample: “CNN’s Wolf Blitzer reported that the ‘Obama administration is conceding that some people, yes some people, will have to pay more’ for health care premiums due to ObamaCare. But Kay Hagan also misled North Carolinians on Obamacare.” (The only variation in these is the name of the embattled Senate Democrat.) Can the GOP win back the Senate on Obamacare?

The medical device tax rears its head in the Mass. Senate special election

The medical device tax rears its head in the Mass. Senate special election-massdevice: U.S. Representative Ed Markey (D-Mass.) offered his support to opponents of the medical device tax, saying that, had he had the chance, he would have sided with the Senate majority in voting to repeal the levy. Markey, a long-time Bay State lawmaker, is hoping to make the jump from the House to the Senate, vying for upper chamber seat left behind by U.S. Secretary of State John Kerry.

Senate chides Medicare for $70M in over-payments for medtech

Senate chides Medicare for $70M in over-payments for medtech-massdevice: Members of the Senate's Finance Committee lambaste Medicare over a largely unrecoverable $70 million sum of over-payments for durable medical equipment.

CMS faces heat over MA cuts

CMS faces heat over MA cuts-politico: The Obama administration is under pressure from Capitol Hill to change course fast on controversial proposed cuts to Medicare Advantage for 2014. The deadline for finalizing rates is Monday. The Centers for Medicare and Medicaid Services has proposed a 2.3 percent cut in the payments to Medicare Advantage plans. That plan has been blasted by insurers and dozens of lawmakers from both parties, including both Senate Finance Chairman Max Baucus (D-Mont.) and ranking member Orrin Hatch (R-Utah).

TAVR poised for further market expansion

TAVR poised for further market expansion-advisoryboard: At the recent 2013 American College of Cardiology (ACC) conference, experts debated the potential to expand TAVR indications to lower risk patients. Ultimately, panelists concluded that TAVR has strong potential for expansion to intermediate risk patients but should not be performed in low risk individuals.

WonkTalk: Happy birthday, Obamacare!

WonkTalk: Happy birthday, Obamacare!-washingtonpost: The Affordable Care Act turned three over the weekend. Unlike most other 3-year-olds, who face the challenges of learning colors and the alphabet, President Obama’s health law is up against obstacles much more daunting. What we lack in birthday cake, Ezra Klein and I make up for in health policy discussion.

Medical device tax: Still a long way from repeal

Medical device tax: Still a long way from repeal-massdevice: MASSDEVICE ON CALL — Opponents of the medical device tax notched an important victory when the Senate voted 79-20 last week to strike the 2.3% levy, but repeal efforts have a long way to go. "We need to look at where we can replace the revenue from," Sen. Jeanne Shaheen (D-N.H.) told the Wall Street Journal. Shaheen was 1 of 34 Democrats who voted to repeal the tax, which is expected to generate about $30 billion in revenue over 10 years.

Device tax: Sens. Hatch and Klobuchar offer amendment to help off-set repeal

Device tax: Sens. Hatch and Klobuchar offer amendment to help off-set repeal-massdevice: A bipartisan Senate duo proposed a novel amendment that could help off-set some of the cost of repealing the 2.3% medical device sales tax. Senators Amy Klobuchar (D-Minn.) and Orrin Hatch (R-Utah) offered a non-binding amendment that would establish a deficit-neutral reserve fund, which is to be offered alongside the Senate budget resolution that's already under negotiations.

House Dems' Budget Alternative Calls For $141 Billion In Medicare Savings

House Dems' Budget Alternative Calls For $141 Billion In Medicare Savings-insidehealthpolicy: The House Democrats' budget alternative proposed Monday (March 18) by Rep. Chris Van Hollen (D-MD) includes $141 billion in Medicare savings over 10 years, and suggests savings could be reached through expanding drug rebates to Medicare Part D or other changes to make the program more efficient. Hollen's budget also rejects Medicare vouchers or premium support, a proposal pushed by House Budget Committee chair Paul Ryan (R-WI), and eschews Medicaid cuts, while pledging that no benefits will be cut to achieve savings.

