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Affordable Care Act (ACA)

Health Affairs: Analysis of DC and Fourth Circuit Halbig Decisions
To get smart on the conflicting opinions regarding the legality of ACA premium subsidies in Federal exchanges, you cannot beat Prof. Jost's post. Cases in IN and OK are still pending at trial level.
AP: Oregon's Medicaid Enrollment Soars; Access is Limited by Physician Shortages
Oregon expanded Medicaid and increased care coordination in an effort to increase use of primary care.  With physician shortages and 360k new enrollees, access to care is limited and ER use is rising.
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Employer Sponsored Insurance

KHN: Business and Consumer Advocates Draw Lines in the Sand About Essential Benefits
The ACA essential health benefits provision is set to go into effect in 2016. Businesses are pushing for greater consciousness of premium costs and the consumers are looking to safeguard coverage.
CMS: Slides: Reinsurance Contribution Logistics, Counting Methods
A CMS presentation conveys a range of operational guidance on plans' computation and submission of reinsurance contributions, including methods for counting the applicable number of covered lives for which contributions are due (beginning on slide 22). Also see recent CCIIO guidance on counting methods (here).
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Doctors

AP: Oregon's Medicaid Enrollment Soars; Access is Limited by Physician Shortages
Oregon expanded Medicaid and increased care coordination in an effort to increase use of primary care.  With physician shortages and 360k new enrollees, access to care is limited and ER use is rising.
CMS: Guide: Physician Registration in Open Payments System; Resource Also Available for Teaching Hospitals
CMS offers a "quick reference guide" for physicians looking to register in the Open Payments system, a step that will enable them to view, dispute and correct industry-submitted data on payments or transfers involving them. Also see a guide for teaching hospitals (here).
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Prescription Drugs

Inside Health Policy: Health Plans Continue to Decry Cost of Sovaldi
Following Gilead's report of $3.48B in second quarter sales of Hep C drug Sovaldi, health plans continue to point to drug's excessive cost. Also: IHP($) on Congressional inquiry; NYT; WSJ($)
FDA: Agency Approves Extended-Release, Long-Acting Opioid; Cites Abuse-Deterrent Properties
The FDA approved Purdue Pharma's Targiniq ER (oxycodone hydrochloride and naloxone hydrochloride extended-release tablets), “an extended-release, long-acting opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.” The FDA highlighted that Targiniq ER marks the second extended-release, long-acting opioid analgesic to include labeling noting abuse-deterrent properties that, the FDA says, “are expected to deter, but not totally prevent, abuse of the drug by snorting and injection.” Also, The Hill
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Medicaid – General

Modern Healthcare: Suit Accuses Tennessee of Delaying Medicaid Enrollments
U.S. District Court lawsuit alleges that Tennessee harmed Medicaid individuals by directing them to Healthcare.gov which was not created to process Medicaid and led to delays. Also Hill($), KHN  
AP: Oregon's Medicaid Enrollment Soars; Access is Limited by Physician Shortages
Oregon expanded Medicaid and increased care coordination in an effort to increase use of primary care.  With physician shortages and 360k new enrollees, access to care is limited and ER use is rising.
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Health Information Technology (HIT)

Health Affairs: Primary Care Incentives with Health IT Adoption
Reporting burdens and poor usability still limit full Health IT integration into primary care. This post pushes for reforming HIT payment incentives, innovation, and increased education of HIT.
CMS: CMS Announces 14 Quality Improvement Organizations
The Centers for Medicare & Medicaid Services (CMS) awarded 14 contracts for Quality Improvement Organizations (QIO) that will focus on improving the quality of health services that beneficiaries receive across the spectrum of care. Projects will be based in communities, health care facilities, and clinical practices. QIO projects will include strategic efforts in the following areas: QIO will improve care by convening learning networks to share best practices, providing technical assistance, and compiling and analyzing data for improvement. The new contracts are part of the second phase of CMS' restructuring of the Quality Improvement Program. Related, IHP ($)
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Health Insurance Exchanges

NEJM: Study: 10 Million Uninsured Gain Coverage under First Marketplace Open Enrollment Period
Roughly 10.3 million adults were newly covered under the initial Marketplace open enrollment period, though estimates fluctuate based on confidence intervals. Also: HHS press release; WP; Politico
Health Affairs: Analysis of DC and Fourth Circuit Halbig Decisions
To get smart on the conflicting opinions regarding the legality of ACA premium subsidies in Federal exchanges, you cannot beat Prof. Jost's post. Cases in IN and OK are still pending at trial level.
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Hospitals

