In this Issue
Amidst uncertainties, Ropes & Gray is releasing its third quarterly edition of Health Reform Matters. In this issue, we focus on a few substantive elements of the reform packages under discussion.

• In July, a debate broke out over the wide geographic variations in health care spending in different parts of the country, and whether to bend the proverbial cost curve by addressing the underlying causes of such variations. Many believe that Congress lacks the political will to undertake the kind of payment system reform necessary to accomplish this goal and thereby are looking to delegate Congressional authority to various independent bodies to make the tough choices. Please see the article exploring the competing proposals to tackle this issue.
   
• Employers, individuals and other taxpayers are likely to be affected by the various tax provisions in the legislation. Some are health related—designed either to enforce the individual mandate and employer insurance requirements or to discourage so-called “gold-plated” health plans. Others are pure revenue raisers, intended to offset the burgeoning costs of reform. We provide an analysis of the differences in approaches between and within the two chambers, and their impact on our clients.
   
• Establishing a pathway for expedited regulatory approval of follow-on biologics has long been a goal of those seeking to hold down pharmaceutical costs, but safety, comparability and other concerns have made legislation difficult to pass. Now, the two committees with jurisdiction over the FDA have adopted similar provisions in their health reform bills. We describe the areas of controversy in this debate and the measures approved in committee to address them in the article, “Reform Legislation Includes Regulatory Pathway for Follow-on Biologics.”
   
• Massachusetts has already proven itself a laboratory for national health reform. Now it is again leading the debate with a sweeping recommendation to establish a common “global payment” system for all payers within the Commonwealth. Having successfully expanded coverage, Massachusetts is seeking to contain costs through fundamental payment system restructuring. A Ropes & Gray analysis of the recommendations was recently published by the Bureau of National Affairs and is previewed here.

As the debate continues to unfold this fall, don’t forget that Ropes & Gray’s Health Reform Resource Center is a real-time, “one-stop-shopping” source for legislation, amendments, summaries, reports, studies and other materials on the evolving legislation. We also continue to maintain an up-to-date chart tracking the implementation of funding programs established by the American Recovery and Reinvestment Act. While some of the stimulus money has been allocated, billions in health care funding remain available or are coming on-line for the first time. Our chart, readily available at the Health Reform Resource Center, is an excellent way to keep abreast of these developments.

And as always, do not hesitate to pick up the phone and call your regular Ropes & Gray attorney for more information on any aspect of health reform. We have a multi-disciplinary team closely tracking the policy, process and politics of health reform and can help you understand and prepare for its potential impact on your organization.

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