OVERNIGHT HEALTH: Romney and Gingrich face off on health — again

by Sam Baker and Julian Pecquet - 01/26/12 10:15 PM ET

Beyond essential benefits: The Department of Health and Human Services’s approach to defining (or not defining) essential health benefits will leave insurers plenty of flexibility to make changes in their coverage for prescription drugs, Avalere Health said Thursday. States have to set their benefit mandates according to a “benchmark” plan that covers at least one drug in several classes. But the existing plans that could end up as benchmarks generally cover about 70 percent of all available drugs, Avalere found. Healthwatch has the details.

MA back on the chopping block: House Democrats released a new Government Accountability Office report on Monday that shows the federal government could save billions of dollars a year by halting overpayments to privately run Medicare Advantage plans.

{mosads}Medicare Advantage plans routinely classify their customers as being sicker than if they were on traditional Medicare, triggering higher reimbursement rates, GAO says; the insurance industry says MA plans simply do a better job tracking their customers’ medical conditions. Healthwatch’s Julian Pecquet has more.

Code avalanche: The nation’s largest physicians lobby has sent House Speaker John Boehner (R-Ohio) a letter urging him to halt a federal requirement forcing doctors to switch to new insurance codes in 2013.

The American Medical Association says switching to so-called ICD-10 coding will require doctors’ offices to deal with some 68,000 codes, more than five times the current 13,000. And that’s on top of requirements to switch to electronic medical records. Here’s the story.

Blameless: The Department of Health and Human Services cleared Cornell’s medical school of ethical wrongdoing in a lung cancer study.

The Weill Cornell Medical College had been accused of failing to get informed consent from human subjects in its International Early Lung Cancer Action Program (I-ELCAP) study, but HHS cleared the university. Read HHS’s letter here.

Friday’s agenda

The National Academy of Social Insurance hosts concurrent roundtable discussions starting at 10 at the National Press Club. Of interest to health wonks: Is premium support the right prescription for Medicare? And what’s next for long-term care after the freezing of the healthcare law’s CLASS Act? Here’s the agenda.

The trade group America’s Health Insurance Plans hosts a briefing on Capitol Hill on “Health Plan Innovations: Caring for Medicare and Medicaid Patients with Chronic Illnesses.” That’s at noon in the Capitol Visitor Center, Room 201.

‪The Bipartisan Policy Center releases recommendations for the most effective use of health IT dollars to support “coordinated, accountable, patient-centered health care.” Former Sens. Tom Daschle (D-S.D.) and Bill Frist (R-Tenn.) will unveil their report alongside former Gov. Ted Strickland (D-Ohio) at 10 a.m. at the Bipartisan Policy Center‬.

State by state

New Hampshire Democrats are campaigning against the healthcare “compact.”

Republicans in Oregon are demanding that a healthcare plan in the state include limits on medical malpractice suits.

State lawmakers in California are at an impasse over a bill to provide universal healthcare coverage.

Bill tracker

Reps. Lee Terry (R-Neb.) and Mike Thompson (D-Calif.) introduced legislation allowing physician assistants to provide hospice service to Medicare beneficiaries (HR 3831).

Rep. Brett Guthrie (R-Ky.) has legislation repealing the healthcare reform law’s investments in comparative effectiveness research (H.R. 3827).

Lobbying registrations

Faegre BD Consulting / Underwriters Laboratories (lobbying on food safety and medical device regulation)

Reading list

NPR asks why President Obama isn’t talking as much about healthcare these days.

The AP covers consumer advocates’ fears that plain-English summaries of insurance policies might not come to fruition.

The New York health department is under fire for using actors in its diabetes public service ads, USA Today reports.

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Comments / complaints / suggestions? Please let us know:

Julian Pecquet: jpecquet@digital-stage.thehill.com / 202-628-8527