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Polsinelli Shughart Health Reform and Related Health Policy News
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An executive summary of political, legal and regulatory issues that may impact your business, prepared by Polsinelli Shughart Health Care legal and Public Policy professionals.


Health Reform + Related Health Policy News

Update for November 7, 2012


Top News


Treasury Department Denies Request for Information Related to Decision on Federally-Run Exchange Subsidies

Officials at the Department of Treasury have rejected a request for documents from GOP leaders on the House Oversight and Government Reform Committee in relation to an IRS rule that allows tax credits on health insurance exchanges that are run by the federal government. Opponents of the rule contend that such subsidies are not permitted by the legislative language of the health reform law. Of particular concern to opponents of the rule is that under the Affordable Care Act, small employers could be subject to penalties if they do not offer health insurance and their employees obtain subsidized coverage on state health insurance exchanges. [More ...]


AHA Sues HHS Over CMS Payment Denial Policy

The American Hospital Association (AHA) and four individual hospital systems have filed suit in federal court challenging a CMS policy regarding recovery audit contractor (RAC) coverage determinations. [More ...]


Compounding Bill Requires Compliance with Some Manufacturing Requirements

Rep. Ed Markey (D-MA) has introduced legislation that would regulate some drug compounders in a way that is similar to regulation of drug manufacturers. [More ...]


MedPAC Endorses Changes to Therapy Exceptions Process, Lowers Caps

The Medicare Payment Advisory Commission on November 1 approved recommendations to Congress to reform the payment policy for outpatient therapy services. [More ...]


MedPAC Recommends Eliminating Some Special Needs Plans

In its recent meeting, MedPAC recommended that Congress eliminate some special needs plans (SNPs). SNPs were authorized in the Medicare Modernization Act to target any one of three special-needs populations: beneficiaries who are institutionalized (I-SNPs), have severe or disabling chronic conditions (C-SNPs), or qualify both for Medicare and Medicaid benefits (D-SNPs). [More ...]


Uncertainty on Medicaid Expansion, DSH Funding, Concerns NAPH

States that opt not to expand Medicaid coverage and cuts in federal Disproportionate Hospital Payments (DSH) will have "disastrous consequences" on the low-income population, according to the National Association of Public Hospitals and Health Systems (NAPH). In a recent position paper, NAPH estimated that safety-net hospitals would have $53.3 billion in uncompensated care costs by 2019. [More ...]


State News


Regulatory News


Additional Reading

Click here for a list of additional articles on page 8.


Federal Register

Click here to preview a summary of notices which appeared in the November 5 - November 15, 2012 Federal Register on page 9.




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