U.S. lawmakers plan hearings on medical app regulation

U.S. lawmakers plan hearings on medical app regulation-massdevice: The US House of Representatives ' Energy and Commerce committee will hold hearings over three days in mid March regarding the Food and Drug Administration's approach to regulating mobile medical applications and telehealth products. According to the Washington Post and a letter sent to the FDA by the committee earlier this month, the hearings will focus particularly on whether the new Medical Device Excise Tax (MDET) would apply to medical app developers or even manufacturers of smart phones and tablets if they fall under the FDA's definition of a medical device.

Experts: ACA could overload primary care

Experts: ACA could overload primary care-politico: The health system is girding for millions of new patients under Obamacare, and experts are worried that an already-strained primary care system could buckle unless other health care professionals are marshaled to perform primary care.“We need to get away from the old system of fragmented care and really work on team-based care,” said Wanda Filer, director of the American Academy of Family Physicians, at a POLITICO Pro Breakfast Briefing on Tuesday morning.

Advocate: Doc supervision of nurses 'unsustainable'

Advocate: Doc supervision of nurses 'unsustainable'-politico: An advocate for nurse practitioners argued Tuesday that forcing NPs to work under the supervision of a doctor would be “unsustainable” as demand for primary care ramps up under the federal health law.Angela Golden, president of the American Association of Nurse Practitioners, said at a POLITICO Pro Breakfast Briefing that requiring doctors to oversee nurse practitioners' care would limit their reach as the workforce grows over the next decade.

Sequestration: Cuts are already threatening House seats

Sequestration: Cuts are already threatening House seats-politico:  BELLEVILLE, Ill. — Rep. Bill Enyart might be a Democrat and Rep. Rodney Davis a Republican, but the two rookie lawmakers in Southern Illinois share one fear. Sequestration could cost them their seats.Enyart and Davis are three months into their new jobs — representing next-door districts — and constituents already are blaming them for not doing enough to stop the automatic spending cuts.

Still true after 40 years: Voters prefer cuts in theory, spending in practice

Still true after 40 years: Voters prefer cuts in theory, spending in practice-washingtonpost: In 1967, the political scientists Lloyd Free and Hadley Cantrill wrote that Americans were “ideological conservatives” but “operational liberals.” What they meant was that when asked broad questions about how government should work and what it should do, voters responded like conservatives. But when asked operational questions about which programs should be cut and which services should be eliminated, they responded like liberals. Voters like big cuts and smaller government in theory, but they don’t want to actually cut anything in practice.

Economist: Medical device tax would push 146,000 jobs overseas-massdevice: The medical device tax, a 2.3% levy on all U.S. medtech sales, could push 146,000 jobs overseas, conservative economist Diana Furchtgott-Roth told a U.S. House of Representatives committee this week. Furchtgott-Roth, a senior fellow at the Manhattan Institute think tank, told the House Energy & Commerce Committee that the medical device tax enacted as part of the Affordable Care Act would "shift production offshore," the Washington Examiner reported.

Shutdown, budget bills on floor this week

Shutdown, budget bills on floor this week-politico: President Barack Obama is counting on Senate Budget Committee Chairwoman Patty Murray (D-Wash.) to get her resolution across the Senate floor and set up talks this spring with the Republican House. Playing Martha to Murray’s Mary is Appropriations Committee Chairwoman Barbara Mikulski (D-Md.), whose charge is to keep the government household running through the summer while the “grand bargainers” — well, bargain.

Corker sees a chance for deal

Corker sees a chance for deal-politico: Republican Sen. Bob Corker opened the door for a deal with Democrats on tax and entitlement reform Sunday, saying that Republicans might be open to reform that “generates additional revenues.”Speaking opposite Senate Majority Whip Dick Durbin (D-Ill.)  “Fox News Sunday,” the senator from Tennessee said Republicans want to see a “75-year solution” to entitlements, adding President Barack Obama was moving in the right direction.

Grassley Calls For More CME Oversight To Fill Gaps In Sunshine Rule

Grassley Calls For More CME Oversight To Fill Gaps In Sunshine Rule-thegraysheet: The senator tells “The Gray Sheet” he is likely to conduct more investigations of continuing medical education providers due to a potential loophole in CMS’ final physician payment sunshine regulations. The sunshine law, which he co-wrote, did not specifically address payments to CME organizations.

