The President’s Budget for Fiscal Year 2013

We now face a make-or-break moment for the middle class and those trying to reach it. After decades of eroding middle-class security as those at the very top saw their incomes rise as never before and after a historic recession that plunged our economy into a crisis from which we are still fighting to recover, it is time to construct an economy that is built to last.

The President’s 2013 Budget is built around the idea that our country does best when everyone gets a fair shot, does their fair share, and plays by the same rules. We must transform our economy from one focused on speculating, spending, and borrowing to one constructed on the solid foundation of educating, innovating, and building. That begins with putting the Nation on a path to living within our means – by cutting wasteful spending, asking all Americans to shoulder their fair share, and making tough choices on some things we cannot afford, while keeping the investments we need to grow the economy and create jobs. The Budget targets scarce federal resources to the areas critical to growing the economy and restoring middle-class security: education and skills for American workers, innovation and research and development, clean energy, and infrastructure.

The Budget is a blueprint for how we can rebuild an economy where hard work pays off and responsibility is rewarded.

• President’s Message
• The Budget
• Overview
• Cuts, Consolidations, and Savings
• Analytical Perspectives
• Historical Tables
• Supplemental Materials
• Appendix
• Supplementals, Amendments, and Releases
• OMB Contributors to the Budget
• Fact Sheets
• E-Book
• Past Budgets
• Mid-Session Review

Please take some time to peruse these links and get familiar with the values espoused in the President’s proposed budget.  Then, each time you hear unelected Sen. Heller or Rep. Amodei talk about President Obama operating without a budget for whatever length of time, please remind them that it’s the President’s job to propose a budget and that it’s the job of Congress to pass a budget. President Obama has done that each year he’s been in office.

Remember, according to the Constitution, which the GOP is so fond of talking about, ONLY the House of Representatives can appropriate monies.  So if our nation doesn’t have an approved budget, that’s not the President’s job. It’s the job of Congress to take the budget as proposed by the President, make appropriate adjustments, approve the adjusted budget and return it to him for his signature.  So, they should look in the mirror and chastise their own reflections.

PPACA: Enforcement Efforts Recover ~$4.1B

FOR IMMEDIATE RELEASE February 14, 2012

Contact: http://www.justice.gov | (202) 514-2007 HHS Press Office | (202) 690-6343

Health Care Fraud Prevention and Enforcement Efforts Result
in Record-Breaking Recoveries Totaling Nearly $4.1 Billion

Largest Sum Ever Recovered in Single Year

WASHINGTON –Attorney General Eric Holder and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today released a new report showing that the government’s health care fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayer dollars in Fiscal Year (FY) 2011.  This is the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers or who sought payments to which they were not entitled.

These findings, released today, in the annual Health Care Fraud and Abuse Control Program (HCFAC) report, are a result of President Obama making the elimination of fraud, waste and abuse a top priority in his administration.  The success of this joint Department of Justice and HHS effort would not have been possible without the Health Care Fraud Prevention & Enforcement Action Team (HEAT), created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs, and to crack down on the fraud perpetrators who are abusing the system and costing American taxpayers billions of dollars.  These efforts to reduce fraud will continue to improve with the new tools and resources provided by the Affordable Care Act.

“This report reflects unprecedented successes by the Departments of Justice and Health and Human Services in aggressively preventing and combating health care fraud, safeguarding precious taxpayer dollars and ensuring the strength of our essential health care programs,” said Attorney General Holder.  “We can all be proud of what’s been achieved in the last fiscal year by the Department’s prosecutors, analysts and investigators – and by our partners at HHS.  These efforts reflect a strong, ongoing commitment to fiscal accountability and to helping the American people at a time when budgets are tight.”

“Fighting fraud is one of our top priorities and we have recovered an unprecedented number of taxpayer dollars,” said Secretary Sebelius.  “Our efforts strengthen the integrity of our health care programs, and meet the President’s call for a return to American values that ensure everyone gets a fair shot, everyone does their fair share, and everyone plays by the same rules.”

Approximately $4.1 billion stolen or otherwise improperly obtained from federal health care programs was recovered and returned to the Medicare Trust Funds, the Treasury and others in FY 2011.  This is an unprecedented achievement for HCFAC, a joint effort of the two departments to coordinate federal, state and local law enforcement activities to fight health care fraud and abuse.

The recently-enacted Affordable Care Act provides additional tools and resources to help fight fraud that will help boost these efforts, including an additional $350 million for HCFAC activities.  The administration is already using tools authorized by the Affordable Care Act, including enhanced screenings and enrollment requirements, increased data sharing across government, expanded overpayment recovery efforts and greater oversight of private insurance abuses.

