Tuesday, September 14, 2010

Update on 1099 Amendments; Berwick U-Turn on Rationing?

Politico has two articles this morning on the 1099 amendment votes expected today: One outlining the state of play of the Johanns and Nelson amendments, and a second on an Administration letter sent to the Hill yesterday supporting Nelson and opposing Johanns.  The letter from Secretaries Sebelius and Geithner opposes the Johanns amendment’s reduction in funding for the Prevention and Public Health Fund, which some have characterized as a source of wasteful federal spending on pork projects like jungle gyms.  Perhaps most notably, a Wall Street Journal article quotes a Treasury official as stating the Administration wants to “keep the [1099] proposal…as a means to ensure tax compliance,” while slightly mitigating its impact on small businesses.  (The news that the Administration does not want to repeal the 1099 reporting requirement outright may come as a surprise to the 239 House Democrats who voted for a complete repeal of the new requirement back in July.)  Meanwhile, small businesses themselves continue to highlight the problems that this onerous new reporting requirement will cause, while advocating for the complete repeal of the 1099 provision: The NFIB sent a key vote letter supporting Johanns and opposing the Nelson side-by-side, while US Chamber of Commerce Executive VP Bruce Josten has a Roll Call op-ed on the issue.

Meanwhile, CMS Administrator Don Berwick made news of his own yesterday; the Associated Press reported that in an address at AHIP’s convention in Washington, Berwick “[spoke] out against rationing,” claiming that reducing costs should not involve “withholding from us, or our neighbors, any care that helps.”  Unfortunately, the story also notes that Berwick once again “left without taking questions from reporters,” so no one could question him about how his lengthy prior history of support for rationing “with our eyes open” comports with the comments in his speech.  (The speech is not posted online, so it’s unclear based on the reported excerpts whether “care that helps” will be defined on cost-effectiveness grounds, as Dr. Berwick has previously supported.)  Sens. Grassley and Hatch however sought to remedy Dr. Berwick’s continued failure to answer questions, by writing him yesterday to request that he either 1) ask Finance Committee Chairman Baucus to hold a hearing where he can testify or 2) commit “to appear before a panel of interested senators” in the event Sen. Baucus still refuses to call a hearing.