HC Reform Update from Mark Sanna: The House on Monday is scheduled to take up a $1-billion measure delaying by one month a 23% cut in federal Medicare reimbursements to doctors. The payment reduction is scheduled to go into effect Wednesday if members of the House don't act. The Senate approved the legislation earlier this month. A 1997 law requires that doctors' Medicare rates be adjusted each year based on the health of the economy, with the goal of keeping the program in the black. Rate cuts have been blocked 10 times in the last eight years, including four times this year. Some senators have said they are working on a measure that would extend the current payment rates through 2011.

HC Reform Update from Mark Sanna: Florida Republican lawmakers are reviving a proposed constitutional amendment that takes aim at a major part of the federal health overhaul. The proposal, if ultimately approved by voters during the 2012 elections, is aimed at allowing Floridians to opt out of a federal requirement that they buy health insurance or face financial penalties.

HC Reform Update from Mark Sanna: As the Obama administration presses ahead with the health care law, officials are bracing for the possibility that a federal judge in Virginia will soon reject its central provision as unconstitutional. The novel question before the courts is whether the government can require citizens to buy a commercial product like health insurance.

HC Reform Update from Mark Sanna: A majority of Americans want the Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, according to a new McClatchy-Marist poll. The post-election survey showed that 51% of registered voters want to keep the law or change it to do more, while 44% want to change it to do less or repeal it altogether.

HC Reform Update from Mark Sanna: The Obama administration issued rules on Monday defining a promise to consumers in the new federal health-care law that insurers will spend at least $4 out of $5 they collect in premiums on medical services and other efforts to improve patients' health.

HC Reform Update from Mark Sanna: The Obama administration released regulations this morning detailing a health law requirement. The medical loss ratio, also know as MLR, rule requires insurance companies to spend at least 80 cents of the premium dollar on medical care and quality. For employer plans covering more than 50 people, the requirement is 85 cents. Part of the new health care law, the rule is meant to give consumers a better deal. Administration officials said it will prevent insurers from wasting valuable premiums on overhead, marketing and executive bonuses. 'These new rules are an important step to hold insurance companies accountable and increase value for consumers,” said Health and Human Services Secretary Kathleen Sebelius.

HC Reform Update from Mark Sanna: Eight months into the new law there is a growing frenzy of mergers involving hospitals, clinics and doctor groups eager to share costs and savings, and cash in on the incentives. They, in turn, have deployed a small army of lawyers and lobbyists trying to persuade the Obama administration to relax or waive a body of older laws intended to thwart health care monopolies, and to protect against shoddy care and fraudulent billing of patients or Medicare.

HC Reform Update from Mark Sanna: The Senate on Thursday passed a bill to postpone a 23% cut in Medicare payments to doctors, scheduled to take effect on Dec. 1. The bill would block the cut until Jan. 1. The one-month reprieve goes now to the House, which is expected to approve it. The action followed a bipartisan agreement reached by the chairman of the Senate Finance Committee, Max Baucus, Democrat of Montana, and the senior Republican on the panel, Senator Charles E. Grassley of Iowa. With the agreement, the senators said in a joint statement, “seniors and military families can be confident they will be able to see a doctor and get the medicines they need.’’

HC Reform Update from Mark Sanna: Doctors flooded Congress on Wednesday with telephone calls, urging lawmakers to prevent the 23 percent cut in Medicare payments scheduled to take effect next month. Many physicians have posted placards in their offices saying, “Your doctor may have to stop seeing Medicare patients” if Congress does not act. Administration officials want lawmakers to stop the cut for at least 13 months. But the lame-duck Congress appears unlikely to grant such a lengthy reprieve.

HC Reform Update by Mark Sanna: 80 out of 100 children with ear infections will get better on their own in about three days, according to a review of 135 previously published studies in today's Journal of the AMA. Prescribing antibiotics improves that cure rate only slightly, to 92 of 100 children, the review says. The benefits of antibiotics seem even smaller in light of their side effects: 3-10 children will develop a medication-related rash; 5-10 more will get diarrhea.

HC Reform Update from Mark Sanna: One of every seven Medicare beneficiaries who is hospitalized is harmed as a result of problems with the medical care there, according to a new study from the Office of Inspector General for the Department of Health and Human Services. The study said unexpected adverse events added at least $4.4 billion a year to government health costs and contributed to the deaths of about 180,000 patients a year.

HC Reform Update from Mark Sanna: A leading Senate Democrat vowed Friday to introduce legislation killing a part of the new healthcare reform law that imposes new tax-filing requirements on small businesses. Sen. Max Baucus (D-Mont.), chairman of the Finance Committee and a leading architect of the reform law, said a provision requiring businesses to report more purchases to the IRS will impose undue paperwork burdens on companies amid an economic downturn when they can least afford it. Baucus, who had pushed legislation scaling back the requirement earlier in the year, now wants it repealed in full.

