Weekend Update

Congress returns to Capitol Hill tomorrow following a five week long district work session. Congress had been expected to address the impending end of the federal fiscal year on September 30 and the debt ceiling issue, but now the Syria resolution is taking top priority. The Washington Post and the Federal Times reports that because the House of Representatives is waiting for a Senate vote on Syria first, the House may adopt a simple continuing resolution funding the federal government until December 15, 2013.

Kaiser Health News features a round robin of reports on the IRS’s recently proposed rules implementing the ACAs’ reporting requirements on health plans (Internal Revenue Code § 6055) and large employers (those subjected to the employer shared responsibility mandate, including the federal government, IRC § 6056). The purpose of the reporting requirements is to assess compliance withe the shared responsibility requirements that the ACA imposes on employers and the individual plan participants. The requirement has been delayed one year administratively along with the employer shared responsibility provisions. The first reports will be due in January 2016 for the 2015 calendar year (regardless of whether the health plan operates on a fiscal year that does not match the calendar year.)

The articles try to keep their sunny side up, discussing IRS efforts to minimize the reporting obligation but the bottom line is that health plans will be obligated to report on all participants which means obtaining social security numbers for all enrollees and dependents or meet the IRS’s alternative requirement (make at least two efforts annually to obtain the SSN and provide the birthdate.)  It is a shame that Congress has prohibited HHS from creating the patient identifier number called for by HIPAA in 1996. A patient identifier would help coordinate information sharing on the electronic health information exchanges including these ACA requirements.

Here’s quite a conundrum as Newman would impishly say on Seinfeld. Modern Healthcare reports that a New Zealand medical study reported in the British journal Lancet finds that electronic cigarettes are equally effective as nicotine patches in helping people to quit smoking.

After six months, similar rates of smokers — 6% to 7% — managed to quit after using either the nicotine-containing e-cigarettes or patches. Only 4% of smokers using the placebo e-cigarettes successfully quit. [The placebo electronic cigarettes did not deliver nicotine.]
Among smokers who hadn’t managed to quit, nearly 60% of those using e-cigarettes had cut down the number of cigarettes smoked by at least half versus 41% of those using nicotine patches. Smokers were also much bigger fans of the e-cigarettes; nearly 90% of users said they would recommend them to a friend compared to just over half of people who got patches.
Researchers also found similar rates of side effects in smokers that used the e-cigarettes and the patches. The most common side effect in all groups was breathing problems.

Nevertheless, Business Insurance reports an increasing trend among large U.S. employers to resist employee use of electronic cigarettes:

While some users tout e-cigarettes as a safe way to kick the dangerous tobacco habit, a growing number of employers, including United Parcel Service Inc. and Wal-Mart Stores Inc., have decided they are an unhealthy habit rather than a stop-smoking tool and are imposing tobacco-use penalties on employees who use them. That could put a chill on consumer demand. Ivette Lopez, a spokeswoman for UPS, confirmed that the company’s health plan would begin charging a monthly fee of $150 in 2014 to employees who used tobacco products, including e-cigarettes that carry liquid nicotine. 

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