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ACA update week of October 12, 2015

Week of October 12, 2015
A new analysis published by The Commonwealth Fund found that the United States continues to spend far more on health care than other high-income nations, driven by greater use of medical technology and higher prices. More frequent doctor visits and hospital admissions were not factors. In fact, with only four per year, Americans had fewer physician visits than residents of other developed countries. Americans also experienced poorer results on several key health outcomes measures.


President Obama on Wednesday signed the Protecting Affordable Coverage for Employees Actinto law. Widely supported by Democrats and Republicans, the bipartisan "fix" to the Affordable Care Act (ACA) allows states to determine whether or not to expand the small group health insurance market to firms with between 51 and 100 employees.

Senator Ron Wyden (D-OR) has released a bill meant to prevent a potential Medicare premium spike of up to 52 percent for one-third of Medicare beneficiaries. The ranking member of the Senate Finance Committee is just one of many lawmakers—including House Minority Leader Nancy Pelosi (D-CA)—pursuing a fix to the coming Medicare Part B rate spike.

The Centers for Medicare and Medicaid Services (CMS) is pushing ahead with the third stage of rulemaking on meaningful use, an Electronic Health Records (EHR) incentive program.

Top pharmaceutical executives expressed their concerns over the Trans-Pacific Partnership (TPP) trade deal during a meeting at the White House with President Obama. Focused on the lack of 12-year monopoly protections for biologic medicines, the industry has spoken out against the trade pact.


GEORGIA: The state Senate study committee held its first hearing on "surprise billing" with consumers describing cases of financial hardship caused by surprise balance billing. Representatives of the state medical association, hospital association, AHIP and employers also testified. In its testimony, AHIP referenced its recent report which found a pattern of average billed charges submitted by out-of-network providers that far exceeded Medicare reimbursement for the same service.

From Aetna health reform weekly