CMS Allows Hospitals To Re-bill Claims Denied Due To 'Wrong' Setting

CMS Allows Hospitals To Re-bill Claims Denied Due To 'Wrong' Setting-insidehealthpolicy: Hospitals will be able to re-bill payments that were deemed medically necessary but were denied later through audits because care was given in the wrong setting beginning March 13, according to a CMS notice released Wednesday that addresses an issue raised by hospitals in a suit against the agency. CMS also simultaneously released a proposed rule that would allow hospitals to be paid on an outpatient basis if inpatient claims are denied because a patient should not have been admitted to the hospital. One hospital lobbyist said the rule is good news for the industry, and it would relieve pressure on one of the problems connected to hospitals' increasing use of observation status and increased audits by Recovery Audit contractors.

Obamacare tax on 'medical devices' expected to cost 146,000 jobs

Obamacare tax on 'medical devices' expected to cost 146,000 jobs-examiner: As the fight over Obamacare raged in the House and Senate Wednesday, a new worry emerged that has the potential to push 146,000 high-paid, high-skill American jobs overseas. Former Bush economist Diana Furchtgott-Roth told a House panel that the tiny provision in Obamacare that puts a 2.3 percent tax on "medical devices" such as heart valves, insulin pumps and dental fillings will stifle development of the devices and push production overseas since no other country taxes the items.

Senate Dems block tea party bid to cut Obamacare Read more: http://www.politico.com/story/2013/03/senate-dems-block-tea-party-bid-to-cut-obamcare-88843.html#ixzz2NWNempip

Senate Dems block tea party bid to cut Obamacare-politico: A stopgap spending bill advanced in the Senate Wednesday with Democrats keeping to a middle path in hopes of improving their chances for a strong bipartisan showing — and greater leverage with the Republican-controlled House. On a 52-45 vote, the majority quickly dispatched a tea-party-led bid to cut off funding for President Barack Obama’s signature health care reforms. But five Democrats later crossed the aisle to help Sen. John McCain (R-Ariz.) win an evening vote, 50-48, backing his amendment to cut an estimated $120 million in unauthorized funds from the defense portion of the bill.

Grassley Calls For More Oversight Of CME Process Under Sunshine Rules

Grassley Calls For More Oversight Of CME Process Under Sunshine Rules-graysheet: Industry should expect to see enhanced congressional oversight into the way continuing medical education providers choose and pay physician speakers at educational sessions and in how well companies fulfill their reporting obligations on payments to CME groups despite some wiggle room provided in the recently issued physician payment sunshine regulation, according to Sen. Chuck Grassley.

Obama's Senate Democrats Meeting: Progressives Fire Warning On Entitlement Reform

Obama's Senate Democrats Meeting: Progressives Fire Warning On Entitlement Reform-huffingtonpost: WASHINGTON -- President Barack Obama took a break during his offensive to charm Republican lawmakers open to a budget deal on Tuesday to assure his fellow Democrats he won't give away the store.The president met with Senate Democrats during their weekly caucus lunch in what was, by nearly all accounts, a cordial affair -- several described it as borderline boring. Democratic senators said later they stood united with Obama behind a broad set of deficit-reduction principles.

Senate Funding Bill Gives Cushion To FDA But Doesn't Undo Sequester

Senate Funding Bill Gives Cushion To FDA But Doesn't Undo Sequester-insidehealthpolicy: FDA would be able to collect previously authorized user fee amounts for prescription and generic drugs, medical devices and biosimilars and could receive a bump for some key programs, including food safety, under a Senate-proposed short-term spending bill unveiled this week. The FDA appropriations measure provides some flexibility for the agency, but does not do away with the cuts mandated by sequestration. The funding measure comes as House Republicans unveiled a budget plan that proposes deep cuts to non-defense discretionary programs like FDA.

Warring budgets embody health care fight

Warring budgets embody health care fight-politico: This week's dueling budget releases shows that the fight over health care reform and entitlements is far from over — and the parties are still miles apart on how to move forward with either.But what is clear is that implementation of the health law is moving forward, that Medicaid won't be converted into a "block grant" any time soon and that there is no politically easy answer for Medicare.

