First Edition: April 15, 2015

Kaiser Health News: FAQ: Congress Passes A Bill To Fix Medicare’s Doctor Payments. What’s In It?
Medicare’s troubled physician payment formula will soon be history. As expected, the Senate Tuesday night easily passed legislation to scrap the formula, accepting a bipartisan plan muscled through the House last month by Speaker John Boehner and Democratic leader Nancy Pelosi. The Senate vote came just hours before doctors faced a 21 percent Medicare pay cut. (Carey, updated 4/14)

Kaiser Health News: Boston Bombing Survivors Struggle With Medical And Emotional Recovery
It’s just the crumb of a muffin but Martha Galvis must pick it up. Lips clenched, eyes narrowed, she goes after the morsel, pushing it back and forth, then in circles, across a slick table top. "I struggle and struggle until," Galvis pauses, concentrating all her attention on the thumb and middle finger of her left hand. She can’t get them to close. "I try as much as I can. And if I do it I’m so happy, so happy," she says, giggling. (Bebinger, 4/15)

The New York Times: Senate Approves A Bill On Changes To Medicare
The Senate on Tuesday overwhelmingly approved sweeping changes in the way Medicare pays doctors, clearing the bill for President Obama and resolving an issue that has bedeviled Congress and the Medicare program for more than a decade. (Pear, 4/14)

Los Angeles Times: Senate Overhauls Doctors' Medicare Payments In Groundbreaking Vote
The unusually bipartisan bill, which passed the House easily last month, will immediately lift the threat of an automatic 21% cut in Medicare fees to physicians, which was set to take effect Wednesday. The legislation also marks a milestone in the push to modernize Medicare, the nation’s mammoth federal insurance program for the elderly, and move it away from the traditional system of paying physicians for every procedure they perform. The bill passed with an overwhelming majority, 92 to 8. (Levey, 4/14)

The Wall Street Journal: Senate Clears Bill To Permanently Change Medicare Reimbursement Formula
President Barack Obama has said he would sign the measure into law. Under the legislation, doctors would receive a 0.5% pay increase starting in July, with additional 0.5% annual pay raises through 2019, before the government starts giving new incentives to doctors to adopt alternative payment models instead of participating in the traditional fee-for-service program. (Hughes, 4/14)

USA Today: Senate Passes Bipartisan 'Doc Fix' Medicare Bill
Sen. Rand Paul, R-Ky., one of three GOP senators who have announced that they are running for president, voted to approve the bill. The other two presidential hopefuls, Sens. Ted Cruz of Texas and Marco Rubio of Florida, voted against it. Senate Majority Leader Mitch McConnell said the bill would "ensure seniors on Medicare don't lose access to their doctors." Many doctors would have been reluctant to accept Medicare patients if the federal payments to physicians had dropped 21%, the bill's supporters said. (Kelly, 4/14)

Politico: Bipartisan Senate Ends Flawed Medicare Payment Formula
The legislation repeals the old Medicare payment formula, called the Sustainable Growth Rate, and replaces it with a new one. It also funds the Children’s Health Insurance Program and community health centers for two more years. It will be paid for by having high-income seniors cover more of their Medicare costs and by requiring basic co-payments in Medigap plans. (Haberkorn, 4/14)

The Washington Post: Hours From Deadline, Bipartisan Medicare Bill Heads To White House
Despite the last-minute nature of the vote, it was lauded by Hill leaders as a bipartisan triumph for both removing a yearly headache from the legislative calendar but also by implementing modest reforms to Medicare, including future incentives for doctors to deliver better care as well as premium hikes for the wealthiest Medicare recipients. ... The "doc fix" has been necessitated by a 1997 legislative provision known as the Sustainable Growth Rate, which mandated that Medicare fees could not exceed the growth in the overall U.S. economy. But as actual health-care costs have far outstripped the fee hikes allowed by the 1997 legislation, Congress has been forced to step in on a yearly basis to reset the rates or risk the possibility that many health-care providers would stop treating Medicare recipients. (DeBonis, 4/14)

