The Weekly Insight: September 25

26th Sep 2017


Texas Insight Reports: September 18-22

  • Health Care Implications of DACA Elimination in Texas: President Trump had his Attorney General Jeff Sessions announced on September 5th that the administration is ending Deferred Action for Childhood Arrivals (DACA). Now he is flirting with making a deal with Democratic lawmakers to replace DACA, though now the border wall, opposed by folks from both sides of the aisle here in Texas, has had its fate intertwined with that of the program. Texas is home to more than 140,000 Dreamers, or beneficiaries of DACA. This is the second-highest number than in any other state in the US.
  • HHSC: Proposed Adjustments for Anesthesia Services: Beginning November 1, 2017, the reimbursement rate to an anesthesiologist supervising a CRNA or AA will decrease from 75 to 50 percent and the reimbursement to a CRNA or AA supervised by an anesthesiologist will decrease from 92 to 50 percent of the calculated rate. Medical services solely performed by an anesthesiologist will receive 100 percent while a CRNA who is supervised by a physician will receive 92 percent of the calculated rate. The testimony indicated support for the rate changes as well as an anesthesia team approach. The problems identified through testimony are largely found in the complex cases served at trauma facilities and children’s hospitals. Here the service cost will exceed the rate and could cause an access to care problem.
  • STAR Kids managed Care Advisory Committee: The STAR Kids Managed Care Advisory Committee, created by Senate Bill 7 of the 83rd Texas Legislature (Regular Session), advises HHSC on the establishment and implementation of the STAR Kids Medicaid managed care program. The STAR Kids Medicaid managed care program is legislatively mandated to provide services for children with disabilities who have Medicaid coverage to improve coordination and customization of care, access to care, health outcomes, cost containment and quality of care. The STAR Kids model must require a health home, care management, and provide comprehensive coordination of acute care and long-term service benefits.
  • Medicare: Part B Premiums: This report provides an overview of Medicare Part B premiums, including information on Part B eligibility and enrollment, late-enrollment penalties, collection of premiums, determination of annual premium amounts, premiums for high-income enrollees, premium assistance for low-income enrollees, protections for Social Security recipients from rising Part B premiums, and historical Medicare Part B premium trends.
  • Legal Sidebar: Eighth Circuit Blocks Lawsuit Challenging Arkansas’s Exclusion of Planned Parenthood from Medicaid: On August 16, 2017, a divided panel of the U.S. Court of Appeals for the Eighth Circuit (Eighth Circuit) vacated two preliminary injunctions against Arkansas that prohibited the state from suspending payments for Medicaid services performed by clinics affiliated with Planned Parenthood Federation of America (PPFA). This decision, Does v. Gillespie, appears to create a circuit split between the Eighth Circuit and four other federal circuits on the question of whether private litigants may challenge a state’s decision to exclude specific health care providers from participating in that state’s Medicaid program. The plaintiff beneficiaries and providers in Gillespie have asked the full Eighth Circuit to review the panel decision.


Federal Healthcare News

  • McCain Announces Opposition to Republican Health Bill, Likely Dooming It: Senator John McCain of Arizona announced on Friday that he would oppose the latest proposal to repeal the Affordable Care Act, leaving Republican leaders with little hope of succeeding in their last-ditch attempt to dismantle the health law and fulfill their longstanding promise to conservative voters.
  • Ryan, White House Reject Bipartisan Health Fix: House Speaker Paul Ryan and the White House have informed Senate Republican leaders that they oppose a bipartisan plan to stabilize Obamacare being written in the Senate, according to Trump administration and congressional sources, in a clear bid to boost the Senate’s prospects of repealing the health law.
  • Public Prefers Obamacare to Graham-Cassidy, 56-33% (POLL): Americans by more than a 20-point margin prefer the existing federal health care lawto the latest, imperiled Republican alternative — another challenge to the GOP’s long-held effort to repeal and replace Obamacare.
  • Trump Administration will make September Subsidy Payments: The Trump administration is keeping a key pillar of Obamacare intact while Congress makes a final attempt to gut the law. Subsidy payments due this week that would continue to defray the cost of covering some Obamacare customers will be paid this week, according to a White House spokesman.