TGIF

The FEHBlog has been bemoaning the fact that Senate has not joined the House of Representatives (H.R. 748) in in voting to repeal the Affordable Care Act's high cost plan excise tax a/k/a the Cadillac tax. The FEHBlog expects that the Cadillac tax will have an outsized adverse impact on the FEHBP due to low family sizes and adverse demographics in the FEHBP.  The FEHBlog listened to an American Bar Association Health Law Section webinar on health care reform activities on Capitol Hill. The speakers were two staff members with healthcare portfolios from the majority party of each House. The Republican Senate staff member explained his understanding that the Senate will not act on repealing a tax, even one has harebrained as this one (FEHBog edit) without an offset or pay go, e.g., increased revenue and/or decreased spending. The Democrat House staff member pointed out that the 2017 tax reform bill did not require a pay-go and could have, but did not, include the controversial ACA taxes. Sigh.

Speaking of the House of Representatives, Govexec.com reports that "the House will vote the week of Nov. 18 on a measure to keep federal agencies open past Nov. 21, when a current stopgap bill is set to expire." The article suggests that the extension may only be for 30 days rather than three months.  A brief extension could trigger post traumatic stress disorder for federal employees.

Also the Centers for Medicare and Medicaid Services announced today the 2020 Medicare Parts and B premium and cost sharing amounts. Highlights

• The Medicare Part A inpatient hospital deductible that beneficiaries will pay when admitted to the hospital will be $1,408 in 2020, an increase of $44 from $1,364 in 2019. 

• For 2020, the Medicare Part B monthly premiums and the annual deductible are higher than the 2019 amounts. The standard monthly premium for Medicare Part B enrollees will be $144.60 for 2020, an increase of $9.10 from $135.50 in 2019. The annual deductible for all Medicare Part B beneficiaries is $198 in 2020, an increase of $13 from the annual deductible of $185 in 2019.

The CMS fact sheet also provides the income adjusted Medicare Part B premiums and more. 

In other news:

• Healthcare Dive reports that the Medicare Payment Advisory Commission, which advises Congress on Medicare issues, has concluded that both vertical and horizontal hospital consolidation is correlated with higher healthcare costs, n yet another study finding rampant mergers and acquisitions drive up prices for consumers. The American Hospital Association reports that 

several commissioners urged MedPAC staff to examine how consolidation among hospitals correlates with consolidation among other stakeholders, including health insurers, pharmacy benefit managers and group purchasing organizations, in order to assess impacts in the context of larger health care environment dynamics. The commissioners also challenged some staff conclusions that federal policy does not create incentives for consolidation, noting Medicare underpayments and electronic health record requirements as possible drivers

• Becker's Hospital Review reports on the Leapfrog Group's Fall 2019 hospital safety ratings. 

• The Washington Post reports this afternoon on the latest Centers for Disease Control report on the vaping crisis. "Federal health officials have identified vitamin E acetate in the lung fluids of 29 people sickened in the outbreak of dangerous vaping-related lung injuries. The discovery is a “breakthrough” that points to the oil as a likely culprit in the outbreak that has sickened more than 2,000 people and killed at least 39, a top official said Friday."

• Earlier this week, HHS's Office for Civil Rights, which enforces the HIPAA Privacy and Security Rules, announced that the University of Rochester Medical Center ("URMC") had agreed to pay  $3 million and take substantial correction action to settle HIPAA rule violation allegations. 

URMC filed breach reports with OCR in 2013 and 2017 following its discovery that protected health information (PHI) had been impermissibly disclosed through the loss of an unencrypted flash drive and theft of an unencrypted laptop, respectively. OCR's investigation revealed that URMC failed to conduct an enterprise-wide risk analysis; implement security measures sufficient to reduce risks and vulnerabilities to a reasonable and appropriate level; utilize device and media controls; and employ a mechanism to encrypt and decrypt electronic protected health information (ePHI) when it was reasonable and appropriate to do so. Of note, in 2010, OCR investigated URMC concerning a similar breach involving a lost unencrypted flash drive and provided technical assistance to URMC. Despite the previous OCR investigation, and URMC's own identification of a lack of encryption as a high risk to ePHI, URMC permitted the continued use of unencrypted mobile devices.