Since 2009, the Departments of Justice and HHS have enhanced their coordination through HEAT and have increased the number of Medicare Fraud Strike Force teams.  During FY 2011, HEAT and the Medicare Fraud Strike Force expanded local partnerships and helped educate Medicare beneficiaries about how to protect themselves against fraud.  The departments hosted a series of regional fraud prevention summits around the country, provided free compliance training for providers and other stakeholders and sent letters to state attorneys general urging them to work with HHS and federal, state and local law enforcement officials to mount a substantial outreach campaign to educate seniors and other Medicare beneficiaries about how to prevent scams and fraud.

In FY 2011, the total number of cities with strike force prosecution teams was increased to nine, all of which have teams of investigators and prosecutors from the Justice Department, the FBI, and the HHS Office of Inspector General, dedicated to fighting fraud.  The strike force teams use advanced data analysis techniques to identify high-billing levels in health care fraud hot spots so that interagency teams can target emerging or migrating schemes along with chronic fraud by criminals masquerading as health care providers or suppliers.  In FY 2011, strike force operations charged a record number of 323 defendants, who allegedly collectively billed the Medicare program more than $1 billion.  Strike force teams secured 172 guilty pleas, convicted 26 defendants at trial and sentenced 175 defendants to prison.  The average prison sentence in strike force cases in FY 2011 was more than 47 months.

Including strike force matters, federal prosecutors filed criminal charges against a total of 1,430 defendants for health care fraud related crimes.  This is the highest number of health care fraud defendants charged in a single year in the department’s history.  Including strike force matters, a total of 743 defendants were convicted for health care fraud-related crimes during the year.

In criminal matters involving the pharmaceutical and device manufacturing industry, the department obtained 21 criminal convictions and $1.3 billion in criminal fines, forfeitures, restitution and disgorgement under the Food, Drug and Cosmetic Act.  These matters included the illegal marketing of medical devices and pharmaceutical products for uses not approved by the Food and Drug Administration (FDA) or the distribution of products that failed to conform to the strength, purity or quality required by the FDA.

The departments also continued their successes in civil health care fraud enforcement during FY 2011.  Approximately $2.4 billion was recovered through civil health care fraud cases brought under the False Claims Act (FCA).  These matters included unlawful pricing by pharmaceutical manufacturers, illegal marketing of medical devices and pharmaceutical products for uses not approved by the FDA, Medicare fraud by hospitals and other institutional providers, and violations of laws against self-referrals and kickbacks.  This marked the second year in a row that more than $2 billion has been recovered in FCA health care matters and, since January 2009, the department has used the False Claims Act to recover more than $6.6 billion in federal health care dollars.

The fraud prevention and enforcement report announced today coincides with the announcement of a proposed rule from the Centers for Medicare and Medicaid Services aimed at recollecting overpayments in the Medicare program. Before the Affordable Care Act, providers and suppliers did not face a deadline for returning taxpayers’ money. Thanks to the Affordable Care Act, there will be a specific timeframe by which self-identified overpayments must be returned. The Obama Administration has made prevention and recollection of overpayments a government-wide priority. These announcements today are just the latest in a series of steps that the administration is taking to protect taxpayer dollars and keep money in the pockets of Americans.

The HCFAC annual report can be found here, oig.hhs.gov/publications/hcfac.asp.  For more information on the joint DOJ-HHS Strike Force activities, visit: www.StopMedicareFraud.gov/.

For more information on the fraud prevention accomplishments under the Affordable Care Act visit:http://www.healthcare.gov/news/factsheets/2012/02/medicare-fraud02142012a.html

PPACA — Progress Seen in Use of Electronic Health Record

FOR IMMEDIATE RELEASE February 17, 2012

Contact: HHS Press Office (202) 690-6343

HHS Secretary Kathleen Sebelius announces major progress in doctors, hospital use of health information technology

Kansas City, MO – Today, U.S. Department of Health and Human Services’ Secretary Kathleen Sebelius announced the number of hospitals using health information technology (IT) has more than doubled in the last two years.  She also announced new data showing nearly 2,000 hospitals and more than 41,000 doctors have received $3.1 billion in incentive payments for ensuring meaningful use of health IT, particularly certified Electronic Health Records (EHR).

Secretary Sebelius is in Kansas City, Missouri visiting Metropolitan Community College-Penn Valley Health Science Institute to make this announcement and discuss the growth of professional jobs in the health information technology field.

“Health IT is the foundation for a truly 21^st century health system where we pay for the right care, not just more care,” said Secretary Sebelius.  “Health care professionals and hospitals are taking advantage of this unprecedented opportunity to begin using smarter, new technology that improves care and creates the jobs we need for an economy built to last.”

Today’s announcement details information from a new survey conducted by the American Hospital Association and reported by the HHS Office of the National Coordinator for Health IT which found that the percentage of U.S. hospitals that had adopted EHRs has more than doubled from 16 to 35 percent between 2009 and 2011.  And, 85 percent of hospitals now report that by 2015 they intend to take advantage of the incentive payments made available through the Medicare and Medicaid EHR Incentive Programs.