Obama to meet with House Republicans

Obama to meet with House Republicans-politico: President Barack Obama will visit Capitol Hill Wednesday to face the only Republicans in power in Washington: the House GOP conference.
Speaker John Boehner’s (R-Ohio) 232-member conference has been Obama’s chief sparring partner since it took the majority in 2010. The last time Obama met with the House GOP was at their retreat in 2010, where cameras captured the president speaking to House Republicans — including Rep. Paul Ryan (R-Wis.)

GOP healthcare policy workers flee Capitol Hill

GOP healthcare policy workers flee Capitol Hill-massdevice:  ON CALL — The GOP's top healthcare policy workers are heading to greener pastures, and it may be due to frustration with the party's inability to gain much traction in healthcare reform.

Parties Stake Out Budget Positions; MedPAC, MACPAC Reports On Tap

Parties Stake Out Budget Positions; MedPAC, MACPAC Reports On Tap-insidehealthpolicy: Budget feuding will escalate this week as dueling plans are unveiled by House Republicans and Senate Democrats, with stakeholders on high alert for proposed changes to Medicare and Medicaid that could result in sweeping consequences on their sectors. President Obama has scheduled meetings on Capitol Hill with the House and Senate Republican and Democratic conferences in an attempt to “untangle some of the gridlock,” as he said in his weekly address to the nation, as the two parties gear up for a likely entitlement battle as they seek to slow health care spending and address the budget sequester.

Confident in ACA’s future, Dems can gripe

Confident in ACA’s future, Dems can gripe-politico: A funny thing happened once the Democrats grew confident that Obamacare is truly the “law of the land.” They started complaining about pieces of it in public.Democrats aren’t walking away from the overall law and its sweeping goals; they still see it as an historic achievement they had sought for generations.

Reince Priebus touts Paul Ryan's 'lemon law'

Reince Priebus touts Paul Ryan's 'lemon law'-politico: Republican National Committee chairman Reince Priebus says Rep. Paul Ryan’s proposed budget would act as a “lemon law” against President Barack Obama’s health care reform.“We hold used-car salesmen to higher standards, I think, than we hold this president. And this is our lemon law,” Priebus said Monday of the Ryan plan on Sean Hannity’s Fox News show.

Dems not sold on a safety net bargain

Dems not sold on a safety net bargain-politico:  President Barack Obama may be thinking about a “grand bargain” to address spending and the federal deficit, but there’s a key constituency he has to persuade to come along. Democrats. The talk of any deal with congressional Republicans — and for now, it’s just that: talk — has liberals worried the White House will give in to changes to safety net programs including Medicare, Medicaid and Social Security.

Republicans resume effort to repeal 'Obamacare'

Republicans resume effort to repeal 'Obamacare'-latimes: Rep. Paul D. Ryan of Wisconsin, last year's Republican vice presidential nominee, said Sunday his forthcoming budget proposal will include repeal of "Obamacare," as his party calls it. That position puts tea-party conservatives at odds with others in the GOP who want to find common ground with Obama on the nation's fiscal woes after the U.S. Supreme Court upheld the health law.

FDA Recalls Guidance Seeks To Allay Manufacturer Anxieties About Device Safety Enhancements

FDA Recalls Guidance Seeks To Allay Manufacturer Anxieties About Device Safety Enhancements-graysheet: A new draft guidance tries to reassure manufacturers that they can make changes to improve a device's performance or safety without fear that FDA will necessarily require a recall. But early reactions suggest industry may not be happy with at least one component of the document.

Negative Impact Of Device Tax On Jobs Challenged At House Hearing

Negative Impact Of Device Tax On Jobs Challenged At House Hearing-graysheet: The medical device excise tax was a topic of debate at a House subcommittee hearing last week, with a push by one witness to counter some arguments against the tax made by industry groups

When it comes to robots, opinions run hot

When it comes to robots, opinions run hot-massdevice:  Robots may not have emotions, but that's certainly not the case when it comes to the investors, doctors, and other associated people who are involved in the surgical robotics market. From promises that robots open up new avenues in surgery that are better and more comfortable for patients to accusations that robots are dangerous and unnecessary, it often feels like the middle ground is perilously thin these days. While the utilization rates don't point to robots disappearing anytime soon, investors in Intuitive Surgical (NSDQ:ISRG) and Mako Surgical (NSDQ:Mako) are likely looking at plenty of volatility and debate for years to come.