The Wall Street Journal: Health Care Law Trips Up Some At Tax Time
The tax filing season has uncovered lingering wrinkles in the 2010 health-care law that have caused headaches for consumers who incorrectly estimated their income, didn’t use a government exchange to buy an insurance plan or changed coverage during the year. Marta Chapman saw her anticipated $850 federal refund wiped out because she received too much in advance tax credits in 2014 to pay her insurance premiums under the Affordable Care Act. That prompted her to drop her plan for this year. (Radnofsky, 4/14)

USA Today: Many Unaware Of Required Tax-Time Insurance Reporting
The special health insurance enrollment period set up for people surprised by their tax penalties hasn't appeared to increase either awareness or enrollment by much, new research shows. People who live in the 34 states that use HealthCare.gov and didn't know about the requirement to have health insurance can sign up through April 30 for 2015 coverage. (O'Donnell, 4/15)

The New York Times: In Race for Medicare Dollars, Nursing Home Care May Lag
Promises of “decadent” hot baths on demand, putting greens and gurgling waterfalls to calm the mind: These luxurious touches rarely conjure images of a stay in a nursing home. But in a cutthroat race for Medicare dollars, nursing homes are turning to amenities like those to lure patients who are leaving a hospital and need short-term rehabilitation after an injury or illness, rather than long-term care at the end of life. (Katie Thomas, 4/14)

The Washington Post: House Members Angry Over VA’s Response To Whistleblowers
Monday’s session demonstrated that VA’s entrenched culture of retaliation against whistleblowers endures, a year after revelations exploded over poor service and the covering up of long patient wait times. The retaliation continues despite the solid efforts of the current VA secretary, who replaced one driven out by the scandal. (Davidson, 4/14)

The Wall Street Journal: Medical-College Entrance Exam Gets An Overhaul
The essay section is out and sociology is in, and test-takers will need to be as familiar with psychology terms like “reciprocal determinism” as they are with organic chemistry. The 8,200 aspiring doctors expected to take the Medical College Admission Test, or MCAT, this week will find a very different exam than their predecessors took. (Melinda Beck, 4/15)

NPR: Is That Corporate Wellness Program Doing Your Heart Any Good?
Odds are your employer has a wellness program that prods you to exercise and eat healthy. But that program may not be doing all that much for your health, according to the American Heart Association, and attempts to measure the benefits of wellness programs often fail. When it comes to improving cardiovascular health, "most of the programs appear to be falling short," says Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, and lead author of the scientific statement, which was published Monday in the journal Circulation. (Shute, 4/14)

The Wall Street Journal: Florida Doctor Linked To Sen. Robert Menendez Indicted For Medicare Fraud
A Florida eye doctor facing corruption charges with New Jersey Sen. Robert Menendez was indicted Tuesday for health-care fraud, with prosecutors alleging he cheated the federal Medicare program while receiving payments of $105 million over six years. The payments to Salomon E. Melgen continued for much of that time despite scrutiny by federal officials, highlighting vulnerabilities in the federal program for the elderly and disabled. (Weaver and Stewart, 4/14)

Los Angeles Times: Florida Doctor In Sen. Menendez Bribery Case Charged With Medicare Fraud
A Forida doctor accused of bribing U.S. Sen. Robert Menendez has been indicted on suspicion of carrying out extensive Medicare fraud at his eye-care practice for a decade and for treating patients for disorders they didn't have, officials said Tuesday. (Pearce, 4/14)

Politico: Menendez Donor Indicted On 76 Counts
But now, Melgen is facing more legal troubles. Federal prosecutors in Florida say Melgen, 61, would falsely diagnose patients at his southern Florida practice for eye conditions such as age-related macular degeneration, submit false Medicare claims and create fake entries on his patients’ medical charts. Melgen would then use the false diagnoses to perform “medically unreasonable and unnecessary tests and procedures” such as laser surgery and eye injections, prosecutors said. (Kim, 4/14)

