House Passes Bill to Fund Government Past March 27
On March 6, the House passed a six-month spending bill to keep the government operating past March 27. The 267-151 vote sends the measure to the Senate where a bipartisan coalition hopes to expand on the package next week and give Cabinet departments flexibility to cope with the automatic spending cuts that were triggered on March 1 when the sequester went into effect.
The continuing resolution passed by the House would chip away at the Affordable Care Act (“ACA”) by withholding funds from several federal agencies charged with setting the law in motion. The bill would deny HHS close to a billion dollars in funds it had requested to help pay for the insurance exchanges. In addition, CMS would not get a requested increase of $29 million for Health Care Fraud and Abuse Control.
Ways and Means Health Chairman Addresses Hospital Billing
Ways and Means Health Subcommittee Chairman Kevin Brady (R-TX) said he doesn’t like the recent trend in which hospitals acquire medical practices that then bill Medicare for the same procedure they did before joining the facility but at much higher hospital outpatient rates. While past legislation has been introduced to equalize payments, hospitals have effectively lobbied against such changes.
In remarks to a meeting sponsored by the Federation of American Hospitals, Brady also mentioned pursuing site-neutral payments in post-acute care, noting the lack of consistency in the payment system for long-term care hospitals, rehab hospitals, nursing homes or home health.
The Medicare Payment Advisory Commission (“MedPAC”) recently indicated they will not make a formal recommendation in its June report on equalizing payments. Brady mentioned no timetable for seeking passage of legislation requiring site-neutral payments.
Senate Bill Seeks $690 Billion in Health Savings
Republican Senators Bob Corker (R-TN) and Lamar Alexander (R-TN) introduced legislation based heavily on the Simpson-Bowles deficit reduction proposal from 2011. The bill (S.11) would glean an estimated $689 billion in health care savings over 10 years, with $290 billion coming from reforms to Medicare Advantage. The bill would also reform Medicaid, prohibit Medigap coverage after 2017 and further means-test Medicare.
Additionally, the bill would accelerate home health productivity adjustments and rebase industry payments in 2015, phase out Medicare “bad debt” payments by 2019 and reduce direct and indirect graduate medical education payments. Savings for the bad debt reduction have been scored as saving $15 billion over 10 years, while the limits to GME/IME would save another $50 billion.
The bill comes as President Obama has increased outreach to House and Senate Republicans. The President has expressed a renewed interest in Simpson-Bowles type proposals, although specific details have not been offered. While there are currently no other cosponsors on the Corker-Alexander legislation, discussions are ongoing with both Republican and Democrat offices.
CMS Delays Stage Three Meaningful Use
On March 5, Acting CMS Administrator Marilyn Tavenner said the agency will not promulgate any new rules on stage three of meaningful use in 2013. Tavenner announced the delay while CMS also issued a request for information soliciting stakeholders’ comments on what new payment policies would have the greatest impact on electronic exchange of health information.
CMS Announces Fifth Round of Participants in Care Transitions Program
On March 7, CMS announced 20 more participants to its Community-Based Care Transitions program (“CCTP”), bringing the total number of CCTP sites up to 102. The CCTP program, which was authorized under the ACA, requires participants to work with hospitals to help transition patients from hospitals to home care or other settings. The law authorizes the CCTP program to spend up to $500 million over a five-year period, which began in the fall of 2011.
Bills Introduced This Week
H.R. 969: Rep. Tom Price (R-GA) introduced a bill that would mandate that neither HHS nor any state (as a condition of receiving federal financial participation under Title XIX of the Social Security Act) could require any health care provider to participate in any health plan as a condition of licensure of the provider in any state.
H.R. 986: Rep. Aaron Schock (R-IL) introduced a bill that would amend Title XVIII of the Social Security Act to ensure the eligibility of eligible professionals practicing in rural health clinics for electronic health records and quality improvement incentives under Medicare.
For more information, please contact John F. Williams, III at 317.977.1462 or jwilliams@hallrender.com.
Please visit the Hall Render Blog at http://blogs.hallrender.com/ for more information on topics related to health care law.