Nearly All Pioneer ACOs Threaten To Drop Out Of Demo

Nearly All Pioneer ACOs Threaten To Drop Out Of Demo-insidehealthpolicy: One of CMS' highest profile health care delivery reform initiatives is on rocky ground as most of the Pioneer ACOs are threatening to drop out of the demonstration if CMS makes them start meeting quality measures instead of merely requiring that they report the measures, according to a letter obtained by Inside Health Policy. The accountable care organizations say the quality metrics are a poor measure of performance, and their complaint could have implications for all Medicare pay systems because CMS is moving toward basing pay on how providers perform. The Pioneer ACOs were supposed to be the few shining examples of organizations that could handle outcomes-based pay.

The era of austerity is here

The era of austerity is here-politico:  President Barack Obama and congressional Republicans are dug in on the sequester, and there are no signs of a quick fix to the $85 billion in across-the-board spending cuts that both sides say they disdain.That could certainly change after a few bad months of economic numbers or a public outcry. But until average Americans feel the cuts, neither side looks willing to budge on the key issue of revenues without some game-changing factor. And neither party is inclined to risk a government shutdown on sequester politics.

McClellan Signals Brookings' New Medicare Reform Ideas May Target Per-Person Costs, Outcomes

McClellan Signals Brookings' New Medicare Reform Ideas May Target Per-Person Costs, Outcomes-insidehealthpolicy:  Former CMS Administrator Mark McClellan said the Brookings Institution will soon release a set of updated Medicare reform proposals and indicated they would outline a broader reform strategy that chiefly focuses on lowering beneficiary costs and improving individual health outcomes. Speaking at a National Journal forum on Medicare, McClellan said legislative reforms to Medicare must stress individualized, prevention-oriented care under an approach in which beneficiaries could share in savings when they make decisions that result in lower costs and care being used more effectively.

Blum: 4- & 5-Star MA Plans Will Be Able To Weather Proposed Pay Cuts

Blum: 4- & 5-Star MA Plans Will Be Able To Weather Proposed Pay Cuts-insidehealthpolicy: CMS Medicare chief Jonathan Blum said Medicare Advantage pay cuts proposed by the agency should not hurt plans that earn 4- or 5-star ratings because the bonuses and increased business that plans get as a result of the high ratings will offset the cuts. Blum told the Senate Finance panel Thursday (Feb. 28) the proposed cuts are designed in part to encourage plans with poor ratings to improve and to weed out those that do not, and he said the cuts would not be as steep if Congress were to replace the Sustainable Growth Rate formula.

FDA proposes more consistent clinical data requirements

FDA proposes more consistent clinical data requirements-massdevice: The US Food and Drug Administration has published a proposed rule that would require medical device clinical studies conducted outside the US in order to support product registrations to be conducted in compliance with Good Clinical Practice (GCP). Part of GCP requires manufacturers using overseas clinical studies in their US registration applications to show proof of review and approval of their studies by Independent Ethics Committees (IEC).

McConnell: No last-minute deal

McConnell: No last-minute deal-politico: Don't get your hopes up for today's sequestration meeting at the White House, Senate Minority Leader Mitch McConnell said Friday morning. "There will be no last-minute, back-room deal and absolutely no agreement to increase taxes," the Kentucky Republican said in a statement

GPO Website Exposes Firms That Are Passing Device Tax On To Customers

GPO Website Exposes Firms That Are Passing Device Tax On To Customers-thegraysheet: Hospital group purchasing organizations are using a new website to fight against manufacturers that they claim are passing the cost of the medical device excise tax on to customers in the form of price increases. The site, called Medical Device Tax Watch (www.devicetaxwatch.com), was announced Feb. 28 by the Healthcare Supply Chain Association. As of the evening of Feb 28, it lists 43 companies that the group says are “shifting the burden of the medical device excise tax ... directly to American hospitals and other healthcare providers.”