The announcement also highlights new data from the Centers for Medicare & Medicaid Services (CMS) detailing $3.12 billion in incentive payments the agency has made to physicians, hospitals, and other health care providers who have started to meaningfully use EHRs to improve the quality of patient care.  In January alone, CMS provided $519 million to eligible providers.  EHR incentive payments can total as much as $44,000 under the Medicare EHR Incentive Program and $63,750 under the Medicaid EHR Incentive Program.

According to the Bureau of Labor Statistics, the number of health IT jobs across the country is expected to increase by 20 percent from 2008 to 2018, a pace much faster than the average for all occupations through 2018.  In conjunction with her announcement today, Secretary Sebelius will tour the Penn Valley Community College Health Science Institute, which trains students for careers in this growing industry.  She will also participate in a roundtable discussion with Community College leaders, students training in the health IT field, health care providers, patients and area employers about the importance of health information technology training in both improving patient outcomes and creating jobs.

The Obama administration provides financial support to eligible health care professionals and hospitals to make the switch to health IT and certified EHRs through the Medicare and Medicaid EHR Incentive Programs.  These programs are funded by the HITECH Act provisions of the 2009 Recovery Act.  The administration has also created a nationwide network of 62 Regional Extension Centers to provide technical guidance and resources to help eligible health care providers participate in the EHR Incentive Programs and meaningfully use certified EHRs.

To meet the demand for workers with health IT experience and training, the Obama Administration has also launched four workforce training programs.  Training is provided through 82 community colleges and nine universities nationwide. As of January 2012, over 9,000 community college students have been trained for health IT careers and another 8,706 students have enrolled.  And as of February 2012, participating universities have enrolled over 1,200 students and graduated nearly 600 post-graduate and masters-level health IT professionals, with over 1,700 expected to graduate by the summer of 2013.

Two other workforce training programs have resulted in the development of a health IT workforce curriculum and a health IT worker competency examination.  The health IT workforce curriculum offers colleges and universities in all 50 states innovative health IT teaching materials at no cost to instructors. And, since its release in May, 2011, over 2,000 individuals have taken the HIT Pro Exam, a competency examination designed to show employers that job-seekers have attained a proficient level of knowledge and skills in health IT.

Health IT can help keep information private and secure. In addition, federal laws require key persons and organizations that handle health information to have policies and security safeguards in place to protect health information—whether it is stored on paper or electronically. For more information on how health IT can lead to safer, better, and more efficient care, visit http://www.healthit.gov/

For more information about the Medicare and Medicaid EHR Incentive Programs, seehttp://www.cms.gov/EHRIncentivePrograms

For more information about the HHS Recovery Act health IT programs seehttp://www.hhs.gov/recovery/announcements/by_topic.html#hit

PPACA provides coverage for ~50K Americans w/pre-existing conditions

FOR IMMEDIATE RELEASE February 23, 2012

Contact: CMS Press Office (202) 690-6145

Pre-Existing Condition Insurance Plan saves lives

Health and Human Services Secretary Kathleen Sebelius today announced that the new health care law’s Pre-Existing Condition Insurance Plan (PCIP) program is providing insurance to nearly 50,000 people with high-risk pre-existing conditions nationwide. The Department released a new report demonstrating how PCIP is helping to fill a void in the insurance market for consumers with pre-existing conditions who are denied insurance coverage and are ineligible for Medicare or Medicaid coverage.

“For too long, Americans with pre-existing conditions were locked out of the health care system and their health suffered,” said HHS Secretary Kathleen Sebelius. “Thanks to health reform, our most vulnerable Americans across the country have the care they need.”

Under the Affordable Care Act, in 2014, insurers will be prohibited from denying coverage to any American with a pre-existing condition. Until then, the PCIP program will continue to provide enrollees with affordable insurance coverage.

PCIP is helping individuals like:

• Gail O’Brien of Keene, New Hampshire who is now getting help with non-Hodgkin’s lymphoma treatments and is responding very well.
• James Howard of Katy, Texas who is grateful for the coverage the PCIP program is providing to treat cancer and says that without it, he would not have been able to continue receiving care.

In many cases, PCIP participants have been diagnosed with and need treatment for serious health care conditions such as cancer, ischemic heart disease, degenerative bone diseases and hemophilia.  As a result of the new law, PCIP enrollees are receiving health services for their conditions on the first day their insurance coverage begins.  Their critical need for treatment, combined with their lack of prior health coverage has led to higher overall per-member claims costs in state-based PCIPs of approximately $29,000 per year, which is more than double the per member cost that traditional State High Risk Pools have experienced in recent years.

