What’s New in Health Care Reform: July 26

The Week in Review provides an overview of the past week’s top health care content, including industry news and trends, Mayo Clinic and Mayo Medical Laboratories news, and upcoming events.

Price Transparency in Medicine Faces Stiff Opposition — From Hospitals and Doctors

Hospitals and doctors often oppose such measures. The American Hospital Association’s position is that health plans — not hospitals — are responsible for telling insured patients about their out-of-pocket costs, according to its website.Via Kaiser Health News.

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Trump's FDA Chief Takes Wide Aim at Opioid Addiction Crisis  

The Food and Drug Administration, as part of a sweeping overhaul in how it regulates opioid painkillers, plans to look to some unusual allies to limit the flood of the addictive pills — health insurers and companies that manage prescription drug benefits. Food and Drug Administration Commissioner Scott Gottlieb plans to meet in September with the benefit payers and insurance administrators, groups the FDA hasn’t typically worked with in its role as a drug regulator. The plan, Gottlieb said, is to stem the tide of addiction to the pills by limiting the number of people exposed to them in the first place. Via Bloomberg.

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Obamacare Repeal Vote Still Too Close to Call

Senate Republicans are barreling toward a dramatic and highly unusual vote on Obamacare without knowing whether they’ll have the votes to start dismantling the health care law. At stake is not just the seven-year-old campaign pledge to repeal Obamacare, but also demonstrating that Republicans — when given full control of Washington — can govern. Sen. John McCain (R-Ariz,), recently diagnosed with brain cancer, made it all the more dramatic when he announced he would return to Washington for the vote. Via Politico.

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KKR to Buy WebMD in $2.8 Billion Deal

Online health publisher WebMD Health said it agreed to be bought by private equity firm KKR in a deal valued at about $2.8 billion. The deal brings together WebMD's websites, such as WebMD.com, Medscape.com, and MedicineNet.com, and those owned by KKR unit Internet Brands Inc, including DentalPlans.com and AllAboutCounseling.com. KKR will pay $66.50 per share, a premium of 20.5 percent to WebMD's Friday closing price. WebMD's shares were trading at $66 before the opening bell. Via CNBC.

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Senate Parliamentarian Upends GOP Hopes for Health Bill

The official rules keeper in the Senate tossed a bucket of cold water on the Senate Republican health bill by advising that major parts of the bill cannot be passed with a simple majority, but rather would require 60 votes. Republicans hold only 52 seats in the Senate. Senate Parliamentarian Elizabeth MacDonough said that a super-majority is needed for the temporary defunding of Planned Parenthood, abortion coverage restrictions to health plans purchased with tax credits and the requirement that people with breaks in coverage wait six months before they can purchase new plans. Via Kaiser Health News.

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CBO Says Revised Senate Plan Would Increase Uninsured by 22 Million

The number of people without health insurance would rise by 22 million in a decade if a revised Senate Republican bill replaced large parts of the Affordable Care Act, while federal deficits would be cut by $420 billion, according to a report from the Congressional Budget Office. The impact of the new report is uncertain, however, as the CBO didn’t include a full analysis of an amendment from Sen. Ted Cruz (R., Texas) that would allow for cheaper but more bare-bones insurance plans because that analysis requires more time. Via Wall Street Journal.

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Fraud and Billing Mistakes Cost Medicare — And Taxpayers — Tens of Billions Last Year

Federal health officials made more than $16 billion in improper payments to private Medicare Advantage health plans last year and need to crack down on billing errors by the insurers, a top congressional auditor testified Wednesday. James Cosgrove, who directs health care reviews for the Government Accountability Office, told the House Ways and Means oversight subcommittee that the Medicare Advantage improper payment rate was 10 percent in 2016, which comes to $16.2 billion. Adding in the overpayments for standard Medicare programs, the tally for last year approached $60 billion — which is almost twice as much as the National Institutes of Health spends on medical research each year. Via Healthcare IT News.

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Obamacare Payments To Continue

Key Obamacare subsidies to insurers will be paid this month, the White House confirmed to The Hill one day before the deadline to make July's cost-sharing reduction (CSR) payments. The administration has not made a commitment beyond this month. The payments help low-income people afford the co-pays, deductibles and other out-of-pocket costs associated with health insurance policies. Insurers have called the payments critical, saying that without them, they would have to massively increase premiums or exit the individual market. Via The Hill.

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Senate Votes Down Broad Obamacare Repeal

The Senate voted narrowly to begin debate on a bill to repeal major provisions of the Affordable Care Act, but hours later, Republican leaders suffered a setback when their most comprehensive plan to replace President Barack Obama’s health law fell far short of the votes it needed. The Tuesday night tally needed to reach 60 votes to overcome a parliamentary objection. Instead, it fell 43-57. The fact that the comprehensive replacement plan came up well short of even 50 votes was an ominous sign for Republican leaders still seeking a formula to pass final health care legislation this week. Via NY Times.

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Here’s How Local TV News is Making it Harder for the Senate to Repeal Obamacare

Local television news discussed health-care reform extensively between the day that House Republicans first revealed details about the American Health Care Act and March 24, the day that Speaker Paul D. Ryan (R-Wis.) told the president that they didn’t have the votes to pass the bill. When the AHCA was revived with newly proposed amendments in late April, coverage picked up again, jumping on May 4, when the House passed the bill. Our hunch is that local TV covered the ACA and the AHCA quite differently. When we did an in-depth analysis of 2013-2014 ACA news coverage, we found that local TV was more likely to focus on political conflict and its winners and losers than on the policy details of the law. While we have not yet conducted that careful analysis on AHCA coverage, we expect that it has been different. For one, the AHCA sought to change some of the most popular (and not previously well-covered in the news) ACA provisions, like a ban on denying health insurance because of preexisting conditions and minimum coverage requirements for all health insurance plans. Via Washington Post.

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Andy Tofilon

Andy Tofilon is a Marketing Segment Manager at Mayo Medical Laboratories. He leads strategies for corporate communications, public relations, and new media innovations. Andy has worked at Mayo Clinic since 2003. Outside of work, Andy can be found running, hiking, snapping photos, and most importantly, spending time with his family.