SAMHSA: Rise in Methamphetamine-Related Hospital ED Visits
A new SAMHSA report found that hospital emergency department visits related to the use of the illicit drug methamphetamine rose from 67,954 in 2007 to 102,961 in 2011.
CDC: Report: Traumatic Brain Injury (TBI) Incidence in the US
In order to promote research and help people better recognize, respond and treat TBI, the Centers for Disease Control and Prevention (CDC) releases period reports on TBI incidence in the US. Data show that in 2010, 2.5 million TBIs occurred either as an isolated injury or along with other injuries.
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Quality

NQF: Trial Needed to Test Impact of Sociodemographic Factors on Quality Metrics
In a press release, NQF backed off expert panel recs to account for sociodemographic factors like poverty in risk adjusting performance on quality metrics, saying a trial period is necessary.
CMS: Slides Highlight Key Proposals on ESRD Quality Incentive Program
On a July 23 National Provider Call, CMS officials presented on ESRD Quality Incentive Program (QIP) proposals laid out in the CY15 proposed rule, affecting the 2017-18 (QIP) payment years (PYs). Key topics include "proposed measures, standards, scoring and [the] payment reduction scale for PY17-18."
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Legal

Health Affairs: Analysis of DC and Fourth Circuit Halbig Decisions
To get smart on the conflicting opinions regarding the legality of ACA premium subsidies in Federal exchanges, you cannot beat Prof. Jost's post. Cases in IN and OK are still pending at trial level.
4th Circuit: Courts Issue Conflicting Rulings Regarding Legality of ACA Premium Subsidies
Two U.S. Court of Appeals panels issued conflicting rulings regarding the legality of offering ACA premium subsidies in federally-facilitated exchanges. In King v. Burwell, the Fourth Circuit Court of Appeals ruled unanimously that the IRS is valid in allowing premium tax credits in both state-run and federally-facilitated exchanges.  The judges found that, "the applicable statutory language is ambiguous and subject to multiple interpretations."  As such, the IRS' interpretation is "a permissible exercise of the agency's discretion". Just hours earlier, in Halbig v. Burwell, D.C. Circuit Court of Appeals ruled 2-1 that ObamaCare subsidies are not legal since the statutory language of the ACA does not explicitly allow enrollees on federally-facilitated exchanges to receive premium tax credits. Split appeals often carry cases to the Supreme Court.  Since Halbig v. Burwell was decided by a 3-judge panel, however, the White House will ask the full 11-member D.C. Court of Appeals court to hear the case.  If the full court, composed of 7 Democratic appointees including 4 appointed by President Obama, rules in favor of the IRS' interpretation of the ACA premium subsidies, the cases are not likely to go to the Supreme Court. Also, The Hill (1), The Hill (2), NJ (1) ($), NJ (2), CQ ($), IHP, Modern Healthcare ($), KHN, WSJ($), USA Today, WP, NYT ($), AP (1), AP (2), Reuters, WP, NPR (1), NPR (2), Vox (1), Vox (2), Bloomberg (1), Bloomberg (2), Health Reform GPS
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Delivery Reform

CMS: Final Demo Agreement: CO Managed FFS for Duals
The agreement provides the terms and conditions for Colorado's Demonstration to Integrate Care for Medicare-Medicaid Enrollees. The demo will run from Sept 1, 2014 through Dec 31, 2017, and provide care coordination, through the state's Accountable Care Collaborative, for more than 48,000 dual eligibles in the state. CMS will share in any savings generated.
Inside Health Policy: CMS Creates Portal for States to Share Innovative Practices
HHS has created a portal on the CMS website to help states aggregate data, coordinate communication, and share best practices relating to delivery system and payment reform.  
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Prevention

Senate HELP Committee: Senate Committee Approves 6 Public Health Bills
The Senate Health, Education, Labor and Pensions (HELP) Committee unanimously approved 6 public health bills including legislation promoting exercise, improving emergency care, and strengthening care provided to individuals suffering traumatic brain injuries. Legislation approved includes the Emergency Medical Services for Children Reauthorization Act of 2014 (S. 2154), Physical Activity Guidelines for Americans Act (S. 531), Trauma Systems and Regionalization of Emergency Care Reauthorization Act (S. 2405), Improving Trauma Care Act of 2014 (S. 2406), Traumatic Brain Injury Reauthorization Act of 2014 (S. 2539), and Paul D. Wellstone Muscular Dystrophy Community Assistance, Research and Education (MD-CARE) Amendments of 2013 (S. 315) Related, The Hill ($)
NPR: Some States Improve Access to Postpartum Contraception
Some states, such as NY, have changed Medicaid reimbursement policy to cover contraception while a woman is still in the hospital after giving birth.
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