HELP Committee Passes Mental Health Legislation

On March 16, the Senate Health, Education, Labor and Pensions (“HELP”) Committee passed a set of bipartisan mental health and opioid abuse bills that include provisions relating to access to care, early intervention and shortages in the behavioral health workforce.

The HELP legislation increases the number of substance abuse patients that health care providers can treat with opioids from 30 to 100 and encourages more use of naloxone, a drug used to counter the effects of opioid overdose. The bill also requires states to better enforce the “plan of safe care” for children born dependent on opioids.

The committee’s bill did not address the Medicaid Institutions for Mental Diseases (“IMD”) exclusion because it does not have jurisdiction over the issue. The Senate Finance Committee may offer amendments that would repeal the IMD exclusion, which prohibits Medicaid reimbursements for enrollees receiving mental health care at hospitals with more than 16 psychiatric beds, before the legislation goes to the Senate floor.  HELP Committee Chairman Lamar Alexander (R-TN) said the full Senate could take up the legislation as early as late April.

Senate Bill Seeks to Close Glitch in GME

On March 14, Sen. Bill Nelson (D-FL), introduced the Advancing Medical Resident Training in Community Hospitals Act of 2016. The legislation, which was referred to the Senate Finance Committee for review, would make it easier for hospitals to train new doctors and help address the country’s physician shortage problem. Rep. Reid Ribble (R-WI) introduced a companion measure (H.R. 4732) in the House.

The bill would amend a provision in the Medicare Graduate Medical Education rule that prevents hospitals that accept part-time medical residents on a rotating basis from creating their own full-time residency programs. The bill would remove barriers that unintentionally limit residency training opportunities and enable at least 11 hospitals to establish teaching programs to train new doctors.

House Budget Committee Passes FY 2017 Budget Proposal

On March 16, the House Budget Committee reported about the FY 2017 budget resolution.  The committee released the proposal, which provides $1.07 trillion in discretionary spending for FY 2017, only a day earlier. The resolution also requires Congress to consider legislation to reduce spending by at least $30 billion over the next two years and at least $140 billion over ten years.  The budget resolution would repeal all of the Affordable Care Act and establish a private Medicare program to compete with the traditional Medicare program in 2024. Means-testing would be increased for Medicare enrollees with high incomes. Medicaid would transition into a block grant to the states, and able-bodied Medicaid beneficiaries would be subject to a work requirement.

The House Energy and Commerce Committee also approved a bill (H.R. 4725) this week that provides nearly $30 billion in cuts to health programs. The legislation reduces federal funding for the Children’s Health Insurance Program and Medicaid coverage for prison inmates, limits how states can tax Medicaid providers and repeals the Prevention and Public Health Fund.

MedPAC Publishes Annual Report to Congress

On March 15, the Medicare Payment Advisory Commission (“MedPAC”) released its annual Medicare payment policy report to Congress. The report included five payment recommendations for post-acute care providers, Medicare Advantage diagnosis coding and cuts to drug payments for safety net hospitals.

In its report, the commission said that safety net hospitals that provide care to a high number of Medicaid beneficiaries and low-income Medicare enrollees receive large discounts from drug manufacturers through the 340B Drug Pricing Program with Medicare paying roughly 106 percent of each drug’s average sales price. MedPAC recommended reducing reimbursement for 340B drugs by 10 percent.

Health-Related Bills Introduced This Week

Rep. Cathy McMorris Rodgers (R-WA) introduced the Unauthorized Spending Accountability Act (H.R. 4730) to gradually cut funding for unauthorized government programs. The bill would pressure Congress to take action on government programs that have expired authorizations by subjecting the programs to a rolling sequester over three years. Funding for such programs would be completely eliminated if Congress fails to act within the three-year sequestration period.

Sens. John Thune (R-SD) and Heidi Heitkamp (D-ND) introduced a bill (S. 2736) to protect access to durable medical equipment for Medicare beneficiaries living in rural areas. The Patient Access to Durable Medical Equipment Act would extend the current payment phase-in period for durable medical equipment from 6 months to 15 months to avoid significant cuts in reimbursement for such products.

Rep. Michelle Lujan Grisham (D-NM) introduced a bill (H.R. 4801) directing the Secretary of Health and Human Services to audit medical loss ratio reports submitted by health insurance carriers.

Next Week in Congress

The House returns on Monday, March 21, but lawmakers are not expected to vote on a budget resolution until after the Easter recess.  Although the Senate has adjourned until April 4, the body is technically not in recess since Republicans plan to gavel in a pro forma session to prevent President Obama from making a recess appointment to the Supreme Court.