HC Reform Update from Mark Sanna: No bargaining, no deals, no compromise — that's the hard-line stance that Republicans have staked in the days since seizing control of the House. Their prescription for the sluggish economy — lower taxes, huge spending cuts, less regulation, and repeal of the sweeping healthcare law just taking effect — excites the party's conservative base. But a long and ugly fight with President Obama and Senate Democrats, starting with next week's lame-duck session, could end up alienating the large number of Americans more interested in jobs than ideological battles.

HC Reform Update from Mark Sanna: Upcoming change to flexible spending accounts, means consumers will no longer be able to set aside pretax dollars in that account to use for medicines bought without a doctor's prescription and creates a "loophole" that may allow consumers to use FSA dollars on over-the-counter medication if they obtain a prescription for it. The loophole may lead to a lot of extra trips to the doctor, overburdening doctors to write prescriptions for drugs such as aspirin.

HC Reform Update from Mark Sanna: Minnesota Gov. Tim Pawlenty, a Republican, stepped up his attack on the law in a move widely perceived as a stage dressing for his potential 2012 presidential run. Pawlenty and Gov. Donald Carcieri, Republican of Rhode Island, filed court papers opposing the health overhaul on Thursday arguing "the governors are safeguarding their citizens from 'federal abuse of the spending power.' They argue the law places liabilities on states through a Medicaid expansion." The amicus brief was filed in a Florida court where 20 other states are suing to block the overhaul. The governor had already issued an executive order banning state agencies from seeking health overhaul related funds without specific permission.

HC Reform Update from Mark Sanna: According to a new report by the Centers for Disease Control and Prevention, 49.9 million people ages 18 to 64," or about 26.2 percent of the adult population, "had no medical coverage for at least part of the past 12 months. … Moreover, when children 17 and under are factored in, the number of Americans uninsured for at least part of a year span numbered 59.1 million.

HC Reform Update by Mark Sanna: The U.S. Supreme Court on Monday rejected a long-shot request for a review of the Obama administration's health-care overhaul before the matter has been fully litigated. The high court's rejection of the health-care challenge, brought by a conservative legal group in California, wasn't a surprise. …The high court almost never hears cases before they have been fully litigated in the lower courts, and it hadn't asked the Obama administration to file legal papers responding to the appeal.

HC Reform Update from Mark Sanna: Congressional Republicans said on Sunday they plan a full-scale assault against President Barack Obama's healthcare overhaul next year but acknowledged it could take until after the 2012 presidential election to repeal it. Representative Paul Ryan, expected to become chairman of the House Budget Committee chairman, said his fellow Republicans will try to deny funding for implementation of the healthcare legislation and hold hearings to point out its shortcomings when the new Congress convenes in January.

HC Reform Update from Mark Sanna: Trying to spur enrollment in a new health insurance program for uninsured people with pre-existing medical conditions, the federal government is doing something private insurers almost never do: slashing rates. That announcement Friday came as the government released the latest enrollment figures for these high risk insurance pools, which have attracted far fewer customers than expected. The program, established under the health law, began signing up enrollees in August and September. Not surprisingly, the states with lower rates have had higher enrollment.

HC Reform Update by Mark Sanna: While repealing the new law remains the first order of business for angry Republicans, most acknowledge it’s a long shot, considering President Barack Obama’s veto power. Still, they’ll possess some powerful tools to challenge the law if they win a majority in the House and take over leadership of the committees. Key Republicans are threatening to withhold funding for overhaul initiatives and to relentlessly pursue hearings and oversight investigations to challenge administration officials’ regulations and communications with the public. Committee chairmen have subpoena power, although holding the gavel is usually enough to get officials into the witness chair.

HC Reform Update by Mark Sanna: Republicans may in fact prefer to "tinker and tweak" the law to keep the debate fresh in the minds of voters in hopes of unseating Obama in 2012. Republicans could use the oversight authority of Congress to slow down or block regulations, essentially tying up the instruction manual for the overhaul. Expect flyspeck scrutiny of agencies implementing the law. GOP lawmakers may be able to pick off unpopular provisions. … Another target is a yet-to-be-named board with the power to make Medicare cuts.

HC Reform Update by Mark Sanna: With major gains in Congress, in governors’ races and in statehouses across the country, Republicans will continue to push for repeal or significant changes to the health care law. President Obama says while he is open to making some modifications, he and Democrats will resist major changes to the measure.

HC Reform Update from Mark Sanna: The Democrats’ ambitious health care overhaul is facing roadblocks from newly elected state officials who harshly criticized it while campaigning and who are now in a position to make good on their promises. While unable to overturn the federal law, the newly elected officials will be under pressure to act. They could slow the pace of implementation, lean on congressional delegations to repeal or change the legislation, seek waivers from some of its provisions, veto state legislation related to it and appoint like-minded people to important positions, such as insurance commissioner slots.

HC Reform Update from Mark Sanna: Two federal courts have ruled that the Obama administration is using overly strict standards to determine whether older Americans are entitled to Medicare coverage of skilled nursing home care and home health care. Medicare will pay for those services if they are needed to maintain a person’s ability to perform routine activities of daily living or to prevent deterioration of the person’s condition, the courts said. Medicare beneficiaries do not have to prove that their condition will improve, as the government sometimes contends, the courts said.