The Wall Street Journal: Christie Calls For Social Security Cuts
In addressing entitlements, Mr. Christie sought to cast himself as independent from an unpopular Congress and willing to tell hard truths about programs he said threatened to “bankrupt our nation.” ... While GOP lawmakers and leaders have often called for scaling back health-care entitlements, Social Security has presented more of a political third rail. Recent Republican budgets haven’t proposed major changes to Social Security and instead focused on overhauling Medicare, the federal health insurance for the elderly and disabled, which trustees last year said was on pace to exhaust its reserves in 2030. Current estimates show the Social Security program will be unable to make full benefit payments by 2034, which means lawmakers could be forced before then to contemplate raising Social Security taxes or reducing benefits. Mr. Christie’s proposal in many ways would go beyond the most detailed overhaul Rep. Paul Ryan (R., Wis.) proposed in 2010. (Haddon, Hook and Timiraos, 4/14)

The Wall Street Journal: Chris Christie’s Expansion Of Medicaid In New Jersey Angers Some Republicans
As Gov. Chris Christie tells audiences in New Hampshire that he wants to cut Social Security and other entitlement spending, his move to expand Medicaid in New Jersey has angered some Republicans. Since the decision two years ago to expand Medicaid in New Jersey under the Affordable Care Act, 400,000 more recipients have enrolled, state officials say. Overwhelmed by the surge, some counties paid staff members overtime to process applications. (Dawsey and Haddon, 4/14)

Los Angeles Times: Christie Calls For Cuts In Social Security, Medicare
New Jersey Gov. Chris Christie, saying that the “American people have the appetite for hard truths,” called Tuesday for cutting Social Security benefits and raising Medicare premiums for future upper-income retirees and raising the retirement age. Although several other Republicans with presidential ambitions have called for changes in the nation’s giant retirement benefits programs, Christie’s proposals are more detailed and more likely to generate controversy. (Lauter, 4/14)

Los Angeles Times: After Soaring Rhetoric, Rubio Begins To Outline Policy Positions
‎He told Hannity that Medicare would need to be changed if it is to remain solvent, a nod to a GOP plan that would give future seniors -- people now in their mid-50s and younger -- a lump sum to buy insurance or apply to Medicare. (Mascaro, 4/14)

Los Angeles Times: Digital Health Records Are Not Safe, Report On Breaches Shows
Electronic health records were supposed to make life better for patients and doctors -- getting rid of bulky and messy paper files, streamlining delivery of care and organizing medical information so that scientists can use it to make discoveries. But those benefits could be for naught if digital medical data aren't safe -- and they don't appear to be. A new analysis of government records, published Tuesday in the journal JAMA, found that close to a thousand large data breaches affected 29 million medical records between 2010 and 2013. (Brown, 4/14)

The Associated Press: Patients' Medical Records Under Threat From Data Breaches
Your private medical information is under threat. That's according to a study that found almost 30 million health records nationwide were involved in criminal theft, malicious hacking or other data breaches over four years. The incidents seem to be increasing. (4/14)

The Wall Street Journal's Pharmalot: Feds To Probe Impact Of Generic Drug Price Increases On Medicaid
Following prodding from Congressional lawmakers, the Office of the Inspector General of the U.S. Department of Health & Human Services says it will conduct a new review of generic drug price increases on the Medicaid drug rebate program. The agency plans to review price increases between 2005 and 2014 in order to determine the extent to which generic drug prices exceeded the inflation rate, according to a letter the OIG sent to U.S. Sen. Bernie Sanders (I-Vt.) and U.S. Rep. Elijah Cummings (D-Md.). (Silverman, 4/14)

The Wall Street Journal: U.S. Tobacco Companies File Suit Against FDA Over Label Regulations
The biggest U.S. tobacco companies on Tuesday filed a federal lawsuit against the Food and Drug Administration, challenging an alleged effort to assert authority over labels on tobacco products. Tobacco subsidiaries of Altria Group Inc., Reynolds American Inc. and Lorillard Inc. argue a recent FDA requirement violates free speech by requiring them to submit labels for approval. (Mickle, 4/14)

Los Angeles Times: New Bills Renew California's Anti-Smoking Effort
California has become a battleground between the tobacco industry and health groups as lawmakers push proposals that include increasing cigarette taxes by $2 a pack and raising the legal smoking age from 18 to 21. The state once led the nation in snuffing out smoking, but health activists say a strong tobacco lobby and a lack of political will have blocked new efforts in recent years. "We used to be leaders, and we are not anymore," said Stanton A. Glantz, a professor of medicine at UC San Francisco. (McGreevy, 4/14)