The primary season began in earnest on Tuesday, May 18 and we learned several important lessons that night. For one, voter turnout was not particularly high, defying the expectations of many observers who believed voter anger would voice itself loudly at the first opportunity. Second, the night clearly went better for Democrats than it did for Republicans. The hard fought special election in PA-12 was decisively won by Democrat Mark Critz over Republican Tim Burns. Rep. Joe Sestak, who polling has shown to be the stronger candidate in a November general election matchup, toppled longtime Sen. Arlen Specter. In Kentucky, we saw progressive state Attorney General Jack Conway advance to take on staunch conservative Rand Paul in the race to succeed retiring Sen. Jim Bunning (R). Moderate Sen. Blanche Lincoln (D) will have to confront progressive challenger Lt. Gov. Bill Halter in a runoff, since Lincoln was unable to cross the 50% threshold necessary to win the primary outright.
Less than 24 hours after the conclusion of these primaries, we saw general election foes confronting one another with negative attacks. Republicans are trying to contain any impression that Tuesday’s results don’t bode well for their long term prospects this year, while Democrats are basing their narrative on the idea that voters evidently still support them.
While we certainly can’t speculate on what this all means for the remaining 5+ months of this year’s election cycle, we can say one thing for sure: this year’s midterm elections will continue to be spirited, intense, and hard fought, right through to November 2.
President Obama Unveils the 2010 National Drug Control Strategy
On May 11, President Obama unveiled the 2010 National Drug Control Strategy. The strategy was developed by the White House Office of National Drug Control Policy (ONDCP) with input from Federal, State and local partners. Highlights of the strategy include:
- Strengthen efforts to prevent drug use in communities including a focus on inhalants, pain killers, “study drugs” and steroids and curtailing drugged driving.
- Seek early intervention opportunities in health care especially by increasing the knowledge of healthcare providers in screening and brief intervention techniques.
- Integrate treatment for substance use disorders into health care, and expand support for recovery.
- Break the cycle of drug use, crime, delinquency and incarceration, including supporting alternatives to incarceration such as drug- and problem-solving courts.
- Disrupt Domestic Drug Trafficking and production with attention to domestic methamphetamine production and criminal distribution of prescription medications for nonmedicinal purposes
- Strengthen international partnerships.
- Improve information systems for analysis, assessment and local management.
For more information on the Strategy, go to http://www.whitehousedrugpolicy.gov/strategy/
DC Voting Rights Act Stalled
The D.C. Voting Rights Act attempts to enfranchise over 550,000 District of Columbia residents through the addition of one House seat for our Nation’s Capitol and another for the Republican-leaning state of Utah, which is the next state scheduled to pick up a seat according to the census count. However, despite the efforts of NASW as well as its coalition partners, H.R.175 was stalled due to significant alterations to the controversial gun amendment orchestrated by Reps. Childers (D-Miss.) and Souder (R-Ind.). NASW will continue to pursue enactment of the D.C. Voting Rights Act since social workers seek equality for all.
Congress Struggles over Medicare Rate Legislation
This legislation is active and we will post a blog about any developments later today, May 28, 2010.
The top priority legislative item Congress plans to complete this week is passage of a conference reported bill, “The American Jobs, Closing Tax Loopholes and Preventing Outsourcing Act” (H.R. 4213). The catch-all legislation includes Medicare, Medicaid and COBRA provisions supported by NASW, and a variety of tax provisions. The multifaceted bill would spur job growth and help Americans hurt by unemployment by:
- Averting the scheduled 21 percent cut in payment rates to Medicare practitioners who bill Part B independently, including physicians and clinical social workers. Rates would be allowed to increase in 2012 and 2013, if spending growth on services “is within reasonable limits,” and primary and preventive care services would receive a slightly larger allowance.
- Extending for six-months increased federal Medicaid matching rates to help states meet their current program needs. The extension sustains increased Medicaid matching rates granted under the American Recovery and Reinvestment Act, providing assistance through June 30, 2011.
- Extending COBRA subsidies for unemployed individuals through the end of this year.
Additionally, the bill would extend dozens of expired tax breaks designed to spur economic growth. The Senate plans to act following a House vote and prior to the Memorial Day recess, which begins on Friday, May 31. Passage of the legislation is very uncertain at this time. Congressional Democrats are deeply divided over the amount of revenue to apply toward the costs of the bill, and Republicans are united in opposition to the package, largely because the Medicaid provision isn’t paid for with offsetting federal spending cuts.
