Legislative & Policy Corner

Appropriations Update
The rumors are swirling in DC that the Senate Labor, Health and Human Services, and Education (LHHS) Appropriations Committee will mark up the fiscal year 2013 LHHS bill during the week of Jun. 11. This bill will include proposed funding levels for the Title V Maternal and Child Health Services Block Grant and other important maternal and child health programs. According to some congressional staff, the president’s budget-proposed funding level for the Block Grant at $640 million for FY 2013 will be the high water mark. It is anticipated that this legislation will not make it to the Senate floor for a vote and will be wrapped up in an end of the year “omnibus” appropriations bill. This legislation is very important, however, because it will provide valuable information about the starting point for negotiations with the House. AMCHP will send a legislative alert with the funding level for the Block Grant as soon as the bill is released to the public.

HHS Announces New Funding, Regulations

CMS Innovation Awards
On May 8, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced the first batch of organizations for the Health Care Innovation awards. Made possible by the Affordable Care Act, the awards will support 26 innovative projects nationwide that will save money, deliver high-quality medical care and enhance the health care workforce. The preliminary awardees expect to reduce health spending by $254 million over the next three years. 

The new projects include collaborations of leading hospitals, doctors, nurses, pharmacists, technology innovators, community-based organizations and patients’ advocacy groups, among others, located in urban and rural areas that will begin work this year to address health care issues in local communities. This initiative allows applicants to come up with their best ideas to test how we can quickly and efficiently improve the quality and affordability of health care.

One interesting project that received financing is a University Hospitals of Cleveland initiative to increase access and care coordination for children beyond the walls of the doctor’s office. This initiative aims to save money and improve the quality of care by extending the expertise of an elite children’s hospital to local pediatric practices treating children with complex chronic conditions and behavioral health problems with physician extension teams and tele-health.

For more information, click here.

School-Based Health Care Center Funding
On May 9, HHS Secretary Sebelius announced the availability of funding for the construction and renovation of school-based health centers. These new investments, totaling up to $75 million, are part of the School-Based Health Center Capital Program, which was created by the Affordable Care Act. For more information, click here.

Increase in Payments for Primary Care
On May 9, HHS Secretary Sebelius also announced a proposed rule that primary care physicians serving Medicaid patients would see their Medicaid payments increase through the Affordable Care Act; this would bring Medicaid primary care service fees in line with those paid by Medicare. The boost would be in effect for calendar years 2013 and 2014. States would receive a total of more than $11 billion in new funds to bolster their Medicaid primary care delivery systems. AMCHP is currently reviewing the regulation and will provide analysis on the implications for our members. For more information, click here.

More States Work to Implement Health Care Law
HHS Secretary Kathleen Sebelius announced on May 16, that that Illinois, Nevada, Oregon, South Dakota, Tennessee and Washington will receive more than $181 million in grants to help implement the new health care law. The grants will help states establish Affordable Insurance Exchanges. These comprehensive health plans will ensure consumers have the same kinds of insurance choices as members of Congress. To date, 34 states and the District of Columbia have received establishment grants to fund their progress toward building exchanges. States can apply for exchange grants through the end of 2014, and these funds are available for states to use beyond 2014 as they continue to establish exchange functionality. This ensures that states have the support and time necessary to build the best exchange for their residents. For more information on the health insurance exchanges, click here.

More Guidance on Health Insurance Exchanges
On May 16, HHS provided more guidance to states on health insurance exchanges, including the Draft Blueprint for Approval of Affordable State-Based and State Partnership Insurance Exchanges, which can be found here. Additionally, a frequently asked questions page can be found here.

HHS also provided guidance on the Federally Facilitated Exchanges (FFEs). The FFE guidance describes the principles under which FFEs will operate in states that do not elect a state-based exchange. States electing a SPE approach must undergo the Blueprint process. The guidance document can be found here.

Affordable Care Act Supports Families of Children with Special Health Care Needs
On May 23, HHS Secretary Sebelius announced $4.9 million in Affordable Care Act funding to support Family-to-Family Health Information Centers, primarily nonprofit organizations run by and for families with children with special health care needs. The centers have served hundreds of thousands of families and health care providers. This funding will support 51 centers, one in each state and the District of Columbia. Each grantee will receive $95,700. A list of awards can be found here. For more information on the program, and other Health Resources and Services Administration (HRSA) maternal and child health programs, click here.