Enrollment in PCIP has seen a nearly 400 percent increase from November 2010 to November 2011.  PCIP enrollment is anticipated to trend upwards of 50,000 enrollees within the coming month.

People who enroll in the PCIP program are not charged a higher premium because of their medical condition.  Program participants pay comparable premium rates to healthy people in the individual insurance market.  By law, premiums may vary only on the basis of age, geographic area and tobacco use.

PCIP provides comprehensive health coverage, including primary and specialty care, hospital care, prescription drugs, home health and hospice care, skilled nursing care, preventive health and maternity care. The program is available in 50 states and the District of Columbia and open to U.S. citizens and people who reside in the U.S. legally (regardless of income) who have been without insurance coverage for at least six months, and have a pre-existing condition, or have been denied health insurance coverage because of a health condition.

The Affordable Care Act directed the Secretary of HHS to carry out PCIP either directly or through a contract with a state or nonprofit entity.  In 27 states, a state or nonprofit entity elected to administer PCIP, while HHS operates the program in the remaining 23 states and the District of Columbia.

The new report can be found at:  http://www.cciio.cms.gov/resources/files/Files2/02242012/pcip-annual-report.pdf

For more information, including eligibility, plan benefits and rates, as well as information on how to apply, visitwww.pcip.gov and click on “Find Your State.” Then select your state from a map of the United States or from the drop-down menu.

The PCIP call center is open from 8 a.m. to 11 p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).

HHS selects challenge winners for Facebook app

FOR IMMEDIATE RELEASE February 23, 2012

Contact: HHS Press Office (202) 690-6343

New applications will support personal emergency preparedness

Three Facebook applications designed to help people prepare for emergencies and get support from friends and family in an emergency – from personal medical emergencies or car accidents to natural or man-made disasters – are winners of a Facebook application challenge sponsored by the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Preparedness and Response (ASPR).

ASPR’s Facebook Lifeline Application Challenge called on software application developers to design new Facebook applications that could enhance individual and community resilience by establishing social connections in advance of an emergency.

Two recent Brown University graduates, Evan Donahue and Erik Stayton, partnered as Team ALP to win first place with their application, named Lifeline. The Las Vegas team JAMAJIC 360 with David Vinson, Erick Rodriguez, Gregg Orr, and Garth Winckler came in second with an app also named JAMAJIC 360. Third place was awarded to AreYouOk? developed by TrueTeamEffort, a team of 11 University of Illinois students led by Alex Kirlik.

Although these top three applications differ in how users interface with the app, all three allow users to designate three lifelines — Facebook friends the person can count on and who agree to check on them in an emergency, supply them with shelter, food, and other necessities, and provide the person’s social network with an update about their wellbeing. Facebook users could use the lifeline app to create disaster readiness plans and share the plans with their emergency contacts, and provide users with news.

In addition, the first place app allows Facebook friends to collaborate on tracking the user’s status in a disaster-affected area so these friends can easily find the user’s lifelines and contact them to report that the user is safe or if the user appears to be missing. This networked approach increases the efficiency of finding missing users. The app allows users to print cards with a snapshot of their preparedness plan to carry in their wallets.

Team ALP’s app also features a news feed and links to credible information sources which make the app useful for large-scale disasters and individual emergencies, such as car accidents and personal medical emergencies.

The lifeline app is anticipated to be launched in the coming months, prior to the start of hurricane season. The team also receives $10,000 and complimentary passes from Health 2.0 to attend the spring Health 2.0 conference in Boston. JAMAJIC 360 receives $5,000 for second place, and TrueTeamEffort receives $1,000 for third place.

“We’re really excited about the potential of the lifeline app to help people not only to reach out to friends and family for the kinds of assistance they may need in an emergency, but also to help improve their personal health and preparedness,” said Nicole Lurie, M.D., HHS assistant secretary for preparedness and response and a rear admiral in the U.S. Public Health Service. “Having people you can depend on for help is especially important during a disaster, so we want to encourage everyone to identify those people in advance. Since so many people use Facebook to connect with one another, it seemed like a natural way to help people to identify their lifelines.”

Dr. Lurie also noted another possible benefit to the Facebook lifeline apps. “People who have friends or relatives they can rely on for help are healthier and live longer than those who don’t, which means establishing these social connections can enhance individual and community resilience,” she said.

To learn more about application challenges sponsored by federal agencies, including challenges that support emergency preparedness, visit challenge.gov.

HHS is the principal federal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves. To learn more about HHS, visit www.hhs.gov.

ASPR leads HHS in preparing the nation to respond to and recover from adverse health effects of emergencies, supporting communities’ ability to withstand adversity, strengthening health and response systems, and enhancing national health security. To learn more about ASPR and preparedness, response and recovery from the health impacts of disasters, visit the HHS public health and medical emergency website, www.phe.gov.
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