The Weekly Insight: November 21

21st Nov 2017

Texas Insight Reports: November 13-17
  • HHSC: Medical Care Advisory Committee: The Medical Care Advisory Committee is a federally mandated committee that reviews and makes recommendations to the state Medicaid director on proposed rules that involve Medicaid policy or affect Medicaid-funded programs. On Thursday, they gathered for their quarterly meeting.
  • HHSC: Hearing on Several Rates: The Texas Health and Human Services Commission (HHSC) conducted a public hearing to receive public comment on proposed Medicaid payment rates for the following:
    1. Medical Policy Review of Texas Health Steps Therapeutic Dental Anesthesia Services (00170-U3).
    2. Proposed Medicaid payment rates for Indian Health Services.
    3. Proposed Medicaid payment rates for the Medical Policy Review of Cardiac Evaluations (93290 and 93297)
    4. Proposed Medicaid payment rates for the Medical Policy Review of Texas Health Steps Therapeutic Dental Anesthesia Services (00170-U3)
    5. Proposed Medicaid payment rates for the Medical Policy Review of Provenge (Q2043)
    6. Proposed Medicaid payment rates for the Medicaid Biennial Calendar Fee Review
    7. Proposed Medicaid payment rates for the 2017 2nd Quarter Healthcare Common Procedure Coding System (HCPCS) Updates.
  • Coverage in the Private Health Insurance Market: The private health insurance market includes both the group market (largely made up of employer-sponsored insurance, or ESI) and the non-group market. Private health insurance does not include government sources of coverage, such as Medicare or Medicaid.
  • Division A of H.R. 3922: The CHAMPIONING HEALTHY KIDS Act: This report summarizes provisions in Division A of the CHAMPIONING HEALTHY KIDS Act. CRS Report R44989, Comparison of the Bills to Extend State Children’s Health Insurance Program (CHIP) Funding, summarizes provisions in Division B.
  • Social Security Trust Fund Investment Practices: Social Security operates with a trust fund financing mechanism. The Social Security trust funds are accounts within the U.S. Treasury that (1) track income and expenditures for the program and (2) hold the accumulated assets for the program. As such, they represent funds dedicated to pay current and future Social Security benefits. (There are two separate trust funds: the Old-Age and Survivors Insurance (OASI) Trust Fund and the Disability Insurance (DI) Trust Fund. They are referred to here on a combined basis as the Social Security trust funds.)
  • (Blog) The Future of Healthcare Interoperability: FHIR: FHIR is a standardized way to exchange health care data by harnessing the power of the internet. In major industries such as banking and education, data is being shared seamlessly between different systems. Yet in health care, there are major data silos that prevent this from happening. FHIR is changing that by allowing different systems to share information with each other using modern web technologies. This new interconnectivity will prevent medical waste, cut clinical and administrative costs, and also ensure a higher quality of care delivery. FHIR is quickly becoming the de facto standard for health care IT with support from the Office of the National Coordinator for Health Information Technology and major vendors who are working to drive its adoption.
Federal Healthcare News:
  • (Nov. 14): Senate Plans to End Obamacare Mandate in Revised Tax Proposal: Senate Republicans have decided to include the repeal of the Affordable Care Act’s requirement that most people have health insurance into the sprawling tax rewrite, merging the fight over health care with the high-stakes effort to cut taxes.
  • First Digital Pill Approved to Worries about Biomedical ‘Big Brother’: For the first time, the Food and Drug Administration has approved a digital pill — a medication embedded with a sensor that can tell doctors whether, and when, patients take their medicine.
  • Middle-Class Families Confront Soaring health Insurance Costs: Consumers [in Charlottesville, Va.] at first did not believe the health insurance premiums they saw when they went shopping for coverage this month on HealthCare.gov. Only five plans were available, and for a family of four with parents in their mid-30s, the cheapest plan went typically for more than $2,400 a month, nearly $30,000 a year. With the deadline for a decision less than a month away, consumers are desperately weighing their options, dismayed at the choices they have under the Affordable Care Act and convinced that political forces in Washington are toying with their health and well-being.
  • Trump officials eye Work Requirements for Medicaid Recipients: The Trump administration plans to do something no other administration has done before — allow states to impose work requirements on Medicaid recipients. In the coming months, the Trump administration could approve waivers allowing eight states to implement the work requirements: Arkansas, Arizona, Indiana, Kentucky, Maine, New Hampshire, Utah and Wisconsin.
  • Study Finds Competing Opioid Treatments Have Similar Outcomes: A long-awaited study has found that two of the main medications for treating opioid addiction (Vivitrol and Suboxone) are similarly effective, a finding likely to intensify the hard-fought competitionbetween drugmakers seeking to dominate the rapidly expanding opioid treatment market.