The Medicare Part B payments for practitioners have a long history of problems caused by a flawed “SGR” payment formula. Three times this year and seven other times over the last seven years Congress has been forced to delay substantial cuts in payments to practitioners. NASW has joined with other independent Medicare practitioners in calling on Congress to replace the flawed formula with one that better reflects the costs of providing Medicare services. The last short-term extension of the payment formula was adopted in April and delayed a decision on practitioner rates until May 31.
New Federal MH Parity Rules Generate Controversy
A number of managed care companies are objecting to new federal rules implementing the Paul Wellstone and Pete Domenici Mental Health Parity and Addictions Equity Act of 2008. Arguing the rules are too rigid, the companies say they limit their ability to manage behavioral health costs. Some plans have begun legal challenges as well as appeals to the White House to relax the rules. At this point, industry litigation and advocacy activities are in an early stage, and it is unclear whether their campaign will be successful. NASW submitted supportive comments on the interim final regulations on May 3. NASW’s comments focused on the interests of consumers and the social work profession. The much-anticipated regulations provided a 90-day public comment period. Additionally, NASW released a Legal Issue of the Month for April 2010, which provides a useful resource for social workers who want to learn more about the law.
New Ruling on Red Flag Rules Hoped for Soon
The Federal Trade Commission (FTC) is expected to announce within days whether it will again delay enforcement of the “Identity Theft Red Flags Rule” now slated to go into effect on June 1. The “Red Flags Rule” would require many businesses and organizations to implement a written identity theft prevention program designed to detect the warning signs of identity theft in their day-to-day operations. As written, the disputed rules would apply to a wide variety of independent professionals, including physicians and clinical social workers, in small private and group practices. The rule’s applicability to health care professionals, particularly small-scale practitioners, is highly controversial. The rule has been delayed previously on two separate occasions. NASW provided information about the identity theft regulations in the June 2009 LDF Legal Issue of the Month.
Representatives of health professionals have found support in Congress for postponing implementation of the regulation, and last year the House quickly passed a bill, H.R. 3763, to exclude licensed health practitioners with fewer than 20 people in a practice from reporting under the rule. The bill then stalled in the Senate, but the Senate chairman with jurisdiction has provided private assurances that he will pass it shortly.
Last week the American Medical Association filed federal suit against the rule, arguing that it places physician practices under the same regulations as banks, credit card companies and mortgage lenders. Their lawsuit filed in federal court in Washington, DC would block the FTC from imposing its rule on physicians. The lawsuit states that the rule requires ‘financial institutions’ to implement a written identity-theft prevention and detection plan and notes that the FTC had announced that physicians had until June 1 to comply.
Archived Health Reform Webchats Available
Do you have questions for health experts about how the new health care bill will affect your healthcare? Since March when the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010 became law, the White House has held monthly and sometimes weekly webchats to answer questions and discuss different aspects of the new health reform bill so that you, your family and friends can be informed. The most recent chat focused on how the Affordable Care Act will hold insurance companies accountable so that the health care system works for you rather than against you.
You can find previous webchats on www.healthreform.gov and also browse the site to find all the fact sheets and the latest information available from HHS on the new law.
National AIDS Strategy Outlined
On May 14, the Office of National AIDS Policy (ONAP) hosted a conference call to give stakeholders an update on the National AIDS Strategy (NAS). Jeff Crowley, Director of the Office of National AIDS Policy and Senior Advisor on Disability Policy talked about the President’s goals in achieving the NAS.
Mr. Crowley explained the NAS will be a short concise plan or roadmap for moving our country forward to 1) lower the HIV incidence, 2) increase access to care and address outcomes, 3) reduce HIV related disparities and 4) coordinate a national response. The NAS aims to:
1) Lower incidence by
- Refocusing on community efforts where HIV is most prevalent
- Using effective evidence based prevention methods
2) Expand coverage of and access to care by
- Creating a seamless system for continuous and coordinated care from HIV positive diagnosis to HIV care
- Taking deliberate steps to increase the diversity of the clinical care providers, including social workers
- Supporting people with co-infections and other social determinants such as housing, transportation and poverty
3) Reduce HIV-related health disparities by
- Ending stigma and discrimination against HIV positive individuals
- Redoubling efforts to provide age-appropriate education about HIV
- Creating new community level approaches to reduce HIV
4) Increase coordination
- Among federal government agencies
- Between the federal government and state, tribal, local governmental and community based agencies
- With better mechanisms and communication efforts on HIV status – a measurable refocus on the domestic epidemic
Once released, the NAS will include a timeline and a description of the federal government’s responsibilities in implementation as well as the role of all interested stakeholders.
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