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We said last week that we expected the Supreme Court to strike down the Individual Mandate in its health care reform hearings.Tuesday's session confirmed our suspicions.

The individual mandate is the feature of the Affordable Care Act that requires nearly all citizens have some sort of coverage -- either government programs such as Medicaid or, if they don't qualify for that, private insurance provided via exchanges or on the market. 

The near-universal involvement shares the risk sufficiently, advocates say, to bring the cost of insurance way down. But it also requires many citizens to purchase a service, which opponents find unconstitutional.
 
This is no shock. The Court is generally portrayed as ideologically split between four conservatives and  four liberals, with Justice Kennedy providing the "swing" vote. It's not a hard and fast rule but, as we said, it seems to apply when major political issues come to the Court.  This is a major political issue, and the Justices are clearly eager to engage. 

The Court is not inclined to recuse itself.

Monday's Supreme Court hearing, beginning the mega-case that will decide the fate of the Affordable Care Act (ACA), included "hard-nosed questions" from the Justices, said Modern Healthcare, but few clues as to which way the judges were inclined.

The latest MedPAC report urges repeal of the SGR -- of course. What will Congress do with that?

 In its March 2012 report, MedPAC recommended a series of payment adjustments, including a 1% increase in payment rates for hospital inpatient and outpatient services. (They found the Medicare profit margins for hospitals improved between 2008 and 2010 -- but remain negative at −4.5%.)

They also recommended Congress "reduce payment rates for evaluation and management office visits provided in hospital outpatient departments so that total payment rates for these visits are the same whether the service is provided in an outpatient department or a physician office."

But the deadline (this past Jan. 1) remains the same. Back in November, you'll recall, CMS gave a break to practices who weren't ready to implement the new ASC X12 Version 5010 standards for HIPAA transaction security. They didn't push back the actual deadline -- but they did say they "would not initiate enforcement action until March 31, 2012." 

Now here we are, mid-March, and 5010 has remained a sore point, with practice advocates calling for another extension

CMS held a provider call Monday, March 12, on the Proposed Rule for Stage 2 Meaningful Use EHR stardards. If you couldn't make the call, here's a breakdown of what you missed:

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